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The Great Unknowns (Updated)

If you read this blog, you probably want to know the true state of play in the health care reform debate.

Well, join the club. After yet another a round of phone calls on Friday, I've become convinced that nobody really knows for sure.

There's a lot of activity and discussion right now. But the key discussions involve a very small circle of people--smaller, in fact, than the circle of people you see quoted in the media, even anonymously. Within that small circle of people, there are the things that only some of them know (like what Speaker Nancy Pelosi really said to President Obama in a conference call Thursday night) and the things that none of them can know (like how members of Congress will feel when returning from recess).

As one senior administration official--yes, sorry, another anonymous one--told TNR on Friday, "I don't think anybody can see the entire board."

So let's start with one of the few things we do know: On Sunday night or Monday morning, the administration is going to post a health care proposal, as the New York Times and Associated Press first reported earlier in the week.

Exactly what this proposal will represent isn't so clear. It's going to be some kind of compromise between the bills that the House and Senate have passed already. But it could be the White House's idea of a what the House and Senate should find acceptable--or it could be the White House's idea of what House and Senate leaders already have indicated they find acceptable.

Which brings us to the question--exactly what is going on between the House and Senate anyway? Leadership and a few key staff have been trying to work out their differences over the last few weeks. Depending, again, on whom you ask, they are close or very close or very very close to an actual agreement.

The issues that have separated the chambers are, as you know, both substantive (e.g., how to tweak the tax on health benefits) and procedural (e.g., which chamber votes first). They are also more complicated than they might seem. The House says it won't vote until the Senate passes a reconciliation bill. But, according to my understanding of the parliamentary rules, you can't write a bill to change a status quo that doesn't yet exist. That makes the actual drafting of legislative language a lot more difficult.

More important than the technical challenges, though, are the raw political ones. The House and Senate don't trust each other; neither one trusts the White House. And, within each chamber, the leaders are constantly trying to figure out what their members will and won't support--which has been difficult to gauge, since many members are reluctant to commit before they've seen a final package.

Still, the general political situation is clear enough. More and more Democrats are coming around to the idea that their best play politically is to pass reform, in some form. But plenty remain skittish. A leadership aide in the House, where the challenge seems larger, calls these members "hand-wringers," which is a bit more polite than David Plouffe's description, "bed-wetters." They tend to be more conservative and/or from more conservative districts. But there are exceptions--not to mention the many liberals who remain nonplussed about voting for a bill that lacks their most cherished feature, a public option.

Make no mistake: Getting to 218 votes in the House and 50 in the Senate will be difficult. But my understanding--and you should view my sources with the same scrutiny you view everybody else's--is that Obama, Pelosi, and Reid all remain convinced that passing a comprehensive bill is both doable and worth attempting. Obama made that clear again, Friday, at a Las Vegas town hall, when he spent ten minutes answering a question on health care and said, for the umpteenth time, that the country desperately needed a real, comprehensive solution to its health care problems. A president planning to give up on a major reform bill would be unlikely to talk that way.

That soliloquy set up Thursday's bipartisan meeting, which is shaping up as perhaps the pivotal moment of this epic political saga. Republicans say the meeting is a charade--that the ongoing discussions between House and Senate leadership are proof the Democrats want to foist a secret plan on the country. But that is, quite simply, nonsense. The central elements of reform are no secret. They've been the subject of literally hundreds of hours of debate on Capitol Hill, not to mention many thousands beyond it. The negotiations over how to calibrate the excise tax or how much of the donut hole to fill are, in the grand scheme of things, minor details.

The Republicans also say the president's interest in bipartisanship is insincere, notwithstanding the fact that Obama and his allies spent last spring and last summer--far too much time, in my opinion--reaching out to Republicans. As I've written (and hopefully you've read) before, this reform bill incorporates numerous ideas Republicans have championed. It's also strikingly similar to the proposal from the Bipartisan Policy Center, which was sufficiently conservative to win the endorsement of two former leaders of the Senate Republicans, Howard Baker and Bob Dole. Still, don't be surprised if, on Thursday, Obama looks for a few more GOP ideas to throw in the mix, both to show good faith and to incorporate ideas he actually supports. 

I have no idea how the Republicans will respond. Maybe a few will break with the pack and offer a real bipartisan compromise of their own, something far smaller and less consequential. It'd be hard for Obama and the Democrats to turn down, much as I wish otherwise. But agreeing to a real bipartisan deal would give Obama a win--which is why, I suspect, the offer won't be extended.

And that will put the spotlight back on the Democrats. Will they give in to the recalcitrant minority? Or will they move forward on their own, confident that the voters will reward progress and that--more important--it's the right thing to do?

The answer will depend on the skill of party leaders, the message from the public, and the judgment of the members themselves. And those things, too, remain unknowable.

Update: Greg Sargent, who's become an indispensable source of reporting on the health care reform negotiations, pried some more information out of Democratic leadership staff on the Hill. I'd actually heard a few different things about the fate of the benefits tax, among other things. But my information could surely be wrong. Like I was saying, a lot of people are talking and it's not always clear who knows, or is telling, the whole story.

In other developments, Obama reiterated his commitment to pushing forward on comprehensive reform in his Saturday radio address, while Reid gave his strongest indication yet that the Senate was gearing up to pass the final amendments to health care reform via the reconciliation process. The Hill's (also indispensable) Jeffrey Young has the details:

Democrats will finish their health reform efforts within the next two months by using a majority-vote maneuver in the Senate, Majority Leader Harry Reid (D-Nev.) said.
Reid said that congressional Democrats would likely opt for a procedural tactic in the Senate allowing the upper chamber to make final changes to its healthcare bill with only a simple majority of senators, instead of the 60 it takes to normally end a filibuster. ...
The majority leader said that while Democrats have a number of options, they would likely use the budget reconciliation process to pass a series of fixes to the first healthcare bill passed by the Senate in November. These changes are needed to secure votes for passage of that original Senate bill in the House.
"We'll do a relatively small bill to take care of what we've already done," Reid said, affirming that Democrats would use the reconciliation process. "We're going to have that done in the next 60 days."

My colleague Jonathan Chait has a "Brief Reconciliation Primer" to remind everybody what, exactly, this means.