The landscape in Washington looks markedly different this morning following a shocking upset in the Massachusetts special election where Republican Scott Brown won the seat formerly held by U.S. Senator Edward Kennedy.  Brown took the seat by a small margin of 52 percent of the vote over his opponent, Attorney General Martha Coakley’s, 47 percent of the vote.  Brown’s win eliminates the Democrats’ 60-seat super-majority in the Senate which allowed them to overcome Republican filibusters.  Senate Democrats needed all 60 votes in their caucus to pass the health care bill, and the loss of one seat now puts their ability to ultimately pass health care reform at risk.  

With Brown winning the election on a platform of issues such as tax cuts and cracking down on terrorism, he has also been clear that he intends to oppose Obama’s health care reform efforts.   This message has come to the Democrats in Washington loud and clear as they scramble to put a health care bill together.  Discussions among Congressional leaders and the White House continue, but with this surprising political turn of events following the Massachusetts election, multiple options for the passage of health care reform are being considered.  Potential legislative outcomes now include:

• Passing health care reform before Scott Brown (R-Mass) is seated.

This is unlikely as a vote would have to take place in both chambers within the next few weeks.  Further, Republicans would be outraged and this type kind of behavior would likely only serve to increase public distrust of already less than transparent behind-the-scenes negotiations on the health bills.

• The House passes the Senate health care bill.

Speaker Pelosi is rumored to be working on a deal that would allow the House to pass the Senate’s bill and a second bill that would provide changes to the provisions of the Senate’s bill which are of most concern to House members. 

• Attempt to push health care legislation through the Senate with only 51 votes, a simple majority.

To achieve this, Democrats would have to use a process known as reconciliation, which involves technical and procedural issues that would delay the process. With Congress eager to move onto economic issues such as job creation, they will probably not favor such a strategy for passing health care reform.

• Try to garner Maine Republican, Olympia Snowe's vote.

Democrats could try, once again, to compromise on a health reform plan with the moderate Republican, Olympia Snowe, but most sources believe this is unlikely now.

• The Democrats fail to pass health care reform.

Although this possibility cannot be entirely ruled out, numerous top Democrats are saying that they prefer the passage of some kind of legislation on health care reform, even if it is considerably downsized compared to the current House and Senate bills, to passing nothing at all.  With both Chambers of Congress spending so much time on this issue, it would be hard to believe they would accept failure on health reform.