Nancy Pelosi does not have the 216 votes necessary to pass the Senate health care bill. She's planning to go ahead without the votes of the Stupak 12. Today the Senate parliamentarian ruled the Senate bill must become law before "fixes" can be made via the parliamentary tactic known as reconciliation. The GOP Senate caucus will rigorously enforce the Byrd rule, limiting the reconciliation changes to budget matters and nothing more.

What's going on? The final push for Obamacare is about to begin. It starts on Monday, when the House Budget Committee will insert reconciliation instructions into the November House health care bill. By late Monday / early Tuesday, Budget will pass this bill and send it to the House Rules Committee, where Pelosi will change the language so that it matches the Senate bill. This is the final compromise legislation that may come to a vote on the House floor within weeks. "They're creating the shell," says Rep. Paul Ryan of Wisconsin.

Why move ahead when the votes aren't there? Pelosi hopes that launching the process will create enough momentum to flip Democrats her way. The clock is ticking. The speaker has two weeks before Congress breaks for Easter Recess. And the recess could kill off health care reform, since many of the wavering Democrats will get an earful from their constituents when they return home. Republicans expect Democrats to lose votes over the break.

But that won't matter if health care reform is already law. Which puts the Democrats in a funny situation. The Senate passed a bill on Christmas Eve filled with gimmickry and special deals in the hopes that the details would be ironed out in conference. Then Scott Brown came along and ruined their plans. House Democrats now have to support a bad bill that wouldn't have passed if it weren't for the Cornhusker Kickback, Lousiana Purchase, and Gator Aid. And they have to do it soon. Or the central policy initiative of the Obama administration will come to naught.

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