Democrats Desperate to Pass Health Care -- Win, Lose or Draw in Massachusetts

Democrats in Washington are feverishly gaming out at least three different scenarios of how Tuesday's Massachusetts Senate election could impact their year-long slog to pass health care reform. The results range from What were we so worried about?, in the event of a Coakley win, to What are we going to do now?, if Brown prevails.

The third possibility of an election too-close-to-call, while delaying the outcome, would also give Capitol Hill Democrats crucial time to shove their bill to a resolution before a successor to Ted Kennedy is ultimately decided.

Here are the three realities Democrats could wake up to Wednesday morning, assuming they can sleep at all election night.

1. Coakley Wins Big: Under the Democrats' best-case scenario, Martha Coakley wins by eight points or more. Rumors of her shortcomings as a candidate and the Obama agenda's demise prove to have been greatly exaggerated. Lawmakers go about their business of duking it out behind closed doors over which package -- the House's or the Senate's -- should ultimately pass.

If Coakley wins by a more narrow margin, however, look for moderates in the House and Senate to be rattled at best and for the final health care bill to hew to the right accordingly. The conventional wisdom held that the Kennedy seat would be a lock for Coakley by 20 points or more. To see her given a run for her money has sent the message to Dems in Washington that nobody on the ballot in 2010 is safe from a similar fate. An appropriately cautious agenda will follow.

2. Too Close to Call: Remember Bush v. Gore? Coleman v. Franken? When elections are that close, lawyers almost always get into the mix and a lengthy delay follows. Although the Minnesota election took place on Nov. 4, 2008, Al Franken did not take his seat in the Senate until nearly eight months later. Candidates in Massachusetts can request a recount, which cannot begin for at least three days, but appeals and lawsuits could drag the process out much, much longer.

Democrats would view a delay in replacing Sen. Paul Kirk as manna from heaven, giving them crucial days, weeks or even months to work out the differences between the two health care bills. Despite the time advantage, a close election would still be seen as a victory for Republicans and enough of a negative judgment on health care reform to spook moderates, who were already anxious over passing a bill that has proved unpopular in the polls. House Democrats' dreams of creating a public option and taxing the rich to pay for it go out the window under this scenario. A hurried and more moderate health bill is the best they can hope for, assuming a bill can pass at all.

3. Brown Wins:

If Scott Brown wins by a clear margin, look for the White House to hit the gas with both feet to pass something, anything, before he takes his seat.

One time-saving, but politically difficult, option would be for the House to quickly pass the Senate's version of health care reform without changes, which could happen as soon as this week and go to Obama's desk for signature immediately.

But progressives in the House are loath to vote for some of the measures in the Senate bill, including the excise tax that could hit millions of middle-class workers. Also, some pro-life Democrats, like Michigan's Rep. Bart Stupak, voted for the House bill but have called the Senate's abortion language "unacceptable" and not something they could ever support.

A second option following a Brown win would be for Democrats to use the "reconciliation" procedure to get a much narrower health bill through the House and Senate, which would need just 51 votes in the Senate, rather than 60, to be approved. Rep. Chris Van Hollen (D-Md.) told Bloomberg News over the weekend that Democratic leaders are prepared to follow this route. "Getting health-care reform passed is important," he said. "Reconciliation is an option."

But the psychology of a health care vote, even under reconciliation, after a Brown victory would be brutal for Democrats. Moderates like Ben Nelson, whose approval rating in Nebraska tanked after he worked a deal for his state and voted for the Senate bill, will have to calculate whether voting for health reform will cost them their seats in November, and if they're willing to take that step anyway. Liberals will have to acknowledge that they may never reach their goal of truly universal heath care and vote for something that falls far short of their hopes of what an Obama agenda would bring.

The irony of the Massachusetts election is that while a Brown win would have Republicans celebrating in the short term, the swearing-in of a Sen. Scott Brown to replace Ted Kennedy could ultimately save Democrats from themselves. The ambitious agenda that Democrats had laid out for 2010, including climate change and immigration reform, would become impossible to push through without Republican votes. Democrats would be forced to play it safe and focus only on jobs and the economy, as many senators, such as Evan Bayh, say they should have done all along.

As the president campaigned on Sunday for Coakley in a last-minute attempt to preserve the "Kennedy seat" for Democrats, White House aides finished a feverish working weekend that included outreach to numerous Democrats to determine where they are on health reform. Those same aides know their universe could change forever Wednesday morning, when for the first time in a lifetime, the Senate seat held by Ted Kennedy for 47 years could belong to a Republican, and the issue that Kennedy called the cause of his life could fall prey to the partisan politics that followed his untimely death.

Follw the Capitolist on Twitter @1PatriciaMurphy.