The Senate is racing the clock to pass a health care bill before it adjourns for the year. Time is running out, with 11 days before Christmas, and with one Democrat-leaning senator flat-out refusing to vote for what he's heard is the latest version of the bill.
Two indications it's do-or-die time? First, Senate Democrats huddled this evening to try to craft a new compromise on health care reform. The closed-door meeting took place in the Mansfield Room, just off the Senate floor.
And on Tuesday afternoon they're heading to the White House to talk health care.
Democratic leaders thought they had a compromise that could pass this week, but it crumbled Sunday as Sen. Joe Lieberman, I-Conn., took issue with a central feature of the compromise: allowing Americans between the ages of 55 and 64 to buy into Medicare.
"It will add taxpayer costs. It will add to the deficit. It's unnecessary," Lieberman said on CBS's "Face the Nation" Sunday.
Senators emerging from the special Democratic caucus confirmed that the Medicare buy-in proposal will have to be stripped from the Senate bill in order to achieve 60 votes, marking a major concession on behalf of liberal Democrats fighting to have a public option, or some kind of alternative. They did not comment on what other changes were made.
While Lieberman left the meeting beaming, saying "we made good progress tonight," liberal Democrat senators seemed less happy.
"Let's not pass something just to pass something," said Sen. Roland Burris, D-Ill., the only Senate Democrat who has said he would oppose a bill without a public option.
Yet Democrats are rallying around the idea that it is their responsibility to swallow their collective pride and govern.
"I am confident that by next week we will be on the way toward sending this bill to the president," said Senate Majority Leader Harry Reid after the meeting.
He compared the legislating process to a steeplechase race, which is long, with hurdles and a big puddle that runners fall in.
Earlier Monday afternoon, Lieberman was dogged by reporters as he emerged from his office in the afternoon. He said then that he liked the core of the bill Democrats are currently debating, but would like to stick just to that.
"The core of the Reid bill is a good bill and I've been focused on trying to get it back to its strong core and take off some of this stuff that runs the risk of creating federal debt and moves toward a government takeover of insurance which I think would be bad," he said.
Congressional sources told ABC News the White House is urging Senate Democrats to give in to Lieberman and to move forward with a scaled-down bill that includes no public option and no Medicare buy-in. White House sources deny this.
According to the actuary for Medicare and Medicaid, the latest version of the bill would add $234 billion to health care costs in the next 10 years.
"I would have a hard time voting for it, because it had reportedly has some of the same infirmities that the public option did," Lieberman said.
Lieberman said he believes the system of subsidies in Reid's current bill is good enough that it makes the expansion of Medicare unnecessary, and the Medicare buy-in is not central to what is important in the Democrats' effort.
"The important thing is I'm for health care reform and if we get together we're going to deliver a health care reform bill that will provide the ability to get health insurance for 30 million people who don't have it now. We're going to regulate the insurance companies and we're going to cut the costs, that's tremendous," he said.
"I'm hopeful and I'm waiting to hear back and this is a very respectful process of negotiation going on," he said.
Lieberman has vowed repeatedly in the past he would not vote for a health care bill with a public option.
The latest version of the bill was crafted by a small group of 10 centrist and progressive Democrats, and sent last week to the Congressional Budget Office. Reid, D-Nev., has yet to release details to Democrats and Republicans alike. The CBO could release their estimate of the health care costs as early as Tuesday.
"On the basic bill, about 2,000 pages, we all know what's in it. But on this -- on these compromises ... they agreed that they were interesting enough to send to get analyzed by the Congressional Budget Office. Sen. Reid has decided that, if you let them out, they'll get mauled," Lieberman said.
Sen. Ben Nelson, D-Neb., whose amendment to restrict federal funding for abortion services failed, said he wouldn't vote for the bill with its previous language on abortion services, but said that was still being worked out.
"I do know that there are some who are, right now, trying to find language that might be compatible with the Stupak language in the house. That's a tall order for people. And I'm not prescribing ahead what they may be able to do," Nelson said on CBS.
Nelson said he would reserve final judgment until after he saw the cost estimates.
Sen. Claire McCaskill, D-Mo., said that until the Senate got the numbers back from the Congressional Budget Office, they were all on hold.
"I have to be assured that this is going to bring down the deficit and it's going to bring down health care costs for most Missouri families," McCaskill said on "Fox News Sunday."
Republicans have seized on the discord.
"They can't get themselves together," said Senate Minority Leader Mitch McConnell, R-Ky., on CBS.
"I think they're in serious trouble on this, and the core problem is the American people do not want us to pass this," McConnell said. "What we really need to do is to stop and start over and go step by step to deal with the cost issue, which is what the American people thought this was all about."
But Sen. John D. Rockefeller, D-W.Va., said despite Democrats' differences, he was confident they would come together in the end.
"We have tremendous momentum," Rockefeller said Sunday on CBS' "Face the Nation."
"You have to look at this most important piece of legislation since Social Security and you have to look at the whole thing. It gets harder and harder to stick on one individual subject and say, I don't like that; therefore I'm going to vote against the bill."
President Obama visited the Senate two Saturdays ago, and sources from the meeting say he delivered that very same message.
"The closer you get, the more you have to look at the whole bill, the more likely you are to say, I have to do this for the nation," Rockefeller said.
The question now is whether Senate liberals would agree, and, following that, if liberals in the House -- many of whom have said they would vote "no" on any bill without a public option -- will go along as well.
At this point, the focus is on keeping the 60 Democrats in line; if that fails, Democrats may make another run at Republicans Susan Collins and Olympia Snowe, but that would require a new round of negotiations that would be unlikely to be completed by year's end. And both Snowe and Collins have concerns similar to Lieberman's.
And even if Democrats can pass their bill through the Senate before Christmas, they will either have to convince House Democrats to pass the same bill or reconcile the two.