Democrats in the Senate are considering using the so-called "nuclear option" or "reconciliation" to push through a health reform bill. The "nuclear option" is an attempt by a majority of the United States Senate to end a filibuster by majority vote, as opposed to 60 senators usually needed to end a filibuster. Although it is not provided for in the formal rules of the Senate, the procedure is the subject of a 1957 parliamentary opinion and has been used on a few occasions, although only for judicial nominations. This would be the first time that it was attempted for such a legislative maneuver and could have serious consequences which may back fire and actually harm reform efforts.
Since there are only 40 Republicans in the Senate, the Democrats would actually only be going nuclear on themselves. Reconciliation lets the Senate pass some measures with a simple majority vote, but non-budget-related items can be challenged. This could knock many provisions from the healthcare plan. Democrats could submit one big bill and fight to keep as many provisions as possible from falling victim to a 60-vote requirement. They could split the bill in two parts - one part dealing with spending questions, would go under reconciliation rules. The other part would still require 60 votes, but it would be subject to Republican amendments. You could actually lose provisions such as protecting people with pre-existing conditions, and the public option for health insurance. Any nuclear attempt is certain to further erode the effectiveness of health reform, and would make Republican gains next year almost certain in conservative areas currently held by Democrats. Remember what happened after 1994 with the "Contract with America" and the subsequent loss in the mid-term elections?
Going nuclear would allow some form of health reform to get through (albeit a watered down and neutered version) but it could also guarantee electoral losses and make Congress even less effective over the coming months. I still believe the best hope for meaningful health reform is to slow down and craft a bill with broad support. Give the American people time to understand what is in it, and try to get something done by the end of the year. Trying to hurry this through could backfire...