Just one week removed from Republican Scott Brown’s lopsided win in the Massachusetts Senate race, healthcare reform is more confusing than ever.  The administration has vowed to press ahead with healthcare legislation, while opponents of the bill are urging President Obama to simply start over.

According to the LA Times, White House senior advisor David Axelrod said that the “president will not walk away from the American people, will not hand them over to the tender mercies of health insurance companies who take advantage of them.”  Equally strong words were issued by Senate Minority Leader Mitch McConnell of Kentucky, who counters that “what we need to do is start over and get it right.”

Both Republicans and Democrats continued to dispute the message and effect of Scott Brown’s win last week. The loss has shaken Democrats, who lost a Senate seat entrenched in the Democratic Party for nearly 50 years, but don’t see the loss as public disapproval of the health care bill, as Republicans do.  Senator Jim DeMint, a South Carolina Republican and a vocal opponent of the healthcare plan, said that “Massachusetts was a rejection of the president’s massive policies of spending and debt.”

Obama’s 2008 campaign manager, David Plouffe, wrote in a Washington Post op-ed that Democrats must “pass a meaningful health insurance reform package without delay.”  But according to McConnell, “Republicans want to start over on a bipartisan basis with legislation that would reduce malpractice lawsuits and allow individuals to deduct the cost of their coverage from their taxes the way corporations can.”  So the existing legislation, “with its huge price tag, is a nonstarter,” he said.

(Elise Amendola/Associated Press)

Though President Obama ridiculed Scott Brown’s pickup truck, a fixture of Brown’s television advertisements and campaign rallies, that truck is about to log many more miles as it’s heading to Washington.  Last night Scott Brown won a special election in Massachusetts to fill an open Senate seat, becoming the first Republican to be elected to the Massachusetts Senate since 1972.

Initially assumed to be an easy win for Democrats, the race with health care reform implications proved to be a major upset, but one indicative of the shifting public tide.  Brown’s victory breaks the Democrats’ 60-vote, filibuster-proof majority in Washington, which greatly lessens the chances of health care reform legislation being passed.  In campaign speeches Brown promised to vote against the health care bill, and voters responded to his message, giving Brown a 52-47 percent win in a state where registered Democrats outnumber registered Republicans 3-1.

While there is speculation that Democrats will attempt to force through the health care bill before Brown officially takes his place in the Senate, Brown’s victory is a chance for the Senate to review the bill from a bipartisan standpoint and to create inclusive legislation that mirrors the goals of both sides of the aisle and, most importantly, the American public.

Tennessee Senator Bob Corker voiced his opinion that “Perhaps it’s not too late…And we can still have true health care reform that actually lowers costs, rewards quality and innovation, and improves access to care for millions of Americans who lack coverage.  I hope the president will take advantage of this opportunity to pursue a bipartisan bill that will stand the test of time.”

Senator John Cornyn of Texas added that “Even in the bluest of blue states, Scott Brown’s message resonated with families, seniors, and small business owners who have rejected President Obama’s massive health care takeover and the Democrats’ out-of-control spending agenda in Washington.”

While Scott Brown’s victory will likely delay health care reform, the delay forces the administration to take a step back and harness the will of the American public, rather than the will of just the Democratic party.  While many pundits claim that it’s better to pass a flawed bill than no bill at all, here’s hoping that both sides can work together to pragmatically reform an ailing health care system without increasing burdens on the American taxpayer and subjecting our trillion dollar health care system to government control.

Today Massachusetts voters head to the polls for a special election to vote for their new Senator, either Democrat Martha Coakley or Republican Scott Brown.  Few people expected Brown to put up much of a fight, as Democrats have enjoyed a firm hold on the state’s Senate seats for decades, but it’s become a very close race.  And the result holds political significance outside of just Massachusetts.

If Brown wins, Democrats will lose their 60 seat majority in the Senate, which would deny them the 60 votes they need to push health-care reform through the Senate without support from Republicans.  The health care bill has remained a very partisan bill, so it’s unlikely that Republicans would vote in favor of the bill, effectively putting an end to the legislation in its current form, and possibly ending health care overhaul in general.

At a time in which the centerpiece of the administration’s agenda is pending this special election in Massachusetts, the election has become a barometer for public opinion; essentially, if Massachusetts’ voters don’t like the health care bill, electing Scott Brown is their way to keep it from passing through the Senate.

While we’ve been inundated with reports on health care reform and the bill currently making its way through the Senate, there has been much confusion on which items will stay in the bill and which will be scrapped.  And since C-SPAN was never allowed to film negotiations, despite the administration’s promise to keep deliberations open to public scrutiny, reform proceedings have remained veiled.  But The Associated Press has pulled together details that have begun to filter out of the final negotiations.

Items likely included in the final bill:

-Private insurance plans sponsored by the same federal agency that oversees government employee benefits.

-A tax on high-cost health insurance plans.

-Increased federal aid to help all states expand their Medicaid programs.

-New health insurance supermarkets, called exchanges, for small businesses and individuals purchasing their own coverage.  The federal government sets the rules, but states share responsibility.

-Subsidies to help middle-class households purchase coverage through the exchanges.

-Taxes on upper-income earners; penalties for employers who don’t provide coverage.

-Consumer protections that prevent insurers from denying coverage to   people with medical problems.

Items likely excluded from the final bill:

-A government-operated health insurance plan to compete with private carriers.

-Counting the value of dental and vision benefits in figuring the insurance tax,

-Letting states have sole control over insurance exchanges.

-Steep penalties for people who ignore a new federal requirement to carry health insurance.

-Stiff payroll taxes on companies that do not provide health insurance to their workers.

-Cuts in guaranteed benefits under traditional Medicare.

Of particular note is the exclusion of a government-operated plan, the so-called “public option” that President Obama and his administration lobbied for.  But its exclusion is mitigated by the possible inclusion of private insurance plans sponsored by the federal government, as well as the establishment of health insurance “exchanges,” which would be regulated in part by the federal government.  Regardless of which items make the final cut, get ready for the government to play an unprecedented role in our health coverage.