Factbox: Democrats try to expedite healthcare bill

(Reuters) - Democrats in the Senate could get around a Republican blocking tactic and ram through elements of healthcare reform with a procedure called reconciliation.

The process would enable them to act with a simple majority rather than the usual 60 votes, but there's a problem -- it is mainly meant for provisions related to taxes and spending and any policy provisions would be subject to challenges.

Democrats control only 59 seats in the 100-member Senate.

Here is a summary and history of the process.

* Reconciliation was created by the Congressional Budget Act of 1974 and its chief purpose was to give lawmakers an effective tool to bring revenues in line with spending and reduce deficits.

* In the case of healthcare reform, Democrats have already laid the groundwork for a healthcare bill under reconciliation and leaders could bypass committee action and bring a bill directly to the floor.

* The House and Senate passed similar healthcare bills but after losing a crucial 60th vote in a special Massachusetts Senate election, they are unlikely to win passage of any final bill worked out between the two chambers.

* As a result, Democrats are looking at passing the Senate bill through the House and using reconciliation to push through changes to satisfy House objections to it.

* Reconciliation would limit Senate debate, but the bill would be open to amendment and Republicans opposed to the Democratic bill are likely to offer dozens. Amendments must be germane and most would likely be ruled out of order.

* The downside for Democrats on using the reconciliation process is that Republicans will be able to challenge individual provisions in the bill on whether they adhere to budget rules.

HOW THE PROCESS HAS BEEN USED IN THE PAST

* The Congressional Research Service said reconciliation has been used successfully 19 times since 1980, when it was used for the first time to pass an $8 billion deficit reduction bill.

* Republican measures accounted for 14 of those instances, according to researchers.

* Republican President Ronald Reagan used reconciliation several times during the 1980s to cut spending for a wide range of programs including Medicare and Medicaid health programs for the elderly and poor and to raise revenues.

* In 1986, a bill allowing laid-off workers to temporarily buy into employer-sponsored health benefits was enacted using reconciliation. The coverage is called COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act.

* Sweeping welfare reforms were enacted in 1996 using the reconciliation process.

* Reconciliation was used in 1997 to create the Children's Health Insurance Program and to create a Medicare program allowing private insurance companies to deliver benefits.

* In 2001 and 2003, Republican President George W. Bush used reconciliation to push through sweeping tax cuts over Democratic objections.

(Reporting by Donna Smith; Editing by Eric Walsh)