Factbox: Democrats prepare to push healthcare

WASHINGTON (Reuters) - Congressional Democrats are prepared to launch a final push to pass President Barack Obama's healthcare overhaul using a procedure called reconciliation that bypasses the need for Republican support.

The tactic, reserved for issues related to the budget and spending, allows passage by a simple majority of 51 votes in the 100-member Senate. It would let Democrats forge ahead on healthcare without the 60 Senate votes needed to overcome Republican procedural hurdles.

Democrats in the Senate and House of Representatives approved bills last year to reshape the $2.5 trillion healthcare industry by cutting costs, regulating insurers and expanding coverage to tens of millions of Americans.

But efforts to merge the two measures and send a final version to Obama collapsed in January after Democrats lost their crucial 60th Senate vote in a special election in Massachusetts.

Here are some facts about how reconciliation would work if it is applied to the healthcare bill in the coming weeks.

* Under this two-step approach, House Democrats would pass the Senate bill without changes, eliminating the need for another Senate ballot. The adjustments to the Senate bill sought by House Democrats could be made separately through reconciliation, avoiding the 60-vote Senate threshold.

"The role for reconciliation would be very limited," Senate Budget Committee Chairman Kent Conrad said on CBS's "Face the Nation" on Sunday. "It would be on sidecar issues designed to improve what passed the Senate."

* Large blocs of House Democrats oppose parts of the Senate bill, so Obama released a package of potential compromises last week that could be adopted by the Senate under reconciliation to ease some of those concerns.

The proposals included a modification of the Senate's tax on high-cost insurance plans and measures to make insurance more affordable for low- and middle-income workers.

* Because reconciliation is confined to budget-related issues, some provisions could not be changed using it. For example, a Senate compromise on language banning federal funding for abortion, which drew the ire of some House Democrats, could not be altered through reconciliation.

* The provisions the Senate tries to pass by reconciliation could be challenged by Republicans, who could argue they are not primarily budget issues. The Senate parliamentarian would rule on the challenge. Republicans have promised to raise a host of challenges.

* It is unclear if the House can muster the votes to pass the Senate bill given the unpopularity of the legislation -- polls show majorities of Americans oppose the overhauls passed by the House and Senate -- and the uncertainty about what could be changed through reconciliation.

The House cleared its version by only three votes in November and has lost at least four votes since then through retirement, death and a change of heart by the only Republican to support it.

House Democrats also could lose support among anti-abortion Democrats unhappy about the Senate's abortion compromise, and liberals unhappy the bill will not include a government-run public insurance option.

* Senate and House leaders have skirmished about which chamber should begin the process, with House Democrats wary of passing the Senate bill without some certainty their concerns will be addressed in the reconciliation process.

Some House Democrats have suggested Senate Democrats could sign a letter pledging to support the changes sought by the House. Senate aides said that would be unprecedented and is not expected.

* Republicans have criticized the use of the process, but the Congressional Research Service said reconciliation has been used successfully 19 times since 1980. Republican measures accounted for 14 of those instances.