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Democrats say that since Republicans are ready to do whatever it takes to block the bill - and now that they have 41 votes in the Senate - reconciliation is the only way to ensure the health plan gets a fair “simple majority” vote. Republicans call it a procedural trick to get an unpopular health plan through Congress.

House Speaker Nancy Pelosi said Tuesday that she still has hope for a bipartisan bill, but “if not, we’ll have to go to a simple majority.”

Each provision in the “fix” bill would have to be ruled by the Senate parliamentarian as being budget-related to qualify for the reconciliation process. While reconciliation eliminates the chance for a filibuster, Republicans would get a chance to offer as many amendments as they would like, further delaying a final vote.

Senate Budget Committee Chairman Kent Conrad, North Dakota Democrat, who would be a key player in passing a bill, has warned that passing the “fix” bill using the procedural measure is possible, but it would be difficult.

Perhaps the most significant wrinkle is that the House would have to pass the Senate’s bill first and the repairs second. But there are many House Democrats who don’t want to vote on the Senate’s bill without assurances that the repairs will pass as well.

c Kara Rowland contributed to this report.