So, what's next?

To understand what's next, we need to understand where we are. The two bills, the Affordable Health Care for America Act (HR 3962, "the House Bill") and the Patient Protection and Affordable Care Act (HR 3590, "the Senate Bill") have some broad areas of agreement between them. Both bills:

• Require all or most individuals to have health insurance;
• Eliminate pre-existing condition limitations for health insurance;
• Provide tax credits and other subsidies to families who cannot afford health insurance;
• Expand Medicaid to cover more families;
• Introduce Health Insurance Exchanges; and
• Increase taxes and fees on insurers, individuals, and other entities to pay for these new programs.

Since both bills have been passed by each respective legislative body, Democrats have some options if they don't want to deal with Republicans. One option is to ram the Senate Bill through the House unchanged, thus bypassing any filibuster attempt in the Senate. To placate House Democrats who are adamant on provisions contained within their own bill, the process would require back room negotiations on future amendments and bills for items like the public option. This is the political equivalent of hari kari. If the Democrats decide to pull a stunt like this after the Massachusetts election, Katie, bar the door! Seriously, why do you think so many Democrats dropped out of races and headed for the doors these past few weeks? They know what the voters think of the current proposals and reacted accordingly. The first rule of politics is self-preservation.

Republicans do not necessarily disagree with Democrats on all these points. Contrary to popular belief, the Republicans have promoted health care reform ideas of their own over the last year. Their plans tend to include:

• Individual health insurance mandate;
• Elimination of pre-existing condition limitations for health insurance;
• Expansion of tax deductions for individual policy holders;
• Tort reform;
• Expansion of Health Savings Accounts;
• Provisions for allowing policies to be sold across state lines.

Clearly, there is a broad-based consensus on the issues of individual coverage mandate and the elimination of pre-existing condition limitations.

Both Democrats and Republicans will be looking to preserve their respective "wins" as we approach the mid-term election cycle. Democrats and Republicans alike will want to claim that they expanded health care. For Democrats, this will likely include proposals to change eligibility rules of Medicare and Medicaid, close the Medicare Part D donut hole, eliminate waiting periods and pre-existing condition limitations, facilitate "Co-Op" programs to compete against insurance companies, and the creation of state-run exchanges to distribute private insurance.

Republicans will likely negotiate on coverage mandates, eliminating waiting periods and pre-existing condition limitations, agree to facilitate non-profit "Co-Ops" to compete with insurance companies, create health insurance exchanges to enable policies to be sold across state lines, and expanding Medicare and Medicaid in some fashion. Watch for Republicans to insist on tort reform and leveling the taxation playing field for individual insurance policies.

When you look at it from this perspective, you see overlaps and the opportunity for collaboration on both sides to accomplish different party "spun" objectives. The devil is always in the details, but in this light, health care or insurance reform begins to feel possible.

Look for negotiations to include moderate Republicans from the Senate and to be conducted in a way that allows for incremental changes to the system starting with an individual mandate and the elimination of pre-existing condition limitations. The administration and the Democrats have come too far to allow for political pop and fizzle on this issue. Negotiating with Republicans to secure a small victory is better than nothing, and the left knows it. Something will get passed. So buckle up for a bumpy media ride with lots of political spin!