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As the Senate debate on health care legislation enters its fifth day today, Senate Majority Leader Harry Reid is still struggling to round up the 60 votes he needs to pass a health care bill. The most contentious issues remain abortion language and the creation of a new government plan.

With four Democrats (including Joe Lieberman) opposing the government plan and liberals refusing to abandon the idea, Sen. Tom Carper is working to forge some sort of compromise. But when Lieberman came out of one of the rooms during negotiations, he said he was unmoved, according to the Hill. “I say it every time before I go into one of these discussions: I feel really strongly about this," Lieberman said. "I’m going to come and listen but generally speaking I didn’t hear anything that changes my mind."

The key thing to keep in mind is that even if moderate Democrats were to agree to some sort of compromise, it would still require 60 votes to pass. That means that Reid can't simply insert the compromise in the bill and be done with it. At least 20 Democrats would have to be willing to infuriate their liberal base and weaken the government plan (possibly more, depending on how Republicans handle Democratic efforts to improve the bill).

At the same time, Ben Nelson is preparing an amendment along with Orrin Hatch that would adopt stricter abortion language along the lines of the Stupak amendment that passed the House. Nelson has said that he would filibuster the final package if it did not include such language on abortion. However, the amendment is all but assured to fail, as there simply are not 60 pro-life votes in the Senate, and pro-choice groups have now had weeks to lobby Democratic Senators.

The Democrats could lose Lieberman and/or Nelson if they were to pick up Republicans Olympia Snowe and/or Susan Collins.

But the problem is that any bill that can get out of the Senate would have a much more limited government plan and much weaker abortion language than the bill that already passed the House. That will cause problems during the reconciliation process, as the two sides try to merge the bills into something that can pass both chambers.