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In order to secure passage of the health care bill, Democrats will have to both resolve their policy differences and address the mutual distrust that exists between the two chambers of Congress. If House members had their way, the Senate would pass a reconciliation bill that made changes to the underlying bill before having to vote on the Senate bill itself. Given that once the Senate bill passes the House, President Obama can sign it into law, many House members are skeptical that the Senate would actually bother using reconciliation to change it. If the Senate can't pass the changes first, the House would at least like to create a scenario under which the House votes on two bills at the same time (the Senate bill and the reconciliation "fix" bill) and then President Obama waits until the Senate passes the reconciliation changes before signing both bills. While there are many different possible scenarios, the course of action will depend largely on a ruling of the House and Senate parliamentarians, which according to the New York Times, is expected over the next few days. Yet before the parliamentarians weigh in, a key Senate Democrat says the path is pretty clear:

Senator Kent Conrad, Democrat of North Dakota and chairman of the Budget Committee, said the reconciliation instructions in last year’s budget resolution seemed to require that Mr. Obama sign the Senate bill into law before it could be changed.

“It’s very hard to see how you draft, and hard to see how you score, a reconciliation bill to another bill that has not yet been passed and become law,” Mr. Conrad said. “I just advise you go read the reconciliation instructions and see if you think it has been met if it doesn’t become law.”

If Conrad is right, and the House has to pass the Senate bill first and have Obama sign it before the reconciliation process can even start, then it will make it that much more difficult for Speaker Nancy Pelosi to convince her skeptical members to take a leap of faith and pass the Senate bill.