The possibility that a Republican might capture Sen. Edward Kennedy's Senate seat next week has changed the tone of health bill negotiations in Washington.

A few weeks ago, when Democratic congressional leaders set about reconciling the differences between the House health bill, H.R. 3962, and the Senate health bill, H.R. 3950, they were confident that they had a large majority in the House and the 60 votes needed to ward off filibusters, or endless rounds of debate in the Senate.

But Massachusetts state Sen. Scott Brown, R-Needham, Mass., a lawyer who is a lieutenant colonel in the Massachusetts National Guard, has run a strong campaign against the Democratic nominee, Massachusetts Attorney General Martha Coakley, and some polls are suggesting that Brown could win a special election set to take place Tuesday.

If Brown wins, Democratic health bill supporters could:

  • Rush a health bill through the Senate before Brown is seated.
  • Rewrite the health bill to appeal to moderate Republicans such as Sen. Olympia Snowe, R-Maine, and Sen. Susan Collins, R-Maine — and to make the bill more appealing to moderate Democrats.
  • Use a process called "budget reconciliation" to get a narrower version of the bill through the Senate with just 51 votes.

President Obama plans to campaign for Coakley Sunday in Boston, White House Press Secretary Robert Gibbs said today during a press briefing that was dominated by questions about efforts to respond to the earthquake that Haiti Tuesday.

Reporters asked Gibbs whether he thinks the Massachusetts special election is a referendum on the health bill, and whether public dislike of the health bill may be hurting Democrats in states such as Massachusetts, New Jersey and Virginia.

"I think the president sees a pretty clear distinction between a candidate in Martha Coakley who's going to fight for Massachusetts and a candidate on the other side who feels comfortable fighting for the insurance industry and big banks," Gibbs said, according to a briefing transcript.

"We'll be happy to have a campaign on whether you're for the status quo, whether you're for protecting insurance industry profits, whether you're for protecting bank company profits, or whether you're on the side of the American people," Gibbs said.

Gibbs also took several questions about the state of health bill negotiations.

House Majority Leader Steny Hoyer, D-Md., said this morning on CNBC that the House and Senate could have a general agreement on the health bill within 72 hours.

Gibbs said during the press conference that congressional negotiators were working on the bill "late last night" and returned to work on the bill at 1:30 p.m. today, but that he did not know exactly which provisions were being reviewed, or what agreements had been reached.

"What about the insurance exchange proposal?" a reporter asked.

"As soon as we have stuff that's locked in on that we'll let you know," Gibbs said.

"We wouldn't have to ask if it were on C-SPAN," the reporter replied, referring to the fight to persuade congressional leaders to open the health bill reconciliation sessions to the public.

Gibbs was asked whether Obama still hopes to persuade some Republicans to vote for the final health bill.

"Our staffs continue to talk to many staffs on the Senate and House side in order to see who's interested in working with us on health care," Gibbs said. "I think I'll just leave it at that."

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