Health-Care's Rocky Path Forward
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The danger of using the budget reconciliation process to pass health care reform all along was that it wouldn't work. The administration was careful to include language in the budget that would allow for this procedure, but they neglected to do the same for climate change after Senate Budget leaders Kent Conrad and Judd Gregg warned them off. Contrary to the prevailing narrative among progressives, Bush was not able to do whatever he wanted by using reconciliation.
In 2005, when Gregg chaired the Budget Committee in the GOP-led Congress, Republicans sought to use budget reconciliation to open the Arctic National Wildlife Refuge to oil drilling. The effort came close to succeeding but collapsed in the House when GOP moderates joined Democrats in opposition.
There is no guarantee that the Democrats can fare any better with their own House 'moderates.' However, it is probably their progressive members who pose the biggest obstacle to passing health care reform.