Washington (CNN) - A finding by the Senate parliamentarian has narrowed Democrats' options for passing health care reform and could force House Democrats to approve the Senate health care bill and have the President sign it into law before they vote on changes to the measure.
Senate Parliamentarian Alan Frumin notified leaders from both parties Thursday that the process Democrats are using to pass health care reform, known as reconciliation, must be tied to something already signed into law, according to staff for Republican Senate Leader Mitch McConnell and other congressional sources.
Practically, this could force House Democratic leaders to ask members who oppose the Senate bill as it stands now to vote the measure into law and have faith that the Senate will agree to a package of changes.
House Democrats are still discussing strategy for passing revisions to the Senate bill using reconciliation. But Democratic aides have admitted that it would be easier to vote on the original Senate bill if it were followed immediately by a vote on the package of changes in reconciliation.
Republicans see the decision as a tactical victory, making the climb to health care passage steeper. Don Stewart, spokesman for McConnell, e-mailed a statement confirming the decision, writing, "The Senate Parliamentarian's office has informed Senate Republicans that reconciliation instructions require the measure to make changes in law."
The parliamentarian's decision leaves open one other option: Democrats could try to tie the changes they want in the Senate health care bill to other laws currently on the books. But it's not clear if that is feasible, especially because some key issues in the health care bill are not found in existing laws, such as how to pay for reform.