There are time limits, but senators can also offer an unlimited number of amendments, too, that many Democrats may not want on their voting record in a tough election year. It is a process that can drag on for weeks, while opposition to Obamacare grows along with demands that Congress turn its attention to the economy and jobs.
"The reconciliation process will turn health care legislation into Swiss cheese, making a bad bill even worse," predicts health care analyst Grace-Marie Turner, president of the conservative Galen Institute.
But the House will have to act first before the Senate reconciliation process can begin, and that's where Democrats face some big obstacles.
Under the plan, House Democrats would have to give final approval to the bill Senate Democrats passed on Christmas Eve, and send it to Obama for his signature. The original House bill, rejected by the Senate, squeaked through on its own, and many House Democrats think the Senate version is weak and impractical.
If House Democrats pass the Senate bill, they would then be asked to vote on a second follow-up bill fixing what they do not like in the Senate's package. This bill would then be debated under the Senate reconciliation rules requiring only a 51-vote majority.
But many House Democrats are very uncomfortable about giving final approval to the Senate's health care version, which does not contain the new public option they had demanded be included. And they are leery of the Senate's promise to pass their follow-up "fix-it" bill.
"The trust of House members ... in the Senate delivering on anything is at an historic low," Democratic Rep. Peter A. DeFazio of Oregon told The Washington Post last week. "And the House taking major action that is dependent on a future action of the Senate, I think that's very, very difficult."
Mind you, all of this is expected to take place in the middle of a brutal midterm election year where the political landscape has turned strongly against the Democrats. As of this writing, the nation's foremost election handicappers are forecasting Republican gains of between 20 and 30 seats in the House and half a dozen or more seats in the Senate. Some now think that a GOP takeover in the House is not out of the question.
In short, reconciliation poses a fiendishly difficult obstacle course for the Democrats' hugely unpopular health care plan, and threatens to flatten their ruling majority in November. And the White House seems to be saying they are okay with that so long as Obama wins the centerpiece of his presidential agenda.