Republican Elected in Special Election—Next Steps in Health Care Reform Uncertain.

On Tuesday, January 19, 2010, the Commonwealth of Massachusetts (MA) voted in a special election to fill the seat in the United States Senate made vacant by the death of Democratic Senator Edward Moore "Ted" Kennedy. Republican Scott P. Brown won the MA special election, running against Democrat Martha Coakley, MA Attorney General and Libertarian Joseph L. Kennedy. As a result of the Republican win, the composition of the Senate changes and the the Democratic Party no longer has the 60 votes "super-majority" necessary to avoid a Republican filibuster on health care reform legislation.

Majority leaders in Congress are working on a backup plan to save health care reform. One of the options is to ask the U.S. House of Representatives to approve the Senate version of the bill, which would send the measure directly to President Obama for his signature. Both Chambers could then pass fixes at a later date that would reflect the House-Senate compromise.

Another option for Democrats is to hurry and pass a compromise bill before he is seated. Under MA state election law, it could take up to 15 days for Brown to be sworn in as Senator. Democratic leaders would need to get cost estimates from the Congressional Budget Office, which might only take several days. Once a deal between the House and Senate is announced, a vote could proceed.

However, House Speaker Nancy Pelosi (D-CA) has promised to wait 72 hours before a floor vote to allow all members time to review the revised legislation. The Senate would then have a procedural vote, which could take a day or two, before a final vote.

The Heart Rhythm Society will continue to monitor health care reform and will update its members as events warrant.