If Republicans remain united against the Democrat's bill, Majority Leader Harry Reid of Nevada will need the votes of all 58 Democrats and two Independents in the Senate in order to pass the legislation. But several of the conservatives in the caucus have made it clear that they still have problems with the bill, and that their vote to allow debate on it does not mean that they would vote to pass it in its current form.
Instead, there will be weeks of debate over the by-now-familiar flashpoints in the legislation, including the public option and abortion.
"I, along with others, expect to have legitimate opportunities to influence the healthcare reform legislation that is voted on by the Senate later this year or early next year," Sen. Blanche Lincoln, D-Ark., said Saturday. Lincoln was the last Democrat to pledge her support Saturday for voting to move the bill forward.
Other conservative Democrats on the fence include Sen. Ben Nelson of Nebraska and Sen. Mary Landrieu of Louisiana. Independent Joe Lieberman of Connecticut is another shaky vote for Reid.
The conservative Democrats are opposed to including a public insurance option in the bill -- even one that allows states to opt out, as the current version in the Senate does.
On NBC's "Meet the Press" Sunday, Lieberman called the public option "radical," and said: "We have a health-care system that has real troubles, but we have an economic system that is in real crisis. And I don't want to fix the problems in our health-care system in a way that creates more of an economic crisis."
But liberal Democrats are just as determined to keep the public option in the final bill.
"I don't want four Democratic senators dictating to the other 56 of us and to the rest of the country -- when the public option has this much support -- that [a public option] is not going to be in it," Sen. Sherrod Brown of Ohio said Sunday on CNN's "State of the Union."
Reid must somehow craft a compromise acceptable to both wings of his party in order to pass the legislation. Other points of controversy are likely to include: abortion -- the Senate bill is not as restrictive as the version passed by the House in terms of limiting federal funding of abortions; affordability -- some senators are worried that the bill will require people to purchase health insurance that they cannot afford; and the federal deficit -- the Congressional Budget Office estimated that the bill would reduce the budget deficit by $130 billion over the next 10 years, but some senators are skeptical and believe that the reduction relies on unrealistic cuts to Medicare spending.
Reid must assuage the doubts of all the members of his caucus on these issues. He's unlikely to pick up many Republican votes; Sens. Susan Collins and Olympia Snowe, both of Maine, are the only Republicans considered a possibility for him. All of the Republicans voted against allowing floor debate on the bill to move forward in Saturday's party-line vote.
"This 20-pound bill is the size of most people's turkeys next week," said Sen Richard Burr, R-N.C., according to the Miami Herald. "And that's what most people in North Carolina think of this bill."
Reid is aiming to pass the legislation before Christmas, so that a final vote on the controversial bill will not be pushed back too far into the 2010 election year.
---- Compiled from wire reports and other media sources