So what happens if pressure from progressive activists doesn't get health care passed? President Obama says the budget reconciliation process is still one option. "[W]e moved forward on the basis of the assumption that we could get a bill through the regular order and the regular process by October," Obama told liberal bloggers on a conference call last night. "If I think that is not possible, then we are going to look at all of our options, including reconciliation. Not because that is my preferred option but because what I think would be unacceptable for the American people is inaction."

A budget reconciliation bill can't be filibustered, and back when Congress was passing its budget, it included so-called reconciliation instructions for health care in the event that the standard congressional process didn't result in a viable bill by October. But there are procedural difficulties with reconciliation itself that would likely complicate Democrats' efforts to pass the sort of reform they want purely via the budget process.