From the September 1 Hill article:

Sen. Judd Gregg has hundreds of procedural objections ready for a healthcare plan Democrats want to speed through the Senate.

Gregg (N.H.), the senior Republican on the Budget Committee, told The Hill in a recent interview that Republicans will wage a vicious fight if Democrats try to circumvent Senate rules and use a budget maneuver to pass a trillion-dollar healthcare plan with a simple majority.

The death of Sen. Edward Kennedy (D-Mass.) leaves Democrats with 59 Senate seats -- one shy of the 60 needed to overcome a filibuster. That, combined with the pushback from Republican negotiators, has prompted Democratic leaders to look more closely at using budget reconciliation to push a healthcare overhaul through.

The maneuver was originally intended to help reduce the federal deficit by allowing spending cuts and tax increases to pass by majority vote, but it has since been used to fast-track wider-scope legislation, such as former President George W. Bush's 2001 tax cuts.

Republicans, however, warn that if Democrats attempt the maneuver, their healthcare bill will end up looking like Swiss cheese.

Reconciliation is a part of current Senate rules -- not a circumvention of them

Reconciliation process is part of congressional budget process. The budget reconciliation process is defined by the U.S. House Committee on Rules as “part of the congressional budget process ... utilized when Congress issues directives to legislate policy changes in mandatory spending (entitlements) or revenue programs (tax laws) to achieve the goals in spending and revenue contemplated by the budget resolution.” A "Glossary of Budget Terms" posted on the website of the Senate Budget Committee's Republicans defines “Reconciliation Process” as a “process by which Congress includes in a budget resolution 'reconciliation instructions' to specific committees, directing them to report legislation which changes existing laws, usually for the purpose of decreasing spending or increasing revenues by a specified amount by a certain date. The legislation may also contain an increase in the debt limit. The reported legislation is then considered as a single 'reconciliation bill under expedited procedures' ” [emphasis in original].

Gregg and Republicans supported use of reconciliation during Bush administration

Republicans have repeatedly used reconciliation to pass President Bush's agenda. Republicans used the budget reconciliation process to pass President Bush's 2001 and 2003 tax cuts as well as the 2005 “Tax Increase Prevention and Reconciliation Act.” The Senate also used the reconciliation procedure to pass a bill containing a provision that would permit oil drilling in the Arctic National Wildlife Refuge. (The final version of that bill signed by President Bush did not contain the provision on drilling.)

Gregg supported reconciliation to help pass Bush's agenda. MSNBC.com's First Read blog responded to the September 1 Hill article by reporting that Gregg's “position on reconciliation is something of an evolution, considering he supported using reconciliation in the Bush years for ANWR and tax cuts.”

Gregg introduced reconciliation bill that included a provision to open up ANWR to drilling. A March 31 Washington Post article reported that “while Gregg has sharply attacked Democrats for considering the use of reconciliation, which would allow them eventually to pass legislation to reform health care with 51 votes rather than the normal 60 that would be needed to avoid a filibuster, Gregg publicly favored such a provision as Budget Committee chairman in 2005 as part of an attempt to push through a GOP-backed proposal to allow oil drilling in the Arctic National Wildlife Refuge.” Gregg was one of 51 senators who voted against striking language allowing the reconciliation process to be used to open up the refuge from the budget resolution and introduced a reconciliation bill that, as originally introduced in and passed by the Senate, included a provision to open up the refuge to drilling. (The bill as enacted did not contain such a provision.)

Congress previously has used reconciliation to pass health care measures

Congress used reconciliation to pass Medicare Advantage. As part of the Balanced Budget Act of 1997, enacted through the reconciliation process, Congress -- which was controlled by the Republicans at the time -- created the “Medicare+Choice Program,” currently known as Medicare Advantage or Medicare Part C. The program allows seniors to enroll in HMO-type plans rather than the traditional Medicare fee-for-service plan.

Congress used reconciliation to give laid-off employees temporary access to employer's group insurance plan. As stated on the Department of Labor website, as part of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), Congress gave “workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances.”

Congress used reconciliation to pass Patient Self-Determination Act. As part of the Omnibus Reconciliation Act of 1990, Congress passed the Patient Self-Determination Act, which requires hospitals, nursing homes, HMOs, and other organizations that participate in Medicare or Medicaid to provide information about advance directives and patients' decision-making rights.

Republicans repeatedly attempted to use reconciliation to pass increase in Medicare eligibility age. The version of the Balanced Budget Act of 1995 introduced by then-Senate Budget Committee Chairman Pete Domenici (R-NM) using the reconciliation procedure contained a section providing for raising the Medicare eligibility age. As the Congressional Research Service reported, the provision was stricken from the bill during floor consideration on the basis of a point of order that the provision was “extraneous” to matters appropriate to reconciliation.

The Balanced Budget Act of 1997 -- also introduced through the reconciliation procedure -- also included a provision to raise the eligibility age. Fifty Republicans voted in favor of waiving a point of order against the provision that it was extraneous, allowing the provision to remain in the bill. The final version of the bill signed by Clinton did not contain this provision.