Ezra Klein has a post up arguing that if Coakley loses the Senate race in Massachusetts next week, the impact on health care reform is negligible because either (a) Democrats in Massachusetts won't certify Brown as the winner until after a vote on health care is held in the US Senate (and Paul Kirk, the interim Senator, would remain Senator until Brown would be sworn in and would vote for the reform bill), or (b) the Senate bill would simply be the final version of the bill and the House would have to accept it in full.
I agree with Ezra that those would be the two best options available to Democrats. I disagree that either would work.
If Coakley loses, I believe health care reform will be dead. The Massachusetts election is being held to fill Senator Kennedy's former seat- quite possible the Senator who worked hardest to pass comprehensive health care reform in the past 30 years. The last Republican elected to the Senate from Massachusetts was Edward Brooke, in 1979. Remember the mediaand political buzz that Democrats were in serious trouble after the November elections where two governerships went to Republicans after being held by Democrats? Imagine the media sensation if Kennedy's former seat is next occupied by a Republican with voters knowing full well that electing a Republican is highly likely to kill the health care reform movement. It was hard enough to secure the votes of many weak-kneed Democrats after November's elections; losing in Massachusetts will terrify incumbents in both chambers of Congress (and unlike in November, this time their fear would be legitimate). This is, in part, why the House won't simply support the Senate bill (Ezra's option (b)). They will be in survival mode.
As for delaying Brown's certification and swearing-in (option (a)), well, that would be a PR catastrophe. Bill Owens, for example, was sworn in on November 6, 2009, just three days after the election, to help secure passage of the health care bill. How will it look if Brown isn't sworn in for weeks, or even longer, to give the Senate time to pass a revised health care bill following negotiations with the House? Yeah- pretty awful. Perhaps Massachusetts has a legitimate reason to take longer than New York in certifying election winners. It won't matter. It looks bad, and Republicans will scream "FRAUD" as loud as they can, whether there is any basis in fact for such a claim or not. If town halls were ugly before, they would be a nightmare after.
No, if Coakley loses, the chance for reform is over. At least in the near term. The last time health care reform failed, it took 16 years to get another real chance. Sounds about right this time too.
Coakley may not be the best candidate available. I frankly know almost nothing about her. But she needs to win if health care reform is going to pass.