In December of last year, after Democrats agreed to drop the public option and the Medicare buy-in provision from the Senate health care bill, Sen. Joe Lieberman (I-CT) took to the Senate floor to “declare” his support for the legislation. “The fact is,” Lieberman explained, “31 million more Americans will be able to have health insurance as a result of this legislation.” “That is a giant step forward for our society.” Lieberman praised the “insurance market reforms in this bill” and emphasized his desire to “support” the final conference report.

But today, during an appearance on Fox New’s Your World with Neil Cavuto, Lieberman refused to defend this “giant step forward for our society.” Without explicitly criticizing the Senate legislation, Lieberman said that the close election polls in Massachusetts demonstrated that Americans are “skeptical about this health care bill” and “unhappy about what’s happening in Washington”:

I think we’re at a point where there’s not a single Republican who really will vote for this bill as it is now or as it was moving to be in the conference committee. So this is going to be a loud message from Massachusetts and whether it’s right or wrong, I was impressed again by one of the national polls I saw yesterday that said two things. One is, opposition to the health care reform is very large among independents, unregistered with the party voters. And you know, Massachusetts is thought of as a blue state, it generally does vote Democratic but almost 50 percent of the voters there are unaffiliated so they got the liberty to move back and forth and they’re moving obviously now.

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Lieberman’s effort to align with “independents” and distance himself from “what’s happening in Washington” is highly disingenuous. After all, the Senator ignored the wishes of his constituents — who had approved a statewide public health insurance system with a public option in 2009 — and vowed to filibuster any reform bill that included a public plan or a Medicare buy-in for younger Americans. His refusal to compromise with Democrats stripped the Senate bill of its most popular provisions.

Today, Lieberman is paying the price for orchestrating much of “what’s happening in Washington.” According to a recent survey from Public Policy Polling, Lieberman has alienated Democrats, Republicans and independents and his approval rating stands at just 25 percent. Fifty-nine percent of Connecticut independents and 55 percent of Republicans oppose the senator. During his interview with Cavuto, Lieberman did not dismiss the possibility of switching parties if the GOP takes control of Congress after the midterm elections.

The White House and Congressional Democrats are “scrambling for a backup plan to rescue their health care legislation if Republicans win the special election in Massachusetts on Tuesday.” Publicly, Democrats are insisting that health care reform will move forward, but they acknowledge “that Tuesday’s results could force a tactical shift.”

“Certainly the dynamic will change depending on what happens in Massachusetts,” House Speaker Nancy Pelosi (D-CA) told reporters in California on Monday. “Just the question of how we would proceed. But it doesn’t mean we won’t have a health care bill,” Pelosi insisted. Below are four ways the Democrats can “proceed” if they stay committed to passing health reform this year:

1) House can pass the Senate bill: Democratic House members would be reluctant to support a health care bill that includes lower affordability standards and excise tax thresholds. “House members will not vote for the Senate bill. There’s no interest in that,” Rep. Bart Stupak (D-MI) predicted. Asked about the possibility of passing the Senate bill on Morning Joe, Rep. Anthony Weiner (D-NY) said “I think it’s going to be very hard to ask us in the House to take the Senate bill. Everyone acknowledges it was a worse bill. Everyone said the only reason we were passing the Senate bill is to move the ball forward.” This method would “avoid a scenario in which a new Senator Brown helps filibuster healthcare reform into oblivion” but it opens up the possibility that House Democrats in close elections may vote against the Senate measure.

2) House passes the Senate bill and reconciliation package of changes: Under this approach, “the House would take up the Senate bill only after the White House and congressional leaders struck a deal on key issues, such as taxes and the subsidies to purchase insurance. They would incorporate those changes into a separate budget reconciliation bill. The House would pass both the Senate bill and the reconciliation bill, possibly on the same day. The Senate would then take up the reconciliation bill, which would require only 51 votes for passage.”

3) Both chambers pass conference package before Brown is seated: House and Senate negotiators are close to reaching a final compromise on reform, and the added pressure of losing 60 votes could motivate Democrats to act quickly and pass the conference report before Brown is sworn in. This kind of maneuvering may prove politically unpopular and would require the support of wavering Democratic moderates like Sen. Blanche Lincoln (D-AR) and Mary Landrieu (D-LA). The Wall Street Journal reports that “Democratic leadership aides say they have ruled out pushing the health care bill through Congress before Massachusetts Republican Scott Brown is seated, in the event that he wins.”

4) Pass reform through reconciliation: Democrats had considered passing reform through reconciliation (which only requires 51 votes) earlier last year, but abandoned the effort after it became clear that a reconciliation process would have left reform at the mercy of a parliamentarian and resulted in what Baucus described as “Swiss cheese legislation.” If Democrats embrace this method, they would be abandoning the current bills and delaying reform even further.

Should Scott Brown win the election, Democrats will have to choose between passing an imperfect piece of legislation that would still lower health care costs and cover some 31 million uninsured Americans, or abandon the effort and watch health care costs and the number of uninsured Americans to skyrocket. Democrats should abide by their pledge to give lawmakers and the public up to 72 hours to review the final health care bill, but they should pursue all available avenues to pass reform in the coming months and ignore Republican claims that they’re rushing reform or undermining the Democratic process in Massachusetts.

After all, the health care reform debate has undergone a relatively transparent and open public debate. Both chambers passed reform through regular order and the public has enjoyed months of committee hearings and floor debate, despite Republican efforts to obstruct reform through arcane Congressional procedures. House Republicans shouted down Democrats as they tried to introduce the measure for debate, Republican Senators tried to prevent health care reform from reaching the Senate floor, forced the clerk to read thousands of pages of legislative language, and introduced a stream of message amendments designed to derail reform, not improve it. In fact, when they were in the majority, Republicans — who delayed sitting Al Franken after the 2008 election — pushed through major pieces of legislation without giving 24 hours for members to read over the bills, let alone 72. The GOP forced through the Medicare prescription drug benefit, President Bush’s second tax cut for the wealthy in 2003, and the USA Patriot Act of 2001. In 2005, the House Republican leadership used “martial law” to “rush the House to a vote on the spending cut reconciliation bill before Members (much less the press or the public) had a reasonable chance to examine the legislation and understand what it would do.”

In this case, the public has had every opportunity to examine the reform legislation and its disapproval of the current bills may be an indictment of the sausage making process and the 60-vote threshold in the Senate. Public discontent grew as the public debate dragged on, misinformation about the bills streamed in from conservative commentators, and Senate Democrats were forced to strip the bill of the public option and disregard the House bill’s tax on the wealthiest Americans — these provisions still enjoy widespread popular support.

The reform process has demonstrated that Americans want their lawmakers to do more reform, not less and wavering Democrats should recognize that a Senate like health care bill would lay an important foundation for strengthening the health care system over the long term. Ironically, the final health care bill now closely resembles the Massachusetts 2006 reform effort, which the overwhelming majority of Massachusetts residents and Scott Brown support. National health care reform could help Massachusetts control its skyrocketing health care costs and improve the Massachusetts effort in the years to come.

This morning, Fox & Friends host Gretchen Carlson asked former Governor Mitt Romney if voters in Massachusetts were turning against Martha Coakley because “people in Massachusetts have a already experienced universal health care, so to speak?” Romney responded by defending the Massachusetts reforms. “Massachusetts has shown that you can solve the problem without cutting Medicare, without the so-called public option, without the government stepping in and doing special deals with unions or senators from other states,” Romney said:

ROMNEY: Oh, I think health care has a lot to do with this and Massachusetts showed and Scott Brown by the way supported the health care system here in Massachusetts still does, as I do…Let me tell you, Obamacare would be a very raw deal for people with Massachusetts because we already have a system that’s working here. Ninety-eight percent of our people are insured and if we had a federal, government one-size-fits all plan, Obamacare if you will, people here in Massachusetts would have to pay more taxes, see their Medicare cut. They don’t want Obamacare. They’d rather have what we’ve got here.

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Romney “has shown that you can solve the problem without cutting Medicare” because states don’t have the ability to cut into the federally-funded Medicare program or make “special deals” with senators from other states. In fact, Romney’s effort may have been less ambitious than Obama’s reforms — unlike the national bills, the Massachusetts law did not try to contain health care costs — but it’s not very different from “Obamacare.”

Both bills require Americans to purchase coverage and provide affordability credits to Americans who can’t afford insurance, create insurance exchanges, establish minimum creditable coverage standards for insurers (what Romney refers to as “one-size-fits all plan”) and require employers to contribute towards reform. Like the Massachusetts plan, the final health care bill will also lack a public health insurance option.

While Massachusetts residents may “rather have what we’ve got here,” they didn’t always support the state’s health care reforms — suggesting that support for national reform may follow the same trajectory. In September of 2006, five months after Romney signed reform into law, a majority of Massachusetts residents were discouraged by the sausage making process of reform and only 48% of residents supported the bill. By June 2008, support jumped to 69% and today 79% want the law to continue (although a majority are also pushing the government to adopt cost containment policies).

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