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Even before the final Massachusetts election results are counted, this Senate race is revising Democrats鈥� strategies for pushing healthcare legislation through the US Congress.

If Scott Brown (R) pulls an upset over Democrat Martha Coakley, Senate Democrats lose their 60th vote in the Senate. That would force Democrats into tough choices in the healthcare endgame: Do they rush a compromise package through both the House and Senate before the winner of the Massachusetts election can be seated? Alternatively, could the House muster the votes or political will to accept the Senate鈥檚 version of the bill, thus avoiding another Senate vote?

On Tuesday, aides to Speaker Nancy Pelosi were playing down reports that the House would bow to the Senate. Even with the uncertainties of the Massachusetts race, 鈥渢he House position on the Senate bill is clear, and we are working towards compromise,鈥� says spokesman Nadeam Elshami.

But for a relatively unknown Republican state lawmaker to run a close race for the seat held by Sen. Edward Kennedy for 47 years is a game-changer. At issue is more than a Senate seat: This race may signal that public support for healthcare reform is weaker than Democrats had assumed.

鈥淲e鈥檝e learned that the healthcare bill is an albatross around the necks of Democrats even in the most liberal state in the country,鈥� says GOP pollster Whit Ayres, commenting on the Massachusetts race.

鈥淚ndependents are disgusted with the fiscal irresponsibility they see coming out of Washington, and they鈥檙e disgusted with this healthcare bill, which they see as raising their taxes, increasing their premiums, increasing the cost of healthcare, and lowering the quality,鈥� he adds. 鈥淲hat concerns people is the cost of healthcare, not coverage. But the priority of Democrats has been coverage, not cost.鈥�

Polls in the run-up to Tuesday鈥檚 vote give Mr. Brown a 2-to-1 edge with independent voters. This is the same margin that helped GOP challenger Chris Christie oust incumbent Democratic Gov. Jon Corzine in the New Jersey governor鈥檚 race last November. Governor-elect Christie, sworn in Tuesday, campaigned on limited government and fiscal responsibility.

As the Massachusetts race tightened, national Republican groups targeted the election as a referendum on healthcare reform, as well as on the broader Obama agenda. At a rally at Northeastern University in Boston on Sunday, President Obama hit on the national consequences of Tuesday鈥檚 vote.

鈥淲e know that on many of the major questions of our day, a lot of these votes are going to rest on one vote in the United States Senate,鈥� he said. 鈥淭hat's why the opponents of change and progress have been pouring money and resources into the commonwealth, in hopes of promoting gridlock and failure. They want to keep things just as they are.鈥�

In a closed meeting with House Democrats last week, Mr. Obama assured the caucus that he understood that healthcare was a 鈥渉eavy lift鈥� but that once a final bill emerged, he would take the case to voters nationwide. A loss on Tuesday, however, would call into question the power of Obama鈥檚 coattails and his capacity to make good on that promise.

鈥淚鈥檝e covered elections for 30 years, and I don鈥檛 remember a time when an election in one state for one senator has had the import this race has,鈥� says G. Terry Madonna, director of the Center for Politics and Public Affairs at Franklin & Marshall College in Lancaster, Pa.

But he cautions against reading the results of Tuesday鈥檚 election as a simple referendum on healthcare. 鈥淗ealthcare is huge, but I don鈥檛 think you can separate healthcare from the economic concerns that people have,鈥� he says. 鈥淭o single out healthcare would be a mistake.鈥�

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