The Senate voted this evening by a 60-39 majority to commence debate on Senate Majority Leader Harry Reid’s bill that would radically expand government control over private health care decisions. The bill is over 2000 pages long, costs an estimated $2.5 trillion over the first ten years of implementation and carries a half trillion dollars in new taxes. Many Americans have to be thinking right now — they have heard from their dissenting constituents at Town Hall meetings and have seen the poll numbers for Obama’s health care bill dropping like a rock so why would they keep moving this bill forward?

This debate will center around many issues including huge taxes increases, economy-killing employer mandates and:

1. Abortion: Congressman Bart Stupak (D-MI) offered an amendment to the House bill to ban all federal funds flowing into the health care system from funding abortion. Senator Reid put language in the bill that allows some funds to go to abortion services by using an accounting gimmick. This issue could take the bill down, because the House approach is far different from the Senate approach. If this bill becomes a referendum on abortion policy, it may fail.

2. Cost: Senator Reid has promoted his bill as costing the federal government $849 billion and as a budget cutting bill. Conservatives in the Senate have pointed out that the costs are more accurately $2.5 trillion over the first 10 years of implementation because the benefits are not even scheduled to be paid out until 2014. There is a huge disparity between the two sides as to the cost of the bill and if it gets bigger and bigger on the Senate floor, then it may suffer a legislative implosion.

3. The Public Plan: Senator Joe Lieberman (D-CT) has pledged to support a filibuster of any bill containing the public option. Senator Olympia Snowe (R-ME) will only accept a public option with a trigger. Other Senators have expressed reservations about different permutations of the public option. A bill with a too strong public option may not have the support to pass the Senate.

4. Wild Card: As with all these debates, there may be an issue that comes out of the blue and becomes central to the bill. There were debates over “death panels” during initial stages of the debates and controversies over coverage for illegal immigrants. Some other issue may be offered as an amendment or may be buried in the 2000 pages of the bill that may become the next controversy to prevent passage.

The week after Thanksgiving, the Senate will start the process of considering and voting on amendments to the bill. This process may go in one of two directions. It is possible that Reid uses the amendment process to buy just enough votes to pass the bill through targeted special interest amendments. Expect Connecticut, Nebraska, Arkansas, and, yet again, Louisiana to receive special treatment in the amendment process. If Senator Reid is able to buy support during this process, the bill will pass and the President will sign Obamacare before his State of the Union.

Scenario two kicks in if opponents of the bill play hardball. If opposing Senators offer non-germane amendments, like the legislation to restore the 2nd Amendment in the District of Columbia or a resolution of disapproval for Attorney General Eric Holder’s decision to try Kahlid Sheik Mohammed in federal courts, then the Senate would be mixing some volatile issues into the health care mix. Regardless the course of action, this bill will either pass or fail as a direct result of the actions of a handful of Senators.

Read more about the five major flaws of Majority Leader Harry Reid’s health care bill here and at FixHealthCarePolicy.org.

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