As the health care debate continues to drag on, construction industry groups are still concerned about a provision in the Senate-passed bill, sponsored by Sen. Jeff Merkley (D-Ore.) that would require construction firms with six or more employees to provide health insurance to their employees, or pay a penalty. For other industries, the threshold is much higher at 50 or more employees.

Non-union construction and engineering groups strongly oppose the measure, claiming that it unfairly singles out the construction industry. They say that it could put some small firms out of business, as well as hinder growth. They would rather see efforts to cut costs through such vehicles as association health plans and tort reform.

But unions praise the Merkley provision, saying that many non-union employers in the construction industry don’t provide health insurance coverage, which gives them an unfair advantage when bidding against construction firms that do provide health benefits. They add that the added burden on taxpayers who must bear the cost of emergency room visits by non-covered workers can undercut any savings that a community might get through a lower-bid project.

Whether the Merkley language is included in the final package, while important to firms in the construction industry, is less of a concern to congressional leaders right now than whether they can pass a final bill at all. There is considerable debate as to whether Democrats can use a process called reconciliation, usually used for budgetary issues, on the bill.

Essentially, the House would vote on the Senate-passed bill without changes, then put together a separate “reconciliation” package that fixes things about the Senate bill that House members don’t like. The Senate would then vote on the House-passed bill, and, if approved, the legislation would go to the president.

Citing the “Byrd Rule” a group of 41 Republicans signed on to a letter to Senate Majority Leader Harry Reid (D-Nev.) this week saying they will oppose any provisions in the bill that come up for a vote that deal with policy rather than the federal budget. The Byrd rule prohibits action on measures that do not relate to budgetary issues and requires 60 votes to override.

“We will enforce points of order,” Republican Policy Committee Chairman John Thune (S.D.) told reporters Wednesday.

Moreover, Republicans say that the reconciliation process can’t begin until the bill is actually signed by the president, an assertion that some Democrats dispute.That question is important because some House members,, including some moderate Democrats, are worried that the Senate, once the bill was signed into law, would simply keep the version signed by the president and forgo the "fixes" sought by the House.

Meanwhile, House Speaker Nancy Pelosi (D-Calif.) stresses that the reconciliation bill “will not be about health care reform, health insurance reform in its totality; it will be only about the changes that will be made to the Senate bill. And those reflect the President’s proposal, which honor many of the requests we had in the House.”

But Speaker Pelosi has yet to reveal the specifics as to what would be in the House reconciliation bill. That leaves little time for leaders to wrap up work on the bill before the Easter recess, which begins March 29. With everything seemingly up in the air, that deadline looks increasingly unrealistic.