A PATH TO PASSING HEALTH CARE LEGISLATION A PATH TO PASSING HEALTH CARE LEGISLATION President Obama suggested last week at the health care summit that he and congressional Democrats are prepared to use a legislative tactic, known as reconciliation, allowing a simple majority to pass his $950 billion legislation. USA TODAY's David Jackson looks at the tactic and its previous uses. What is it? Congress created a legislative process, known as reconciliation, in 1974 to make it easier to align tax cuts and spending levels with the budget resolutions that they pass. How does it work? In the House, special rules are adopted to limit the length of the debate and number of amendments that can be offered. The Senate limits debate to 20 hours with no opportunity for the minority party to block the bill. Under this tactic in the Senate, it takes only 51 votes to pass a bill instead of the usual 60 votes that are required to prevent a filibuster by the minority. The Byrd rule Sen. Robert Byrd , D-W.Va., a master of the Senate's rules and procedures, pushed Congress in the mid-1980s to adopt a rule saying any amendments offered during the reconciliation process must pertain to budget issues. Disagreements are resolved by the Senate parliamentarian, who is appointed by the majority. Using the tactic It has been used 22 times, including 16 in which Republicans controlled at least one chamber of Congress. Three efforts were vetoed by President Clinton . Some notable uses of this legislative tactic: 1982: To pass a law opening health maintenance organizations to Medicare recipients. 1986: To create a health insurance program, known as COBRA, that allows employees to buy coverage for up to 18 months after they leave a company. The acronym stands for Consolidated Omnibus Budget Reconciliation Act. 1993: To pass Clinton's first budget, which was approved by only one vote in the House and Senate. 1996: To overhaul the way the federal government provides welfare benefits and to put more people to work. 1997: To pass an agreement between Clinton and a GOP-led Congress to balance the federal budget. 1997: To create the State Children's Health Insurance Program, known as S-CHIP, and the Medicare Advantage program, which provides seniors with additional benefits such as vision, dental and hearing coverage and helps coordinate health care for those with chronic conditions. 2001: To enact President Bush 's $1.35 trillion tax cut package, including cuts on individual tax rates and estate taxes and provide a $1,000-per-child tax credit. 2003: To enact more tax cuts proposed by Bush, including a cut in the top capital gains rate to 15% and a cut in the top rate on dividends to 15%. Sources: Congressional Research Service and USA TODAY research WASHINGTON  The White House 's top health care adviser on Sunday repeated a call by President Obama for "an up or down vote" on health care legislation as House Speaker Nancy Pelosi tried to rally Democrats around a final bill. Nancy-Ann DeParle, director of the White House Office on Health Reform, said Obama is ready, if necessary, to move his $950 billion health care bill using a legislative tactic in the Senate that would require only 51 votes for passage. "All the president is talking about is do we need to address this problem and does it make sense to have a simple up or down vote on whether or not we want to fix these problems," DeParle said on NBC'sMeet the Press. The White House has said Obama's health care plan, unveiled last week before a bipartisan summit, would extend coverage to 31 million people and change insurance industry regulations. It would include a mandate that almost everyone obtain insurance or pay a fine and provide financial aid to those who cannot afford to buy it now. Obama would pay for such a proposal by taxing the unearned income of the wealthy. OBAMA: President 'fit for duty' into 2012, doctor says ON POLITICS: Pelosi's job to pass health care gets tougher THE OVAL: Obama announces 'way forward' next week TIMELINE: The road to health care legislation Pelosi, D-Calif., appearing on ABC's This Week, said that "time is up" for Congress to pass a health care bill. She said her House members, including many who face difficult re-election campaigns in November, will need to see what the Senate wants to do before deciding how they will vote. Pelosi called on lawmakers to draw on the same courage that previous lawmakers drew upon to pass the bills that created the federal safety-net programs of Social Security and Medicare. "We're not here just to self-perpetuate our service in Congress," she said. "We're here to do the job for the American people." In the House, Democrats currently have a 255-178 edge over Republicans. There are two vacancies. Rep. Eric Cantor, R-Va., the minority whip, made it clear Republicans see a Democrats-only bill as an election-year issue. "If Speaker Pelosi rams through this bill, through the House … they will lose their majority in Congress in November," he said Sunday on Meet the Press. Sen. Lamar Alexander, R-Tenn., objected to using the legislative tactic, known as reconciliation, on a health care bill. "There's never been anything of this size and magnitude and complexity run through the Senate in this way," he said on ABC's This Week. House Majority Leader Steny Hoyer, D-Md., said on CBS' Face the Nation that Democratic congressional leaders will take the next couple of weeks to further shape Obama's proposal and to start counting votes. Obama will announce his ideas for moving legislation forward in the next few days, spokesman Robert Gibbs said. Contributing: Associated Press Guidelines: You share in the USA TODAY community, so please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Use the "Report Abuse" button to make a difference. You share in the USA TODAY community, so please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Use the "Report Abuse" button to make a difference. Read more