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Could fears over healthcare reform lose the Democrats what should be a very safe seat? And could that cost Obama the bill? There's no doubt healthcare has become the main issue in the election of the Massachusetts senate seat, left vacant by the death of Teddy Kennedy.

It would be a grievous blow for Obama if this seat went Republican for the first time since JFK took it for the Democrats in 1953: especially as the result will come on the eve of the anniversary of his inauguration next week.

You'll notice there are a lot of "ifs" in this piece. I don't actually think they will lose the seat, but there is an awful lot at stake. On the face of it, the well-known Democratic candidate Martha Coakley, the state's attorney general, should walk it. Most opinion polls give her a clear lead, but one has her opponent Scott Brown ahead by a neck. that with a poor turn-out and a good showing for the independent, the Republican candidate could just do it.

It is what he would do next that makes this election so fraught, and so important. Just before Christmas, the Democrats scrapped 60 votes to pass the bill. There is now intense wrangling in an attempt to merge this bill with one from the house. But it will, in the end, go back to the senate for another vote.

And Obama needs every last vote. So Brown says he would be the "41st" senator: the one to deprive the Democrats of the two-thirds majority they need to block a filibuster and get through a final version. The administration is rumoured to be preparing some jiggery pokery about the timing of his swearing in and of any vote if things go wrong for them at the polls.

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