Barack Obama is set to announce a “way forward” on health care in just a couple hours, and every indication is that he will press for a reconciliation “sidecar” approach if Republicans, as expected, refuse to work on a bipartisan package. That pivot could come as soon as the next few weeks, if previous published reports calling for final passage by the Easter recess are accurate.

The president will outline the plan to pass the bill, including having the House of Representatives pass the Democratic Senate health care reform legislation as well as a second bill containing various “fixes.”

He will call for an up or down vote, as has happened in the past, and though he won’t use the word reconciliation, he’ll make it clear that if they’re not given an up or down vote, Democrats will use the reconciliation rules.

White House officials will make the argument these rules are perfectly appropriate because the procedure is not being used for the whole bill, just for some fixes; because reconciliation rules are traditionally used for deficit reduction and health care reform will reduce the deficit; and because the reconciliation process has been used many times by Republicans for larger legislation such as the tax cuts pushed by President George W. Bush.

Republicans have already rejected Obama’s inclusion of a few of their health care proposals in the bill, so expect reconciliation to be the next move, after the House presumably passes the Senate bill.

I say “presumably” there because it remains to be seen whether Nancy Pelosi can corral the needed 216 votes to pass the Senate bill, especially before reconciliation fixes are put into motion. Under the plan floated, President Obama would actually sign the Senate bill into law before the reconciliation fixes are completed, which has to make House members nervous. But the unpopularity of the bill and the politics of the midterms has even those who voted for the bill previously uneasy about taking the leap again. Mike Arcuri (D-NY) is a good example.

U.S. Rep. Michael Arcuri, D-Utica, said Tuesday he would vote against the Senate version of the health care bill that could soon go before the House of Representatives for approval.

Arcuri, who voted in early November in favor of the House version of the health care bill, said he is against the Senate bill for three main reasons:

* He doesn’t want to see the bill passed as a “mega bill,” and he believes more success would be had by breaking the bill apart and passing aspects of it incrementally, he said.

* Arcuri also said he isn’t comfortable with the possible Democratic strategy of passing the bill through reconciliation. This would get around Republican opposition by having the House pass the Senate bill, then the Senate would make amendments requested by the House, and the House would pass the new Senate bill. In other words, a Republican filibuster in the Senate could likely be avoided.

* The Senate bill differs from the House bill in ways Arcuri said he dislikes. He cited a provision that would tax benefits on insurance policies, expand Medicaid eligibility, provide an unfairly low amount of funding to the state and not allow for negotiations on prescription drug prices.

“There would have to be some dramatic changes in it for me to change my position,” Arcuri said.

Some of these points are completely valid, some less so (he cares about the reconciliation process while sitting in a majoritarian body?). But the actual content of his complaints are less vital than the fact of the complaints themselves. This will play out a hundred times, with leadership needing to talk down, cajole and/or threaten skittish Congresscritters. But sometimes skittishness wins.

In Arcuri’s case, his own opponent calls this proposed vote against health care “flip-flopping [...] pandering, politics and opportunism.” There’s little benefit to flipping to a no vote when your opponent will merely use the previous yes vote as the basis for his campaign. But such logic frequently escapes Democrats.

I can see lots of House Democrats making legitimate arguments to vote against the Senate bill, and Arcuri’s lament is just a bellweather for what’s to come in the next couple weeks. If March 19 comes and goes without passage in the House, you’ll know Nancy Pelosi doesn’t have the votes.

UPDATE: Democratic leaders continue to insist that they have the votes, which of course they would do at this point. I will happily believe them when they schedule a vote. Until then, they’re still working on it.