For Democrats to pass health care reform, which has already passed the House and Senate, they merely need the House to pass the Senate pass and then have both houses pass a budget reconciliation measure to iron out the outstanding disagreements. The view in official Washington, however, is that this would be Wrong. This belief comes through loud and clear in this passage in the New York Times:
Seeking to avert the collapse of major health care legislation, the White House and Democratic leaders in Congress face a crucial decision about whether to use a procedural maneuver that would allow them to advance the bill despite the loss of their 60-vote majority in the Senate.
The maneuver, known as budget reconciliation, could allow President Obama and his party to muscle the legislation through Congress with a simple majority vote in the Senate. But it carries numerous risks, including the possibility of a political backlash against what Republicans would be sure to cast as parliamentary trickery.
And this one:
At the same time, two centrist Democrats who are up for re-election this year, Senators Blanche Lincoln of Arkansas and Evan Bayh of Indiana, said they would resist efforts to muscle through a health care bill using a parliamentary tactic called budget reconciliation, which seemed to be the easiest way to advance the measure.
And this one:
In a sign of how hard it is for Democrats to regroup on major health care legislation, two centrist Democratic senators said on Tuesday that they would oppose efforts to muscle through a bill using a procedural tactic called budget reconciliation.
When you're a news reporter, you don't have to explain your beliefs. (Indeed, you're not supposed to.) You just push the reader toward them with stacked language. In this case, the Times has apparently adopted "muscle" as its shorthand description for the use of budget reconciliation for any provisions related to health care.
Reconciliation used to be a procedure used solely to advance budget legislation. Its use has expanded in recent years as the filibuster has grown more common. The filibuster used to be a rarely-employed device used to extend debate, or less often prevent a vote, in cases of unusually strong disagreement. Over the last few decades, it has slowly evolved into a routine supermajority requirement. Because that supermajority requirement has made significant legislative change exceedingly difficult, reconciliation has evolved into an important countermeasure. Yet imposing a routine supermajority requirement has simply become an accepted practice -- you need 60 votes to pass something through the Senate -- while using reconciliation has developed a reputation as some sort of gangster tactic. Why is it a legislative trick, or "muscle," to let the majority win but not to thwart the majority will?
Update: Jonathan Not Me summarizes a report from the Center on Budget and Policy Priorities. Summarizing his summary, the strongest points are that reconciliation has been frequently used for non-deficit-reducing purposes, and that health care reform (which does reduce the deficit) is actually an appropriate issue for reconciliation.