Senate Majority Leader Harry Reid (D-NV) released the "Patient Protection and Affordable Care Act" (H.R. 3590) in mid-November, and Senate Democrats mustered 60 votes to invoke cloture and proceed to debate on health reform on November 21. Since that time, the health care debate has dominated the Senate's focus, with the goal being to vote on a final Senate bill before Christmas. The bill on the floor is the merged version of bills previously marked up by the Senate Finance and Health, Education, Labor and Pensions (HELP) Committees. The Congressional Budget Office (CBO) scored Reid's bill as costing $848 billion over 10 years and resulting in a net reduction to the federal budget deficit of $130 billion over that same period. Hundreds of amendments have been filed, although few have received floor time for debate. Many are "message" amendments that sponsors do not expect will actually be accepted. Themes of note include a number of proposals to allow for "reimportation" of pharmaceutical products; proposals to govern settlements between brand and generic pharmaceutical companies; changes to the Medicare Part D program; and issues related to drug reimbursement, discounts and rebates. Much of the sustentative discussion on the bill is taking place off the floor, as Senators seek to have language added to Reid's manager's amendment, and Reid attempts to find a way to secure the 60 votes necessary for final passage. In the new year, the House and Senate are currently expected to hold an abbreviated conference on their bills, with substantial pre-conferencing already under way.