WASHINGTON - This week, Senate Democrats will attempt to push through a jobs bill that has stalled in the chamber for seven weeks. Majority Leader Harry Reid (D-Nev.) filed for cloture on Monday afternoon, leaving just days before a vote on the American Jobs and Closing Tax Loopholes Act, or House Resolution 4213, a $23 billion bill to extend federal unemployment benefits and other emergency stimulus measures. The cloture motion signals that Reid believes he has the votes to pass the long-mired legislation. But there are still signs that the contentious, job-saving bill might not pass - leaving people on unemployment benefits, doctors and states in financial limbo.

If Congress does not pass the bill, hundreds of thousands will lose their federally extended unemployment insurance. Doctors will take a 21 percent cut in Medicare reimbursement rates, possibly causing them to drop needy patients. (Image: US Chron) Calling for an end to debate on the floor, Reid warned, "We'll learn a lot this week about who wants to fix problems, and who wants to make excuses." He castigated the opposition party's intransigence: "If Republicans have their way, next week will be yet another without a lifeline for the most needy, those willing and wanting to work. The other side has slowed and stalled just about every piece of legislation this year - just as they did last year and the year before that.  That's not a secret. The numbers don't lie, and Republicans make no efforts to hide their strategy of delay."

What is at stake? If Congress does not pass the bill, hundreds of thousands will lose their federally extended unemployment insurance. Doctors will take a 21 percent cut in Medicare reimbursement rates, possibly causing them to drop needy patients. Starting in December, the federal government will provide less backing to the Federal Medical Assistance Percentages program, or FMAP, which provides states with money for Medicaid so that the "poorest of the poor," in Reid's words, can see doctors.

The bill has broad support, but not broad enough. Reid needs a Republican to cross the aisle to vote for the legislation, and needs to hold the Democratic coalition together. As of Monday, that was not happening. The floor debate was contentious - with Republicans bashing what they view as Democrats' free spending, and Democrats detailing the impact of job losses and the possible effect of Medicaid cuts in their states. No Republicans have yet come out in favor of the bill, with moderate Sens. Olympia Snowe (Maine), Scott Brown (Mass.) and Susan Collins (Maine) apparently remaining in opposition. Additionally, Sen. Ben Nelson (D-Neb.) has signaled that he might not vote for the bill as it ups deficit spending.

That means that Democrats might need to pare the bill down. And changing it comes with its own problems. The Senate has altered the House version enough that Congress will need to reconcile the versions or the House will need to re-approve the bill. Differences between the two might make that difficult: Moderate "Blue Dog" House Democrats, for instance, successfully fought for the removal of the $24 billion in Medicaid funding - which Reid hopes to keep in. And every week that Congress does not approve the bill is another week that thousands of the long-term unemployed go without unemployment insurance checks.

Against this backdrop of contentious fighting over deficit spending, President Obama has renewed calls for more stimulus to battle sky-high unemployment rates. Fifteen million Americans - about 9.7 percent of the work force - remain jobless. In a letter to Reid, Senate Minority Leader Mitch McConnell (R-Ky.), House Speaker Nancy Pelosi (D-Calif.) and House Minority Leader John Boehner (R-Ohio), Obama called unemployment a "crisis" and asked the congressional leaders to pass Medicaid funding as well as a new provision to save local workers' jobs.

"I am concerned ... that the lingering economic damage left by the financial crisis we inherited has left a mounting employment crisis at the state and local level that could set back the pace of our economic recovery," Obama wrote. "The lost jobs and foreclosed homes caused by this financial crisis have led to a dramatic decline in revenues that has provoked major cutbacks in critical services at the very time our Nation's families need them most. ... [If] additional action is not taken hundreds of thousands of additional jobs could be lost."

McConnell responded, "[B]ecause Democrats can't seem to resist any opportunity to use a must-pass bill like this as a vehicle for more deficit spending, they've piled tens of billions of dollars in unrelated spending and debt on top of it, all at a moment when the national debt has now reached $13 trillion for the first time in history. This is fiscal recklessness, plain and simple."

Republicans last week released a counterproposal to the Democrats' jobs bill. But it funds the new jobs bill out of stimulus spending and forces across-the-board governmental budget cuts (exempting defense spending). Democrats oppose the measure.