The buzz among long-term care providers today, as expected, is the upset in the Massachusetts Senate race. How healthcare reform will play out now is anyone’s guess.

To say Tuesday’s defeat of Republican Scott Brown over Democrat Martha Coakley has thrown a monkey wrench in the works of reformers is an understatement. A cannonball may be more like it. The Democrats have lost their crucial 60th vote, and therefore, their filibuster-proof majority.

Of course, the dramatic irony is that the new senator, who campaigned on blocking healthcare reform, is taking the seat formerly occupied by the liberal healthcare reform champion Sen. Edward Kennedy.

That the election may is a referendum on the president is arguable, but there is no question that it has jolted Congress about its plans for reform.

“Obviously, the election of Scott Brown brings more questions to the table as to how the administration and Democratic leadership will pursue healthcare reform,” said Susan Feeney, spokeswoman for the American Healthcare Association.

Commented Larry Minnix, president and CEO of the American Association of Homes and Services for the Aging: “I think it puts healthcare reform in a very tight place. There are major things in the bills that could help a lot and, in that respect, it certainly makes things difficult because we thought we were close to a bill. It’s disappointing, but the needs and objectives are still the same. There’s hope that something will get done.”

Minnix, whose organization has been leading the charge for the Community Living Assistance Services and Supports (CLASS) Act, is hoping that the House will adopt the Senate’s version, for the sake of expediency.

Otherwise, it could be back to the drawing board for healthcare reform—and many major provisions, including the CLASS Act, a stronger Medicare commission, nursing education grants, an expansion of Medicaid, transparency requirements and millions of dollars in Medicare cuts. 

Meanwhile, among the thousands of pages of reform legislation is language extending the therapy caps exception process, which expired at the end of the year. Providers have been depending on passage of the bill to resolve this problem.

It appears they will have to wait some more.