Essentially what’s happening here is by requiring $1 Billion in budget cuts in a $3.5 Trillion budget, the Democrats are able to use a reconciliation process which does not require 60 votes to stop debate in the Senate.
Reconciliation is generally a process to make it easier for budget cutting, but is being used here to lay the groundwork to fast track (potentially) massive changes in our Health Care System (including the possibility of a Governmental Health Care Exchange).