Healthcare reform could require Congress to make exceptions to pay-as-you-go budgeting, according to one of Sen. Edward Kennedy’s (D-Mass.) most senior aides.

“Certainly, there’s a strong inclination within large quarters of Congress that [health reform] has to be substantially paid for, but whether it’s every penny, every dime – those discussions still have to happen,” Kennedy aide Michael Myers said at a briefing hosted by the liberal healthcare group Families USA Thursday.