New Hampshire Republican Senator Judd Gregg has circulated a letter to his Senate colleagues, instructing them on how to use the rules of Senate debate to delay and perhaps even defeat the health care bill being debated in the upper chamber.

The letter, obtained by The Hill (PDF), TalkingPointsMemo and Politico (PDF), among others, runs through numerous procedural rules that would allow the Republican minority to hold up progress on the health bill.

It will likely add fuel to arguments by supporters of health care reform that the GOP's goal in the debate is to block Democrats from making progress on the issue.

Gregg's letter reminds senators that they can propose amendments to the bill that have nothing to do with health care reform:

Until cloture is invoked, Senators may offer an unlimited number of amendments -- germane or non-germane -- on any subject. This is the fullest expression of a full, complete, and informed debate on a measure. It has been necessary under past Democrat majorities to use the rules governing the amendment process aggressively to ensure that minority Senators get votes on their amendment as originally written.

The letter also suggests Republicans can delay debate by insisting on a roll call to ensure that quorum is met, even if it's obvious there are enough senators in the room to meet quorum. The Republicans can then further delay things by raising procedural "points of order" that they can then appeal even if they are struck down:

A Senator may make a point of order at any point he or she believes that a Senate procedure is being violated, with or without cause. After the presiding officer rules, any Senator who disagrees with such ruling may appeal the ruling of the chair—that appeal is fully debatable. ... The Senate may dispose of a point of order or an appeal by tabling it; however, delay is created by the two roll call votes in connection with each tabling motion (motion to table and motion to reconsider that vote).

"If Sen. Judd Gregg gets his way, the dilatory tactics that have marked the early days of the Senate health care debate will grow more and more severe," writes Brian Beutler at TalkingPointsMemo.

"Just in time for the holidays, here it is in black and white, the Republicans' manual for stall, stop and delay," the Huffington Post quoted Jim Manley, spokesman for Senate Majority Leader Harry Reid. "And what do the American people get? Higher costs and less coverage. What kind of present is that?"