Health Care Reconciliation In Tentative Budget Deal!

by: Chris Bowers

Fri Apr 24, 2009 at 14:57


It appears that the Republican "threat" to make gigantic public displays of partisan asshattery if Democrats provided cheaper, more accessible health care to Americans has failed. Although victory has not yet been finalized, a tentative budget deal between congressional Democrats and the White House denies Republicans the option to filibuster health care reform:

Democrats in Congress and the White House have struck a tentative budget deal that includes reconciliation instructions that will make it easier to push through healthcare reform this year.

The deal, which still needs approval from the full House and Senate, would allow Democrats to pass healthcare reform with just a simple majority in the Senate, instead of the 60 votes needed to pass most controversial legislation, according to a congressional aide.

The budget agreement does not include reconciliation instructions for climate change legislation, which both Senate Republicans and Democrats have argued against.

The decision to include reconciliation instructions will likely rile Republicans, who portrayed the use of the maneuver as an attack on Senate rules. But top Democrats have said that they'll resort to reconciliation rules if Republicans remain unwilling to cooperate on long-awaited healthcare legislation.

Senate Budget Committee Chairman Kent Conrad (D-N.D.) stressed that the deal has yet to be finalized. He noted that he and House Budget Committee Chairman John Spratt (D-S.C.), who held talks on the budget Thursday night, still need to present "options" on the budget resolution to their fellow colleagues.

The lack of reconciliation for climate change is not a surprise, given that the Senate overwhelmingly voted against it a few weeks ago. Also, it is likely that some Senate whipping will need to be done in order to ensure this victory on health care (on at least two occasions, the House has already voted in favor of using reconciliation on increased health care investment). Still, this is very promising for increased health care investment in America. Without the filibuster available to Republicans, it is highly likely that in 2009 Democrats will succeed where they failed in 1994. This might be the biggest legislative victory for progressives in, well, about as long as I can remember.

On a less positive note, Senator Max Baucus has tabled debate on a public option (that is, government funded and operated) in the health care reform package for now. However, it remains on the table, so that fight is not yet lost. After the victory on reconciliation, I am more positive than ever that we will eventually win the public option fight, too.

Chris Bowers :: Health Care Reconciliation In Tentative Budget Deal!

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Until a single payer socialist system pervades health care in this country, no one will win. (4.00 / 1)
Only America, Mexico, and a third country view medicine as a business for profit taking at the expense of the poor and middle class. It is a deadly business. Universal health care is nothing more than an interim stage to getting there.  

a needed interim step unfortunately (4.00 / 1)
medicine as a business for profit taking at the expense of the poor and middle class. It is a deadly business.

absolutely awful

people's health is no business, no place to make money on

the concern should how to treat, not how to profit

Universal health care is nothing more than an interim stage to getting there.  

getting where?

I wish we could enact single-payer tomorrow but since that isn't happening we must try to do it incrementally.


[ Parent ]
My fear is that (4.00 / 4)
there will be a battle and then a compromise in which the public option is "saved" and the Obama administration and Baucus "appear" quite progressive.  The "devil" will be in the details, however, and the public option will be set up to fail.  The insurance companies will make lost of noise in opposition, but all will know that the statute is written such that the public option will be a poor alternative.  I don't know how, but there are many ways.

A few bloggers at Open Left or firedoglake will object, but they will be shouted down by those woishing to cannonize Barack Obama.  

And the insurance companies with their wholly owned politicans will continue to screw Americans.


Your pretty damn (0.00 / 0)
pessimistic, even with this good news. Even a watered down public option (no bargaining rights) or a kick in public plan would be a win that could deliver care at a much better cost then the insurance companies. Ideally we'll get a public plan with bargaining power, a public insurance exchange, a health fed, prexisting conditions ban, community rating, major subsidies and a mandate. But we could still get a very good package without a perfect public plan.  

John McCain: Beacuse lobbyists should have more power

[ Parent ]
no, we can't -- if there's a public plan at all, it won't do anything to hurt HMO/Insurance profits (4.00 / 1)
-- they explicitly won't allow it to hurt private insurance (non) providers in any way at all.

And we don't need a new public option -- we have Medicare and it already is cheaper and better -- it only needs to be expanded and funded to cover all.


[ Parent ]
A lot of politicians (0.00 / 0)
believe that the public option should be an extension of Medicare anyway, so I'm not sure the WH and congress are as far off from where yoiu want them to be as you think.

Also, for those of you asking for a single payer, it is impossible to have single payer pass through congress from where we are now, its harder to do than privatizing SS was for the republicans. So be realistic, once there's a good public plan with bargaining power its puts the country on a path to single payer, which is amazing considering where this debate was 6-7 years ago.  


[ Parent ]
but it doesn't put us on a path to single-payer -- it entrenches the middlemen instead -- (4.00 / 3)
it subsidizes them and makes it official policy that HMOs and private insurance cos are how the US provides care.

and none of the key players in this whole thing are actually for a strong public option, nor for Medicare for all -- in fact, Obama just tried to bring HMOs and private insurance into the VA care process too -- all vet groups fought back and they backed off for now.

Neither Baucus nor Kennedy nor Obama has made a public option integral to this "reform".

And single-payer advocates inside and outside of Congress have not been part of the regular meetings and crafting of this at all -- but insurers and their lobbyists/orgs all have been.


[ Parent ]
compare/contrast it to student loans -- govt legally inserted (& subsidized) banks as how to get loans -- (0.00 / 0)
and now is (maybe) trying to cut out those private middlemen and have govt directly make the loans.

why do the opposite with healthcare? esp when we already have Medicare/Medicaid and VA as successful examples of care delivery?


[ Parent ]
Well, in an ideal world, sure... (0.00 / 0)
But, there's a multi-billion dollar industry that could buy non-stop media if they were about to be made extinct, and they could inject enough fear, uncertainty and doubt to make this fail just like they did with Clinton's plan...

I'd love to be able to do it...  Maybe we can use single payer in reconciliation as a threat for Republicans to go along with the real plan.  Obama already told the GOP to screw themselves today (see huffington post)...

I think we should always be pushing for single payer or medicare for all (which technically isn't single payer, but still a good system), if for no other reason than to shift the overton window... My hope is that the public option will be a foot in the door and morph into single payer someday...  

So, we should definitely keep pushing and get the best we can get...

Can I ask why you troll rated my other comment?  I'm trying to figure out what I said that was troll-worthy...

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


[ Parent ]
It's much easier to improve an existing... (2.00 / 2)
...public option than it is to implement it int eh first place.

Even if it is weak, it should be in there...

I think Baucus is smart in tabling discussion for now... Time weakens all good provisions.  Slip it in late, when there is little time to break it up...

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


[ Parent ]
that's where we disagree (4.00 / 1)
the only reason that any of this is happening at all is because the failure of the health care system is so blatant and so much on the minds of voters. once a plan is in place, the details that govern that plan will sink into obscurity. there will be no motive to go against very strong lobbying by very deep pockets. they only need 40 Senators. look at the Medicare prescription "plan" - 6 years and counting, still no authority to negotiate prices.

we'll get a "public plan" that's set up to fail, and we'll be scolded for complaining about it by people like Families USA and their good friends at PhRMA. we'll continue to waste a third of health care dollars on insurance adjustment costs and profits, and the increase in health care costs will continue. and the unique opportunity to change that will be gone.

not everything worth doing is profitable. not everything profitable is worth doing.


[ Parent ]
Good (0.00 / 0)
now any excuses of "we had to to get 60 votes" are not valid. We need 50 votes to pass healthcare reform. We will have 59 Senators caucusing with the Democrats. We can lose nine Democrats. Nelson, Bayh, Licoln, Carper, Landreiu, Lieberman, Conrad, Bennet, Pyor and Warner could all vote no and it could still pass.  

John McCain: Beacuse lobbyists should have more power

this will cement private HMOs and Insurers -- and their business models -- in the system -- (0.00 / 0)
-- "cheaper, more accessible health care" has never been the goal --

health insurance is already accessible to all who can pay for it -- if actual health care was the focus, this "reform" wouldn't have been written by the health insurance industry and would include massive expansions of care-giving facilities -- instead of focusing on the purchase of insurance as the goal instead.  


actually, no (4.00 / 3)
I believe there are people with pre-existing conditions who cannot get private insurance at all. (Depending on your state)

[ Parent ]
Yes... (4.00 / 1)
Even if money were no object, those people are completely shut out of the system...

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!


[ Parent ]
they can still get health care tho -- w/money -- just not insurance -- (4.00 / 2)
sorry -- i should have said care in the first place.

but that's the whole point -- we don't need health insurance -- which is what this whole legislation is about -- we need health care. Insurance is not integral to providing care -- and most certainly harms and prevents care for more or more all.  

mandating that everyone buy insurance (even with subsidies) and/or mandating that insurance companies accept everyone's money (whether from us or from employers or from govt, etc) to give coverage, etc -- is not actually providing health care.

all private insurers make money by denying and limiting health care -- this "reform" will simply ensure an unending revenue stream and not force them to change their profit focus to a care focus. It's cementing and subsidizing their business model as the official preferred way to provide health care.

their goal with this "reform" is not increasing actual care -- it really never has been.


[ Parent ]
Public Option Fight (0.00 / 0)
When this legislative agreement is actually passed, it will be a significant victory. At that point, our job will be to exert major pressure to include the public option that insurance companies do not want. Given their influence, it will be difficult, but I also am optimistic it can be done.

It will take hard work on our part.  


I think the best we can hope for (4.00 / 1)
Is that state-level single payer isn't forbidden by the reform package.

Also in the reconciliation are student loans (4.00 / 1)
according to CQ.  With an 11 year old, I like this too.

John McCain won't insure children

HUGE as well (4.00 / 2)
Obama is standing firm on healthcare and reforming the college loan program, thats very good news.  

[ Parent ]
Good to see Obama being assertive (4.00 / 2)
In a meeting with House Republicans at the White House Thursday, President Obama reminded the minority that the last time he reached out to them, they reacted with zero votes -- twice -- for his stimulus package. And then he reminded them again. And again. And again.

A GOP source familiar with the meeting said that the president was extremely sensitive -- even "thin-skinned" -- to the fact that the stimulus bill received no GOP votes in the House. He continually brought it up throughout the meeting.

Obama also offered payback for that goose egg. A major overhaul of the health care system, he told the Republican leadership, would be done using a legislative process known as reconciliation, meaning that the GOP won't be able to filibuster it.

Democratic aides said that Obama made clear to the GOP leadership that he would continue to work in a bipartisan way, but that they didn't have veto power over health care policy. GOP aides, however, said that Obama was pretty clear that reconciliation would be used. "From what was told me, it sounded more like he would almost definitely use reconciliation for healthcare. I don't think he hedged much," said one.

http://www.huffingtonpost.com/...


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