Procedural Dead-ends on Health Care Reform

by: Chris Bowers

Mon Sep 28, 2009 at 12:23


Here are four procedural dead-ends on health care reform:

  1. No public option from the Finance Committee. The Finance Committee will vote tomorrow on the public option. As I wrote on Friday, and as The Hill reiterates today, none of the amendments will pass. A public option will not by part of the health care bill passed by the Finance Committee.

  2. Nothing will pass the Senate with 51 votes. While virtually anything can pass the Senate with only 51 votes, nothing in health care reform legislation will actually pass the Senate with only 51 votes. The reason for this is two-fold.

    First, Senate Democrats are not going to use the nuclear option. They just aren't.  That is too bold a move for such a cautious group-not to mention one that is so focused on a public image of bipartisanship.

    Second, for many of the same reasons, Senate Democrats are not going to use reconciliation. If they attempt to do so, either in the Budget committee that is merging the HELP and Finance committee bills or by splitting the bill in conference, Senate Republicans will propose points of order requiring 60 votes to pass reconciliation. Since Senate Democrats have already ceded this procedural territory through their unwillingness to use the nuclear option, they will need 60 votes to pass anything. As such, they might as well just target 60 votes for cloture.

    Until Senate Democrats are willing to use the nuclear option, they will need 60 votes to pass anything. That is a battle we are going to engage here on Open Left, but it isn't a battle that can be won during the short time frame of health care reform.

  3. No good strengthening amendments will pass on the Senate floor. If there is no public option in the bill that passes through Kent Conrad's Budget committee, don't expect one to emerge from the Senate via amendments. The 60-vote culture will be in effect for all amendments to the health care bill when it arrives on the Senate floor, and so there won't be enough votes for the public option--or any other significant strengthening amendment-if it is not included in the bill that comes out of the Budget committee.

  4. Don't expect much strengthening from the conference committee. Due to the 60-vote culture of the Senate-a culture that seems locked in for health care-there will inevitably be a narrow vote margin for the bill coming out of the Senate. As such, even if there is a public option in the House version of health care reform (highly likely), don't expect it to survive the conference committee if the Senate does not include one. Sure, the House might get a couple of small concessions to improve the Senate bill in conference, but mainly the Senate bill will survive and conference committee compromise.

    The narrow Senate vote margin, combined with the Obama administration's rabid desire for a health care bill, will provide the Senate version of the bill with more leverage in the conference committee. We already saw this play out on the stimulus package, where the narrow Senate margin allowed its version of the stimulus to largely stay intact during the conference committee. The House was only able to win the conference committee on the federal budget because of the wider margin in the Senate.

This means that the only viable way to get a public option in health care reform legislation will be for a public option to be included by the Budget committee when they merge the HELP committee and Finance Committee bills. The conference committee would be a longshot backup plan, but really the Budget committee is the procedural path to a public option right now.

Now, the Budget committee, like the Rules Committee in the House (which merges bills in that chamber), has an ostensibly independent committee chair. However, the reality is that each of these committees is really an extension of the overall majority leadership in each chamber. Just as Rep. Louise Slaughter (House Rules Committee chair) isn't going to break with Pelosi in the House, Senator Kent Conrad (Senate Budget Committee chair) will not go against Senator Reid. This is actually a good thing for public option advocates, since if it was all up to Kent Conrad, the public option would be dead already. At least with Reid, there is a chance.

So really, this all comes down to whether Harry Reid wants to include a public option in the merged Finance and HELP committee bills. Or, perhaps to put it a different way, whether Reid feels more pressure to put a public option. The pressure he will receive, in both directions, from his fellow Senators, from the Obama administration, from industry lobbyists, and from grassroots organizations will be intense. If we are going to win this fight, we need to make certain that Senator Reid feels as though he has no other choice but to include a public option in the merged Finance and HELP committee bills. At this point, we don't really have any other option.

Chris Bowers :: Procedural Dead-ends on Health Care Reform

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Harry Reid's current stand on health care (4.00 / 3)
Harry Reid: Public option trigger 'pretty doggone good idea' http://www.lasvegassun.com/new...

Dem leadership past and present selling the trigger. Bill Clinton weights in:

Now, the one Republican who's come up with a good idea is Senator Snowe. She deserves a lot of credit for saying when we did this Medicare prescription drug bill, instead of giving the government the power to negotiate for lower prices we gave the drug companies a chance to offer them, but we held the power in reserve. And if there was any state in America where there was no competition, you could do it. So let's do that for health care. That's a good idea. That's, that's the kind of debate the country needs, and I hope that the Republicans will come forward with it.
http://campaignsilo.firedoglak...

Looks like the insurance Industry just bought itself 30 million more customers at our expense.


I would only support a trigger (4.00 / 2)
...if there was a chance that the trigger could actually be set off. However, the way it's constructed under Snowe's amendment, it is impossible to trigger.

[ Parent ]
re: trigger (4.00 / 1)
However, the way it's constructed under Snowe's amendment, it is impossible to trigger.

can you please explain how it's constructed?


[ Parent ]
Geez, Chris -- what happened to your optimism? (4.00 / 4)
Reid?  Reid?  Then we are dead.  End of story.  What happened here?  You were pretty confident a short while ago.

if reid is the only way forward... (4.00 / 4)
we may have a hope. Reid is up for a tough re-election fight, and he's going to need funds.

We could offer him a carrot for helping America on health reform (and implicitly, a stick).

Or, even better, we could actually raise a ton of funds and hold them in reserve. If we get a public option, Reid gets the funds. If we don't, Reid gets a kick in the ass.


yes yes yes (4.00 / 3)
Remember how much money was raised for Joe Wilson's opponent a couple weeks ago? People would dig deep for a "public option" campaign fund.

Once the fund gets big enough you say to members facing tough reelection campaigns: there's money in it for you if you vote the right way. Has to be a big fund to counter the money they feel they will lose from people connected to the insurance industry.


[ Parent ]
What about whipping PO opponents to vote for cloture? (4.00 / 4)
Sen. Sherrod Brown was very optimistic last week that a bill with a public option could get through the Senate before conference:

http://tpmdc.talkingpointsmemo...

Even if Budget does not include the PO, can't floor amendments pass with 51 votes, as long as there are 60 votes for cloture on the floor amendment?


This seems like the only hope... (4.00 / 3)
Basically get Senators on board for cloture even if they vote against the PO... the problem is, the insurance industry isn't stupid, and the Senators they've bought aren't either... So they'll all know what the meaningful vote is.

Also, I wouldn't rely on Lieberman for ANYTHING.


[ Parent ]
The public option (4.00 / 5)
in the Senate HELP committee is very very weak, nothing like the robust public option we have been told that we are fighting for. Lucy is about to pull the football away.

The public option was a diversionary tactic to distract progressive forces away from single payer.

HB 3200 contains the Kucinich amendment that gives states the option to create their own single payer systems. THAT is the best we can hope for.

The fight for single payer has moved to the states and Pennsylvania is one of the states that might pass a single payer plan.

You have been played. Sooner or later it happens to us all. Shift strategy, support the Kucinich amendment and get ready to fight for single payer in your state.


Exactly. (4.00 / 2)
The reason the left lost the latest battle for health care reform is that it ceded everything before the fight even began.  Now all we can do is hope that the coming violation isn't so bad that we can't rise again.  The thing to do from the start should have been to make serious efforts to pass H.R. 676, but none were ever made.  Now, there is a small glimmer of hope in that we have the Kucinich amendment to H.R. 3200, which would allow states to pass their own single-payer systems independently of the federal government.  If we're to draw any lines in the sand at this point, it'll have to be for that or nothing.  As evil as the GOP is, you never see it ask for crumbs - the party demands everything and refuses to budge even an inch.  THAT'S why the Republicans are still in charge in spite of nominally being the minority political party.  Why the left can't seem to understand this is beyond me.



[ Parent ]
so can we sink the whole bill? (4.00 / 2)
assume, as seems likely, that the ultimate conference bill has a mandate, crappy subsidies, and either no public option at all, the trigger BS, or the Schumer "level playing field" public option.

is that bill worth passing?

me, i would say no. i don't believe in "fix it later" from any of those starting points - moving from them to a better system would be more difficult than going there from scratch, and the Mandate Tax will be political poison in 2010 and beyond. i really don't want a Speaker Boner or President Palin in my future.

would the House vote against it? really? i'd hope so but i doubt it.


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


Why would we do that? (0.00 / 0)
Democrats have promised the people healthcare reform and failing on it again will be the last straw.  Something has to pass.  

[ Parent ]
if the bill makes the current situation worse, why would we want it passed? (4.00 / 5)


[ Parent ]
I don't understand reconciliation argument (4.00 / 1)
This is the first I've ever seen the suggestion that reconciliation will actually take 60 votes.  Chris seems to imply that the Republicans can filibuster reconciliation?  Can Chris or someone else who knows Senate procedure better than me explain and/or disagree that 60 votes will be required.

If Reid is our last great hope (4.00 / 3)
then we're screwed to Nevada and back.  The guy's got the GOP nipping at his heels in 2010 and he's looking at (and taking advantage of) every opportunity to move a little more to the right.  Like most of the congressional Democrats, he still doesn't understand that no shift to the right will result in less pressure on him to move to the right.  

I admire those of you suggesting this is a great opportunity to funnel donations to him in exchange for his support of the public option, because I'm just not capable of that level of optimism any longer.


sink the bill in Finance... (4.00 / 2)
the other possibility is to try and kill the Finance committee bill.   That way, the Senate HELP bill, not a bill "reconciled" by Kent Conrad, is what gets considered by the full senate.   And while the HELP bill "public option" sucks (thanx all you HCAN geniuses!  brilliant job of shutting single payer advocates out of the picture, and moving the overton window to the right!) at least there is a chance that what comes out of the conference committee will be good.

No, we MUST get a bill (0.00 / 0)
Sink the bill and sink the Democratic party in 2010.  

[ Parent ]
what do you prefer (4.00 / 1)
passing a bad bill, winning in 2010, and losing a whole generation

or

killing the bill, losing in 2010 but having good prospects afterwards?

and when I say "losing a whole generation" I really mean it. bush did something the public didn't want (iraq) and we saw how he paid for it. what do you think a mandate to buy from big health without public/gov't/no-profit option would be?

just read the poll:

Nationally, voters oppose a mandate to purchase private insurance by 64% to 34% but support a mandate with a choice of private or public insurance by 60% to 37%.
http://www.openleft.com/diary/...

and did you like the 2-to-1 margin of the young voters we got last year? well, require just-starting grads to write monthly checks to big health and kiss those votes good-buy


[ Parent ]
We are not going to have good prospects after 2010 anyway (0.00 / 0)
With the way the economy and Afganistan are looking, we are going to have good long spell in the wilderness of politics.  If we can get through 2010, we can probably at least save the House.  

[ Parent ]
so you want to pass something, even if it is bad, just to hold the house in 2010? (0.00 / 0)
We are not going to have good prospects after 2010 anyway  
With the way the economy and Afganistan are looking,

that sounds like a right-wing talking point to me

we are going to have good long spell in the wilderness of politics

... if we pass bad legislation

our electoral prospects are tied to what legislation we pass

If we can get through 2010, we can probably at least save the House.

sarah, is that you?


[ Parent ]
We can pass nothing and lose forever (0.00 / 0)
Or pass something and win.  

[ Parent ]
no, if the people don't like that "something" we will not win (4.00 / 2)
Or pass something and win.  

the democrats will lose if they pass something that will be unpopular, as a big health mandate w/out a public option will be. I repeat: "Nationally, voters oppose a mandate to purchase private insurance by 64% to 34% but support a mandate with a choice of private or public insurance by 60% to 37%."

we will not win if we just "pass something."
we will win if we pass something that works.


[ Parent ]
It wont even go into affect until 2013 (0.00 / 0)
We will probably have a chance to change it and add a public option later if we pass the bill now.  If we pass nothing, we will never get another chance because Republicans will be in power.  

[ Parent ]
re: 2013 (0.00 / 0)
We will probably have a chance to change it and add a public option later if we pass the bill now.

no, we won't get such a chance. big health and friends will be much more powerful if we hand them 30 million customers now.

now big health loses customers every month and wants an individual mandate so we have leverage. if they get the individual mandate they will be in 'open war' mode if we try to add a public option.

If we pass nothing, we will never get another chance because Republicans will be in power.  

never? we didn't pass anything in 1994 and we have a chance after 15 years. never is not the same as 15 years.

furthermore, if we pass something bad the time we'll have to wait to try again will be a lot longer than it will be if we pass nothing.


[ Parent ]
Win what? (4.00 / 2)
An election?

Who cares if the Democrats win elections when the result is reform in name only?


"It sounds wrong...
     ...but its right."


[ Parent ]
what happened? (0.00 / 0)
Don't expect much strengthening from the conference committee. Due to the 60-vote culture of the Senate-a culture that seems locked in for health care-there will inevitably be a narrow vote margin for the bill coming out of the Senate. As such, even if there is a public option in the House version of health care reform (highly likely), don't expect it to survive the conference committee if the Senate does not include one. Sure, the House might get a couple of small concessions to improve the Senate bill in conference, but mainly the Senate bill will survive and conference committee compromise.

did the progressive block fold?


the progressive block is in congress (0.00 / 0)
the problem is the senate. we don't have a progressive block who is ready to vote down a bill that lacks a public option, save maybe rockefeller.


[ Parent ]
in order for a bill to be sent to the president, it must pass both houses, yes? (0.00 / 0)
or did they abolish the house?

IF the progressive block holds and say 50 progressives at the house say 'if the bill doesn't have  robust public option we are voting no' the bill can't pass


[ Parent ]
You want nothing to pass? (0.00 / 0)
A public option CANNOT pass the Senate.  We are going to have to settle for something in between.  

[ Parent ]
you want us to pass bad legislation? (0.00 / 0)
I prefer no legislation over bad legislation

we will lose if we pass bad legislation

which may very well be your ultimate objective


[ Parent ]
You have the benfit of being healthy... (4.00 / 1)
Even the original Baucus draft is a massive improvement for the chronically ill from the nothing we have now...

I realize that Democrats have not been good at being callous to its citizens the way Republicans are.  It makes them better politicians, but we are dealing with millions of sick people who have absolutely nothing right now.

Do not forget about them!

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 ]
re: health (0.00 / 0)
You have the benfit of being healthy...

that assumption is totally wrong

Do not forget about them!

I'm not. I include them in my thinking.

[ Parent ]
re: (0.00 / 0)
he problem is the senate. we don't have a progressive block who is ready to vote down a bill that lacks a public option, save maybe rockefeller.

roland burris too. possibly we could convince bernie sanders too.


[ Parent ]
Major flaw in your analysis, Chris (0.00 / 0)
And it's here:

Second, for many of the same reasons, Senate Democrats are not going to use reconciliation. If they attempt to do so, either in the Budget committee that is merging the HELP and Finance committee bills or by splitting the bill in conference, Senate Republicans will propose points of order requiring 60 votes to pass reconciliation. Since Senate Democrats have already ceded this procedural territory through their unwillingness to use the nuclear option, they will need 60 votes to pass anything. As such, they might as well just target 60 votes for cloture.

I believe that the point of order only requires 60 votes to overrule if the Senate parliamentarian rules that the point of order is valid. Reports are the Schumer has been working closely with the parliamentarian to craft a bill that can get through the reconciliation process, so I think it's premature to just assume that the Republican points of order are going to stop the bill.


why pay attention to you??? (2.00 / 2)
as long as you will not throw reid and obama or anyone else under the bus you are shit. your little primary or funds thing are as scary to washington pols as my grandmothers. they are dead. i feel as though obama lied to me. all the obama stuff came off both my cars in mid sept. obama won indiana with about 5 votes to a township. i personally will reverse that. i'm already talking to people about his failures. i will not work his gotv again. obama is a failure. he can correct that at anytime now. if he screws health care, well screw him. same for reid. i will donate to his opponent. i'm not a democrat, i'm a progressive. thank you. 60 votes ain't shit. 80 or 90 might be enough, probably not. reid even expects you to buy your own knee pads. he's right. breid

I agree (0.00 / 0)
Soooooooooooo much!!!!!!!!!!!!!

[ Parent ]
The first part is over the line (0.00 / 0)
But I recommended it b/c I don't think you are trolling.  You are saying something, angrily, but something worth hearing, although I don't agree with you (yet).  It would be scary if we banned anger from this site, but I also don't support personal attacks on fellow bloggers, which your subject and first three sentences are.

[ Parent ]
your right (0.00 / 0)
i should have said us instead of you. the rest stands. breid

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