Health reform state of play, 3/1: Endgame emerging

by: Chris Bowers

Mon Mar 01, 2010 at 19:10


On Wednesday, President Obama will offer detail on his vision for the final procedural path, and substantive agreement, for completing health reform:

President Obama Wednesday will detail both the substance of his final health care reform legislation proposal and the process for getting it through Congress once and for all.

White House Press Secretary Robert Gibbs told reporters during his daily briefing today that Obama will offer the pathway to final passage by outlining the "next steps." But Gibbs also dodged questions on specifics or how the president would help Speaker Nancy Pelosi or Senate Majority Leader Harry Reid secure enough votes in their chambers.

Here is what to expect from this announcement:

  • It will involve budget reconciliation.  House Democrats are demanding a budget reconciliation fix to the Senate health care bill.  Senate Democrats are nearly unanimous in being open to the idea.  Last week, the White House released a proposal that can be passed through the reconciliation process.  If health reform wasn't finished through reconciliation, it would be a massive shock.

  • It won't have a public option.  The White House, Speaker Pelosi, and key public option supporters in the Senate (Harkin and Rockefeller) have all signaled that the reconciliation bill will not have a public option when it is introduced.  So, the only way to pass a public option at this point is to have one added on the floor of the Senate via amendment to the reconciliation bill.  Such an amendment would require only 51 votes for passage, and could be any type of public option as long as it was germane to the "Byrd rule."  Jon Walker unpacks all of this in more detail, looks into the possibilities of forcing a vote on such an amendment.

  • Counting votes in the House. Given that 59 of the 60 Senators who voted for the health reform bill back in December are still in the Senate, getting 51 votes to pass a health reform bill through the Senate should not be difficult.  Democrats could lose nine votes and still pass the bill-very, very doable.  The real problem is passing a bill through the House, even with the Senate passing a "fix" to their bill.

    Back in November, the bill passed the House by a vote of 220-215.  However, since that time, three Representatives who voted for the bill are no longer in the House, and one who voted against the bill has also left.  That makes the current county 217-214, with 216 needed for passage.

    From that point, the trick is offsetting the Stupak bloc with non-Stupak Democrats who voted against the bill last time. This is possible, but it will be close.  Back in November, Stupak had at least nine Democrats, and Republican Joseph Cao, with him.  However, ten Democrats who voted against the bill last time have signaled they are open to voting for it this time.  Speaker Pelosi is going to need all ten of those to pass the bill over the objections of the Stupak bloc.

The end is coming into focus.  Wednesday is a very big say.
Chris Bowers :: Health reform state of play, 3/1: Endgame emerging

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Not so sure (0.00 / 0)
Obama won't address abortion as a stand alone amendment.  

Not to be a downer (4.00 / 2)
But will this bill require me to purchase insurance I can't afford?

not only that (4.00 / 4)
but I'm not sure if you can call "insurance" the thing you'll be required to purchase

[ Parent ]
BS... (4.00 / 2)
Even the Senate bills' minimum requirements are much better than the junk insurance offered now. Even the GOP admits that... in fact, they want the insurance requirements to be more junky.

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 ]
But where is the enforcement? (4.00 / 4)


Montani semper liberi

[ Parent ]
who needs enforcement? (4.00 / 3)
the insurance companies are so honest sadie. enforcement won't be needed.

[ Parent ]
You are not suppose to ask those kinds of questions. (4.00 / 4)
Trust in the one.  

[ Parent ]
To complete my analogy: You can either take the blue pill or the red pill (4.00 / 1)
But know this, if you take the Red pill I can only offer you the truth. Nothing more. The red pill is a symbol. Of your desire to return to reality. Inside your dream, you'll fall asleep. If  you believe in the one you will take the blue pill.  

[ Parent ]
Those who are too lazy to think ... (0.00 / 0)
engage in stupid analogies based on third rate sci fi novels.

Give it a rest. We're all tired of the juvenile self-absorption.


[ Parent ]
Yes, dc is really complicated and I am lazy for pointing (4.00 / 1)
out the simplicity of narratives there. Thanks.

[ Parent ]
The Matrix is a sci fi film (0.00 / 0)
and it's hardly third rate.

[ Parent ]
In a word, no (4.00 / 1)
No, it won't. If you can't afford insurance through the exchange, you can access subsidies that can, depending on your income level, make it almost free (and if can't even afford that, you can get Medicaid).

My goodness. You'd think after 12 months of this, readers of a progressive blog would at least know what's in the damn bill!


[ Parent ]
Well, Then (4.00 / 3)
those who can't afford it should just be given Medicaid or Medicare, instead of going through the middlemen insurance companies. Why sould taxpayers pick up the tab for the insurance companies? Free, my rear end.
And don't be so quick to put down people who ask questions.

[ Parent ]
Hey, would it be possible to simply allow a Medicare buy-in for the uninsured (0.00 / 0)
without the need for insurance reforms and an individual mandate?

I ask because I'm assuming Medicare would not deny coverage based on preexisting conditions.  I don't know if adverse selection would affect it if it were to start accepting anyone who doesn't have insurance.


[ Parent ]
Ian Welsh (0.00 / 0)

who writes for Open Left, said this in November about the subsidies in the House bill [emphasis added]

Meanwhile the bill itself will force people to buy insurance, provides inadequate subsidies, and falls hardest on the middle class and young people-forcing them to spend a huge chunk of their discretionary income on average, and doubtless pushing many families into bankruptcy (plenty are on the verge, it is impossible to imagine that this won't push them over the edge).

He also said

I can only conclude that both Democratic politicians and many progressive bloggers want to be back in the opposition, since they keep being willing to swallow bad policy.  Policy so bad, in fact, that it seems designed to hurt Democratic electoral prospects.

He was not that impressed with the Senate bill,either.



[ Parent ]
It was an honest question (4.00 / 1)
It's hard to follow what is or isn't in this bill or that bill.  I can only be so much of a wonk -- don't patronize your fellow readers.

[ Parent ]
so I see Nathan Deal (R-GA) is resigning next week (0.00 / 0)
http://tpmmuckraker.talkingpoi...

Was that in your count? A vote is a vote after all.


New Jersey politics at Blue Jersey.


Yes, it looks that way... n/t (0.00 / 0)


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 ]
I wonder why he is resigning so suddenly (0.00 / 0)
I keep on hoping that some in the GOP are suffering pangs of conscience over that party's behavior, and have had enough.

[ Parent ]
TPM thinks (0.00 / 0)
It is an ethics problem.  I don't I recall ever hearing his name before, so I don't know.



New Jersey politics at Blue Jersey.


[ Parent ]
Why "to spend more time with my family," (0.00 / 0)
of course!!!

[ Parent ]
"Wednesday is a very big say." (0.00 / 0)
Did you mean "Wednesday is a very big day"?

re the Public Option (4.00 / 1)
over at The Plum Line, Conrad told Sargent today that he believes the House must act first on not only the Senate bill, but also the sidecar fix:
http://theplumline.whorunsgov....

   Conrad also explained in new detail why he believes that the House must pass the Senate bill first, a view that has been denounced by some critics who want the Senate to pass its fix before the House acts.
   Conrad said that under Congressional rules, for a reconciliation fix to be "scored," it's not necessary that it become law, but it is necessary for it to have passed both houses of Congress before getting fixed. "For the scoring to change it has to have passed Congress, and that means both houses," he said.
   "The only thing that works here is the House has to pass the Senate bill," Conrad continued. "Then the House can initiate a reconciliation measure that would deal with a limited number of issues that score for budget purposes." After that, the Senate would pass the same reconciliation fix, Conrad explained, because even on the fix itself the House must go first because the lower chamber must initiate "revenue bills."

He may simply be blowing smoke. It may be possible for the Senate to initiate the fix by stripping out the entirety of a House "revenue bill" that is one of the 290 languishing in the Senate dead letter office. But... if his view prevails, that means the House would have to pass both the reconciliation bill once, without the P.O., and then again after the P.O. (not to mention any other potential changes) is successfully inserted by the Senate. That seems to me a significantly more perilous path than we've all been speculating about.


I suppose (0.00 / 0)
an optimist could say the House passes the reconciliation bill with the previously passed House public option, then the Senate accepts it. But I agree, it sounds very difficult for the Senate to insert a public option.

 

New Jersey politics at Blue Jersey.


[ Parent ]
I think it's gonna be really hard (0.00 / 0)
unless we generate an overwhelming demand for it.  And I don't know if we can pull that off without the WH's help.  I for one am tired of us having to fight all these battles alone.

[ Parent ]
"It's gonna be hard" (4.00 / 1)
because none of them have back bones," and because they need their little "pay offs" from the corporations.  This includes Obama, and it all makes me physically ill!

[ Parent ]
I actually think it might be (0.00 / 0)
more dangerous for the House to include it and send it to the Senate, because then it's vulnerable to an onslaught of amendments, one of which could be popular enough, like a resurrection of the Trigger, that it could be used to hold the entire reconciliation fix hostage.

[ Parent ]
How will a triggered PO get 51 votes? (0.00 / 0)
A relative handful of Senators have come out for it: Tom Carper, Olympia Snowe, maybe a few others.

[ Parent ]
in the scenario I'm talking about (0.00 / 0)
where the House initiates the fix and includes a P.O., enough ConservaDem Senators could oppose it, and attempt to substitute a Trigger via amendment. They could withhold their support for the entire fix, unless their amendment was adopted.

[ Parent ]
How many ConservaDems are needed for that? (0.00 / 0)
Because we can lose 9 votes and still pass it.  The usual suspects - Ben Nelson, Lincoln, Lieberman and Landrieu - will vote against it for sure.  That leaves 5 more slots.  Which 6 other Senators would vote against it and kill it?

Or, we can set up a counterBlock that will deny the votes for some ConservaDem BS unless they agree to this. (Unlikely to happen though, considering that no liberal Senator even voted against the Senate bill on final passage)

I say we try it and see what happens.


[ Parent ]
Correction (0.00 / 0)
You can't be a "key public option supporter in the Senate" and speak out against it at the same time.  

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