Yesterday, President Obama signed health care reform into law. As Mike Lillis explains in the Washington Independent, the bill now proceeds to the Senate for reconciliation. The whole process could be complete by the end of the week. Republicans and their allies have already moved to challenge reform in court.
Legal challenges
The fight is far from over, however. Steve Benen of the Washington Monthly notes that Republicans have already filed papers to challenge health care reform in court. The Justice Department has pledged to vigorously defend health care reform, according to Zach Roth of TPM Muckraker.
The legal arguments against health care reform center around the constitutionality of an individual mandate, i.e., the requirement that everyone must carry health insurance. This argument is specious. The bill characterizes the mandatory payments as a tax, and imposes a fine for those who don't pay their insurance tax. There is no question that Congress has the authority to levy taxes in support of the general welfare and providing health insurance to the people easily meets that legal criterion.
Dave Weigel of the Washington Independent reviews some of the other formidable legal barriers to challenging health care reform in court. But take heart, teabaggers! Birther-dentist-lawyer Orly Taitz is on the case.
Violent outbursts from reform opponents
Some anti-reform activists have resorted to intimidation. Five Democratic offices were vandalized in the days surrounding the House vote, as Justin Elliott reports for TPM Muckraker. Someone hurled a brick through the window of the Niagara office of Rep. Louise Slaughter (D-NY), the chair of the powerful House Rules Committee.
Slaughter is notorious on the right for drawing up the controversial "deem and pass" strategy for moving the bill forward. Her plan was never put into action, but she has become a target anyway. Another Democratic office in Slaughter's district was damaged by a brick bearing a quote from conservative icon Barry Goldwater: "Extremism in defense of liberty is no vice."
Elliott notes that a conservative blogger in Alabama is doing his best to incite similar attacks, though it's not clear whether he instigated any of the original five:
...Blogger Mike Vanderboegh has been tracking the breaking of windows at Dem offices after issuing a call Friday: "To all modern Sons of Liberty: THIS is your time. Break their windows. Break them NOW."
Reproductive rights take a hit
Anti-abortion extremist Rep. Bart Stupak (D-MI) failed to get his ultra-restrictive abortion language inserted into the health care bill, but the final bill does impede health insurance coverage for abortion.
For example, those who choose abortion coverage will have to write two checks: One for their regular premium and one for a dollar to go into a separate abortion coverage fund. Many analysts fear that the extra hassles will discourage private insurers from covering abortion at all. Pro-choice activists were in a weaker negotiating position because, unlike Stupak and his allies, they weren't prepared to kill health reform if their demands weren't met.
The greater good?
Now that health care reform is safely signed into law, the pro-choice movement is stepping back and asking itself some tough questions.
In The Nation, Katha Pollitt argues that the pro-choice movement deserves to be rewarded for sacrificing its own agenda for the greater good. She suggests that the Democrats could reward the reproductive rights movement by fully funding the Violence Against Women Act, addressing maternal mortality and other policy changes to advance women's health and freedom.
Jos of Feministing counters that with their go along to get along attitude pro-choice groups have only demonstrated that they can be ignored with impunity: "You don't get rewarded for demonstrating a lack of political power, you get further marginalized."
At RH Reality Check, Megan Carpentier argues that national pro-choice organization like NARAL and Planned Parenthood ceded their leverage too easily. While anti-choicers were beefing up their lobbying presence in Washington, major pro-choice groups were scaling back. Pro-choice groups compromised early and easily, perhaps because they were overly confident that their service to the Democratic cause would be rewarded in the end.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.
OK... while many are watching the NCAA Basketball games, I'll be watching the big sports action of the weekend: The Health Care bill in the House of Representatives.
CSPAN is showing BOTH the debates in the House and the Reconciliation Bill debate in the House Rules Committee (on CSPAN 2). The major players will all be out there, making the points or stalling to try and get the bill bogged down. Whatever happens today will determine what gets voted on tomorrow.
Weekly Pulse: Pelosi Makes Her Move; GOP Rep. Calls for Coup
By Lindsay Beyerstein, Media Consortium blogger
Speaker Nancy Pelosi (D-CA) has laid out a strategy to pass health care reform in the next couple of days by allowing the House to vote on the details of the reconciliation package instead of the Senate bill itself. As usual, progressives are fretting that winning will make them look bad. On the other hand, conservatives are baying for blood and calling for revolution.
'Deem and pass'
Nick Baumann of Mother Jones discusses the parliamentary tactic known as "deem and pass" (D&P), which House Democrats plan to use to avoid voting for the Senate bill before the Senate fixes the bill through reconciliation. The House doesn't want to sign a blank check. If the health care bill passes the House first, there's no guarantee that the Senate will make the fixes as promised.
Originally, the hope was that the Senate could do reconciliation first. The problem is that you can't pass a bill to amend a bill that isn't law yet. That would be like putting the cart before the horse. To clear that hurdle, the House will invoke a rule that deems that Senate bill to have passed if and when the House passes the reconciliation package. It's sort of like backdating a check. Ryan Grim explains the process in more detail on Democracy Now!
D&P does not equal treason
Progressives like Kevin Drum worry that D&P will make the Democrats look bad. Meanwhile, the Tea Party crowd is calling for Nancy Pelosi to be tried for treason, as TPM reports. The bottom line is that D&P is no big deal. Republicans used the process 36 times in 2005 and 2006; Democrats used it 49 times in 2007 and 2008. D&P is constitutional. We know because it has already been upheld by the Supreme Court. Kevin Drum writes, "If you have a life, you don't care about the subject of this post and have never heard of it."
Teabag revolution
There is no joy in Tea Party Land, as Dave Weigel reports in the Washington Independent. The tea baggers are frantically lobbying to stop the bill, but the reality is starting to sink in. Their leaders are shifting from trying to kill the bill to planning the tantrum they're going to throw when it passes:
While many held out hope that plans to pass the Senate's version of reform in the House would stall out, others pondered their next steps. Some, like Rep. Steve King (R-IA), took a dark view of what might come.
"Right now, they're civil, because they think they have a chance of stopping this bill," said King to reporters, waving his arm at a pack of "People's Surge" activists forming a line to enter the Cannon House Office Building. "The reason we don't have violence in this country like they do in dictatorships is because we have votes, and our leaders listen to their constituents. Now we're in a situation where the leaders are defying the people!" Later, King would expand on those remarks and speculate on a possible anti-Washington revolt in which Tea Parties would "fill the streets" of the capital.
Sounds like King is calling for a revolution, doesn't it? As it turns out, that's exactly what he says he wants if health care reform passes. Eric Kleefeld of TPMDC reports that King is hoping for something akin to the uprising that overthrew the Communists in Prague in 1989. "Fill this city up, fill this city, jam this place full so that they can't get in, they can't get out and they will have to capitulate to the will of the American people," King said in an interview with the Huffington Post.
Women and health care reform
Health care reform seems poised to pass. Amid the heady excitement, there's a sense of gloom in the reproductive rights community. Bart Stupak was defeated, but health care reform will probably end private insurance coverage for abortion.
In The American Prospect, Michelle Goldberg urges feminists to support reform anyway. She argues that the women suffer disproportionately under the status quo. If reform passes, it will insure 17 million previously uninsured women. Expanding health care coverage might help reverse rising maternal mortality rates in the United States.
A recent report by Amnesty International found that at least two women die in childbirth every day in the U.S., a much higher rate than most developed countries. The anti-choicers had the advantage because they were willing to kill health reform over abortion. The pro-choice faction did not allow itself the luxury of nihilism.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.
Beyond the sheerly political mush of Health Care 09/10, there's the mush on the Congressional rules which govern the legislation. And, natch, both mushes get mushed together.
You can understand that our friends on the Hill may simply view this as a necessary condition of warfare: drawing bright lines can only help the Enemy, etc.
They might, in turn, understand (but probably don't give a damn) that outsiders doubt (based, in my case, on 5+ years of observation) that the insiders (on our side, at least) have a proper grasp of the rules.
This is of particular concern on health care, where we have a perfect storm brewing: a vital bill for the Dems, intertia in Congress, a tricky (not to say, tricksy) weapon to be wielded to unblock the bill's passage, dire consequences of failure.
This is a situation which the current leadership have sedulously avoided in those 5+ years; they have taken the view (with great justice!) that their troops aren't up to pulling off that kind of coordinated series of precision shenanigans.
Now, they're committed.
Let's take a couple of points on the rules governing reconciliation:
First, is the motion to proceed to the motion to appoint conferees debatable (and hence subject to filibuster)?
The Congressional Budget Act doesn't deal with the point, that I can see; The Hill says
The parliamentarian has ruled that the limit on debate does not allow senators to filibuster the motion to proceed to a reconciliation bill.
I haven't nailed it down; butRiddick'ssays that it's a general rule that the motion to proceed conference reports is nondebatable, and passes on a simple majority (p472)!
Second: during Senate floor proceedings on a reconciliation bill, can amendments be ruled out of order as being dilatory?
Apparently, the GOP Alamo is to mass-produce amendments to prolong the vote-a-rama till the Last Trump. There is provision in the rules to rule non-germane amendments out of order, but no similar provision for dilatory amendments.
Of course, the cloture rule covers dilatory amendments - but (for reasons that escape me) not the rules relating to reconciliation.
Now, as we know, Generalissimo Joe can rule which ever way he chooses on points of order, and, if, on appeal, a simple majority of the Senate backs him up, that settles the issue. If Biden pulls a dilatory amendment rule from his ass, that's fine.
The appeal is (so far as I can see) debatable; but the time taken comes out of the 20 hours. However, given the volume of GOP amendments to be expected, what happens when the 20 hours has run out? Can Biden just rule all the remaining GOP amendments out of order as dilatory (or non-germane), with no possibility of appeal, because the 20 hours has expired? Or is he even allowed to rule on amendments - again, because time has run out?
Senator Mark Begich is open to using reconciliation for health reform. From a letter to a constituent:
Thank you for contacting me regarding health care reform.
The reconciliation process is a budgetary tool used to address spending and deficit issues with a simple majority vote. The budget reconciliation process has been used 22 times by both parties since 1980. Action to clean up the health reform bill will further reduce the deficit.
Comprehensive health care reform has already passed the Senate with 60 votes. If the House passes the Senate bill, the President could sign that version of comprehensive reform into law. I believe reconciliation would only be used as a tool to take out special backroom deals and to eliminate concerns raised by many Alaskans I've talked with. The President has proposed narrow changes which I support, including completely closing the coverage gap for seniors' prescription drugs, eliminating the special Nebraska funding provision, providing additional federal financing to all states to help pay for the expansion of Medicaid, and strengthening the Medicare waste, fraud, and abuse provisions.
Again, thank you for contacting me. As the 111th Congress moves forward, please continue to be in touch with your thoughts and concerns.
Via lord_mike in quick hits, Senator Robert Byrd is open to using budget reconciliation to fix the Senate health reform bill. Byrd's staff writes into a local West Virginia newspaper:
I believed then, as now, that the Senate should debate the health reform bill under regular rules, which it did. The result of that debate was the passing of a comprehensive health care reform bill in the Senate by a 60-vote supermajority.
I continue to support the budget reconciliation process for deficit reduction. The entire Senate- or House- passed health care bill could not and would not pass muster under the current reconciliation rules, which were established under my watch.
Yet a bill structured to reduce deficits by, for example, finding savings in Medicare or lowering health care costs, may be consistent with the Budget Act, and appropriately considered under reconciliation.
This is the end of the reconciliation whip count. If Robert Byrd is OK with a reconciliation fix, then there is no longer any doubt the Senate has the votes for a reconciliation fix.
How meaningful is Byrd's support? In 2009, Byrd switched his vote on the federal budget from "yea" on April 2nd, to "nay" on April 29th, entirely because the April 29th version of the budget left open the possibility of using reconciliation for health care (the April 2nd budget did not). From Byrd's statement at the time:
"I like this budget. I support many of the policies that the President's budget embraces - including middle-class tax relief, and badly needed investments in our nation's infrastructure - but I cannot, and I will not, vote to authorize the use of the reconciliation process to expedite passage of health care reform legislation or any other legislative proposal that ought to be debated at length by this body."
"Using reconciliation to ram through complicated, far-reaching legislation is an abuse of the budget process. The writers of the Budget Act, and I am one, never intended for its reconciliation's expedited procedures to be used this way. These procedures were narrowly tailored for deficit reduction. They were never intended to be used to pass tax cuts, or to create new Federal regimes. Additionally, reconciliation measures must comply with Section 313 of the Budget Act, known as the Byrd Rule, which means that whatever health legislation is reported from the Finance Committee or legislation from any other Committee that is shoe-horned into reconciliation will sunset after five years. Additionally, numerous other non-budgetary provisions of any such legislation will have to be omitted under reconciliation. This is a very messy way to achieve a goal like health care reform, and one that will make crafting the legislation more difficult."
If Byrd is now open to a reconciliation fix after writing that last year, then the Senate will do a reconciliation fix.
With all due respect, the Daily Mail's hyperbole about "imposing government control," acts of "disrespect to the American people" and "corruption" of Senate procedures resembles more the barkings from the nether regions of Glennbeckistan than the "sober and second thought" of one of West Virginia's oldest and most respected daily newspapers.
As Natasha said to me this morning, "let's never take a trip to the nether regions of Glennbeckistan." [Homer Simpson revulsion noise]
By contrast, 44 Democratic Senators have stated, without any countermanding statements, that they are open to reconciliation. You can see the list here. I am including both "yes" and "maybe" Senators for question #1 on that chart, since anyone who is a maybe has at least left the door open.
Further, a look at the 14 members of the Democratic Senate caucus who have yet to make a public statement on reconciliation shows that it should be easy to round up the remaining seven votes to use the procedure. Here are the 15:
Mark Begich (AK)--freshman
Mark Udall (CO)--freshman
Chris Dodd (CT)
Ted Kaufman (DE)--freshman
Bill Nelson (FL)
Daniel Akaka (HI)
Jon Tester (MT)--freshman
Kay Hagan (NC)--freshman
Byron Dorgan (ND)
Ron Wyden (OR)
Mark Warner (VA)--freshman
Jim Webb (VA)--freshman
Patty Murray (WA)
Robert Byrd (WV)
Among this list, only Bill Nelson and Robert Byrd pose serious threats against the use of reconciliation. The rest are either all freshman (who aren't going to block major legislation), and / or they are reliably liberal votes. It should be pretty easy to round up another seven from this list.
While it is still worthwhile to get 50 Senators on record as not just open to, but favoring, reconciliation, the outcome of the Senate reconciliation whip count seems like a foregone conclusion. The Senate has the votes to use reconciliation. Now, the question is what will actually be in that reconciliation bill.
There's a definite head of steam (no small thanks to Chris) behind passing the healthcare sidecar bill via reconciliation.
And the political will to do the thing is, naturally, a sine qua non to it happening.
However, in tandem with the lobbying process, it's as well to consider the difficulties - an interreacting mix of the procedural and the political - in getting it done.
For starters, it's the sort of complex series of shenanigans which we've never seen Harry attempt, never mind see through to success. It requires not only will on behalf of both party and leadership, but coordinated technical expertise wielded skillfully on the floor and off.
I can't remember the last time anything so complicated was brought off: I'd say it would every bit as complex as Johnson passing the 1957 Civil Rights Bill.
On the other side - the GOP are bound to look on the very use of reconciliation as legitimising massive resistance (to coin a phrase).
I'm pretty sure that the Interests would be happy to see the Senate bill enacted; and the GOP took care (by going along with unanimous consent agreements) not to get in the way of it passing the Senate.
But the Interests would recognize that the Dems going for reconciliation would be a partisan challenge that the GOP could not pass up: it fits to a T their metanarrative of holding the Alamo against the Washington Establishment (to mix a metaphor or two).
Whatever opportunities to cause mischief will be taken; pressure on must-pass and marquee legislation (reduced floor time this pre-election session) will be maximized; the Dem leadership's will and expertise will be tested at every turn.
Fox and friends will be crying coup d'état - or some English equivalent. The flabbiest WH spokesmen will be invited on cable to defend the process, with a view to driving wedges within the WH and between the WH and the Senate. (Sebelius, for instance - pretty flabby on Maddow, for instance.) The vacillation of the WH on health care in general and the public option in particular suggests it could get ugly pretty soon.
Then, there are the rules. I'd be fairly certain that getting the sidecar within the boundaries of the Byrd Rule is going to be tricky - certainly, every element in the sidecar needs the most careful consideration from the Byrd viewpoint.
The Parliamentarian will be helpful in giving Harry and Co help in threading the needle - but the chance that he will balk at some key provision must be significant. And that provision is probably the quo for some quid elsewhere in the bill.
Practice is that the chair, whose responsibility it is to rule on compliance with the Byrd Rule, abides by the Parliamentarian's decision in every case. But the law (§904(d) of the Congressional Budget Act) says that it's the chair's decision.
Are the Dems prepared to have the chair go against the Parliamentarian if necessary? If not, best not start the whole thing.
(It takes 60 votes to overturn the chair's ruling, by the way.)
How likely is that Dem senators will get cold feet in the face of such an exercise of raw power?
Meanwhile, the GOP will be looking for every opportunity to filibuster - every motion to proceed, for instance.
And, if the bill escapes the Byrd Rule trap, there'll be dozens (hundreds?) of amendments in the vote-a-rama.
(Unlike cloture, every unvoted amendment gets its vote, thus potentially extending the floor debate indefinitely.)
All during this process, GOP morale will be sky-high. And, natch, they'll be getting the teabaggers doing their thing at maximum decibels.
In common with the massed ranks of the lefty sphere, I'd love to see the Senate Dems finally throw down, after years of whining and cringing. But they'd better make sure they're in shape for the long battle ahead.
JTA...
What's with the pre-summit WH bill? Supposedly, Congressional Dems haven't seen it - doesn't mean they don't know what's in it, of course - or agreed it.
Is it a sidecar bill, or does it start from scratch (the GOP proposal, of course!)? Looks like the latter, from the piece, quoting Sebelius. Talking points for the summit? (Easy to get the discussion bogged down in drafting - perhaps that's the purpose.)
Why the WH should roll out a bill at this stage (presumably WH staff have been working on a text for ages), I'm not sure.
Plus - I'm not sure how they set up the bill as a reconciliation measure (this question applies to the sidecar as well).
You will be shocked, shocked to hear that a Blue Dog Democrat who made a career out of undermining his own party is sucker-punching them on his way out. Sen. Evan Bayh of Indiana abruptly announced this week that he would not seek reelection in November. Bayh's departure is ratcheting up insecurity in the Democratic caucus at the very moment they need to take decisive action to pass health care reform.
Bayh could easily have won a third term, but it's unclear whether any other Democrat can hold the seat. To add insult to injury, Bayh waited until 24 hours before the filing deadline for Democratic primary candidates, sending Indiana Dems scrambling to find a candidate to run in his place. Bayh's tardiness was calculated. Since no Democrats were ready to file by the deadline, the Indiana Democratic establishment will get to handpick Bayh's successor.
In a call with state Democratic officials, Bayh said his abrupt departure is for the best, as Evan McMorris-Santo reports for TPMDC. According to Bayh, he's doing the party a favor by sparing them a contentious primary process. Thanks a lot.
What does this mean for health care reform?
What does Bayh's departure portend for health care reform? Monica Potts of TAPPED argues that replacing a conservative Democrat like Bayh with a moderate Republican won't make that much difference. Bayh was never a reliable Democratic vote.
But Tim Fernholtz of TAPPED dismisses this view as naive. Fernholtz predicts that, for all of Bayh's faults, the senate will be much worse without him: "In essence, the difference between this insubstantial Hoosier and, say, GOP hopeful Dan Coats, is simple: You can buy off Bayh." Bayh voted for health care reform and the stimulus, no Republican, no matter how "moderate" is going to vote that way.
Anyone who expects a moderate Republican from Indiana to support any part of the Democratic agenda is deluded. On the other hand, the Senate Democrats already passed their bill, their only remaining task would be to pass a "fix" through budget reconciliation to make changes in the legislation that would be acceptable to the House. Of course, reconciliation will be a bitter political fight. One wonders whether the demoralized Senate Democrats will have the stomach for it.
About that health care summit...
Note that congressional Republicans have yet to commit to attending the "bipartisan" health care summit that they called for. Christina Bellatoni of TPMDC reports that yesterday White House Press Secretary Robert Gibbs wondered why the Republicans were for the summit before they were against it:
"Right before the president issued the invitation, the-the thing that each of these individuals was hoping for most was an opportunity to sit down on television and discuss and engage on these issues. Now, not accepting an invitation to do what they'd asked the president to do, if they decide not to, I'll let them leap the-leap the chasm there and try to explain why they're now opposed to what they said they wanted most to do," Gibbs said.
Busting the filibuster
On the bright side, the Democrats still have a sizable majority in the Senate, with or without Bayh. Republicans would have to beat all 10 vulnerable Democratic incumbent senators in the next election in order to regain control of the Senate. The more immediate threat to health care reform and the Democrats' ability to govern in general is the institutional filibuster. Structural reform is needed to break the impasse. Lawyer and author Tom Geoghegan talks with Amy Goodman on Democracy Now! on strategies for busting the filibuster.
Public option resurfacing
Mike Lillis of the Washington Independent reports that four senate Democrats have thrown their lot in with progressives clamoring for a public option through reconciliation. Sens. Sherrod Brown (OH), Jeff Merkley (OR), Kirsten Gillibrand (NY) and Michael Bennet (CO) argue for the public option in an open letter to Majority Leader Harry Reid. The letter reads:
There are four fundamental reasons why we support this approach - its potential for billions of dollars in cost savings; the growing need to increase competition and lower costs for the consumer; the history of using reconciliation for significant pieces of health care legislation; and the continued public support for a public option....
Big pharma's lobby
That's nice, but let's not forget who's really in charge. In AlterNet, Paul Blumenthal recaps the sorry history of collusion between the White House, the pharmaceutical lobby group PhRMA, and the Senate. According to Blumenthal the White House steered pharmaceutical lobbyists directly to Sen. Max Baucus (D-MT), chair of the powerful Finance Committee, who was entrusted with crafting the White House's favored version of health care reform.
Abortion and health care reform
As if we didn't have enough to worry about, Nick Baumann of Mother Jones notes that the National Right to Life Committee (NRLC) is making abortion is an obstacle to passing health care reform through reconciliation. The NRLC is insinuating that Bart Stupak (D-MI) and his coalition of anti-choice Democrats will vote against the Senate health care bill because it it's slightly less restrictive of abortion than the bill the House passed. The good news is that it's procedurally impossible to insert Stupak's language into the Senate bill through reconciliation. The bad news is that Speaker Nancy Pelosi (D-CA) needs every vote she can get to pass the Senate bill and anti-choice hardliners could be an obstacle.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.
President Barack Obama's February 25 health care summit, where he will appear on TV with Republican leaders, has been hailed and assailed as yet another gesture towards bipartisanship. But the summit is really a delaying tactic. It's a decoy, something shiny to keep the chattering classes entertained while Congressional Democrats wheel and deal furiously behind the scenes.
At this point, there are two ways forward, and neither of them require Republican support. The first option is for the House to pass the Senate health care bill as written-but with the understanding that the Senate will later fix certain contentious parts of the bill through reconciliation. The second option is for the Senate to pass the reconciliation fix first and the House to pass the bill later.
Someone has to go first
Art Levine of Working In These Times diagnoses a severe case of paralysis on the left: Nancy Pelosi is willing to entertain the first option, but labor leaders like Rich Trumka, President of the AFL-CIO, want the Senate to go first because they don't trust the Senate to fix the bill later. Nobody wants to go first, but somebody has to. If neither the House nor the Senate takes the initiative, reform will fail by default and Americans will continue to suffer.
If the Democrats are going to attempt reconciliation, they need a plan to steer the legislation through the Senate. While everyone else is talking about the summit, procedural experts are probably huddling with leadership, nailing down the details.
Obama's 'Waterloo'
Everyone knows that Obama isn't going to pick up any Republican votes, summit or no summit. The House bill got 1 Republican vote, the Senate bill got 0. Quite simply, Republicans want health care reform to fail. No Republican president since Richard Nixon has attempted comprehensive health care reform. In opposition, Republicans have been intractably opposed reform because they're afraid the Democrats will take credit for it. Sen. Jim DeMint (R-SC) famously said he wanted "break" Obama by making health reform the president's "Waterloo."
Health care reform in the media
Meanwhile, as Monica Potts notes in TAPPED, the media seems to be bending over backwards to treat the Republican's pro forma suggestions as serious proposals for reform, even though the Congressional Budget Office has already analyzed the plan and determined that it will leave millions uninsured without lowering costs. The health care bills as written are already chock full of Republican proposals, like eliminating the public option, easing restrictions on buying insurance across state lines, allowing people to band together in insurance-purchasing coops.
Kevin Drum of Mother Jones worries that the upcoming summit will just give the Republicans more free airtime to spread falsehoods about "government controlled health care."
Voices of the uninsured
This week, The Nation is publishing the stories of some of the millions of uninsured and underinsured Americans: An uninsured woman who was diagnosed with throat cancer last month; a father with a severely disabled son who is about to hit is $5 million lifetime insurance benefit cap; a single mom on the verge of medical bankruptcy; and many others.
In other news
Dr. Gabor Maté, the official physician of Canada's only supervised drug injection site, talks about the science of addiction and his new book with Amy Goodman of Democracy Now!.
Todd A. Heywood reports in the Michigan Messenger that American Family Association of Michigan is doubling down in the dying days of Don't Ask Don't Tell. Not only do they want to ban gays from the military, they want to re-criminalize homosexuality.
This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.
There's a lot of buzz now about pushing a Health Care Reform strategy that commences with the House passing the Senate HCR Bill as is, followed by another bill to improve and strengthen it crafted to pass the Senate via the reconciliation process. That makes a lot of sense. In fact it has always made a lot of sense to break HCR into two component pieces of legislation; one for reforms that reconciliation can't address but that could pass the Senate with the 60 votes needed for cloture, one passed by the reconciliation route with reforms that qualify for that path that can only muster a simple majority in the Senate for passage.
Because it makes so much sense and always has, it virtually begs the question, why is this only being seriously considered now? Why, had Coakley won in Massachusetts and Democrats thus retained their 60 member caucus in the Senate, were House negotiators about to be forced to accept a final piece of legislation that was 90 parts Senate version, and only 10 parts House?
The House could just pass the Senate health care bill, and President Obama could sign it into law. Problem is, the House doesn't have 218 votes unless there is a promise to pass a cleanup fix to the Senate bill through the reconciliation process.
Part of the negotiations center on whether Reid can provide an ironclad guarantee that the Senate will not leave the House in the lurch, aides said. If the House agrees to pass the Senate bill with a companion measure - or a "cleanup" bill - to make fixes, they want to know that the Senate will indeed pass it, too.
There was some talk among Senate leadership on Thursday of putting together a letter signed by 51 Democratic senators pledging to pass a cleanup bill if the House would pass the Senate bill. But that effort fizzled when support for it didn't materialize, insiders said.
"The Senate moderates' viewpoint is, 'We passed our bill. We're not going to spend three weeks on some other bill,'" said a Democratic lobbyist who represents clients pushing for reform.
Large numbers of House think this response is unacceptable. They believe the Senate has acted on so few bills that the House has passed--jobs bill, climate bill, financial regulations, student loans, etc. As such, they feel it is very wrong for the Senate to demand that the House pass one of the few bills they did act on verbatim.
So, that is the current impasse on health care. The House might be able to pass the Senate bill with a promise of a reconciliation fix, but the Senate doesn't want to pass the reconciliation fix.
So, who are the Senators that oppose reconciliation at this point? Figuring that out, and making them change their minds, might be the best path forward on health care at this point.
I spoke to someone from Feingold's campaign about his position on reconciliation in light of the Massachusetts special election. She informed me that while Sen. Feingold is no fan of reconciliation, now that it's reconciliation or nothing (apparently), he would be willing to support reconciliation if that's what it took to get a good bill passed. It wasn't the slightest bit equivocal or hedgy; it was a straight "yes". So that's a bit of good news. Hopefully the House can get their act together.
Could the Massachusetts special election actually make things better for progressives? That would be very surprising, but it isn't out of the question.
Democrats have an absolutely clear path to passing a strong health care reform bill quickly that will re-establish their image for being able to deliver real change, begin to rebuild their bond with their base, and allow them to move on to dealing with jobs and the economy. To fail to take this path will lead to a worse meltdown and beat-down than the 1994 or 1980 elections. What they have to do is buck up their courage, stop acting out, and get the deal done.
The path, which has been suggested by many other people as well as me, is to simply pass the full Senate bill, and then immediately pass a clean-up bill through the reconciliation process, which requires only 51 votes in the Senate. The clean-up bill could include the provisions that progressives in the House and Senate, as well as wide majorities of the American people, have been demanding: the compromise on the benefits tax issue, more affordability for low and moderate income folks, ending insurers' exemption from anti-trust laws, a national insurance exchange instead of the weaker fragmented state run exchanges, and yes, some form of that public option that voters and activists keep saying we want. Doing this kind of double bill approach would allow all the good insurance regulations and other provisions in both the Senate and House versions of the bill that can't be passed through the reconciliation process because of Senate rules to still get done, while making the bill far more politically popular with voters and healing the rifts caused with the base because of all the bad compromises forced by Lieberman and other Democratic conservatives in the Senate.
If the Democrats turn from this path and give up on comprehensive reform after spending the last year working on it and coming so close, it would be one of the greatest tragedies in American history, a historic failure of nerve so unforgivable that I think it might literally break the party in two. If after spending a year on this, and putting Democrats' votes on the board in both houses in favor of it, they walk away and get nothing, they would be seen as utterly incompetent by swing and base voters alike. And don't think that going back to the drawing board and trying to get a scaled back bill that "everyone is in favor of" gets anything done. Having been successful by being the party of no, what exactly is it that the Republicans- any of them- would agree to? Olympia Snowe got every single thing she asked for in the Senate bill after delaying the bill for six months, and she still voted no. What makes anyone think she or any other Republican would vote yes for anything in an election year when it's working so well for the Republicans to say no to everything? And how long would it take to work out a deal with Republicans when we tried for a year and not one of them agreed to anything? While I'm asking questions, let me ask another: exactly which voters do Democrats think we pick up by walking away from health care reform after a year of work and already recorded votes on it in both houses? Certainly not the desperately disappointed base. Do Democrats think swing voters will reward them for spending a year on something, and then giving up on it and getting nothing? Swing voters are wanting results and real change. How does delivering nothing changing nothing on the main thing they have worked on the last year help them with those voters?
Okay, enough of asking rhetorical questions. As President Obama likes to put it: let me be clear. Democrats need to calm down, pull themselves together, and pass the Senate bill and then a parallel bill to clean up the problems in the Senate bill. Progressive leaders like Raul Grijalva need to stop making threats, join hands with their Democratic brethren, and just get this done. Conservative Democrats had their way in the Senate, but now they need to stop complaining and telling Democrats they should give up on passing anything, and get with the program. The President needs to settle down and stop having a failure of nerves, and sending negative signals to Congress. It is time to take the path available to us on health care, do what we should have done four months and get it over with, and move on to jobs, banks, energy, and immigration. By actually delivering on the change we promised, by actually taking on the special interests we said we would and solving problems, Democrats can rebound from this bleak moment and do fine in the next election. All it takes is a little bit of courage and common sense to take the path in front of them.
In my first piece on returning to the fold towards the end of September, I suggested on general political grounds that using reconciliation to pass health care legislation was a non-starter.
By that stage, there had been gigs of blog discussion attempting to dissect the impact of the Byrd Rule and precise weight of the Senate Parliamentarian's rulings which, tempting though it was to get stuck into, were utterly mooted by cruder political realities.
However, as we all contemplate the possibility that another floor show in the House, this time to deal with HR 3590 fresh from the Senate, will demonstrate that a conference report is likely to fail in the Senate, reconciliation is once more rearing its head.
Nate Silver's piece from yesterday goes in some detail through the various difficulties.
I'm loathe to spend time analysing his stuff right now, given that I am still convinced on the grounds I identified in September that reconciliation won't be tried.
I find myself gripped in a bitter argument- with myself- about the fate of health care reform. It's sort of like watching the schizophrenic Gollum in the Lord Of The Rings saga fight angrily with himself over how to deal with Frodo: "the master is so nice to me, he takes care of me and wants to help me" vs. "I will strangle him, I will crush his head against the rocks, I will feed him to the giant spider". In my case, the raging fight with myself goes more like "But there are so many nice things in this bill, I really like a lot of it, and I've wanted this bill for such a long time" vs. "those evil insurers are screwing us again, I want to kill this bill, crush it against the rocks".
Okay, now that I've officially admitted that the health care fight has driven me crazy, let me take a step back and look a bit more coolly at this whole dynamic, and how we turn this chickensxxt into chicken salad. Here are some thoughts as we move forward:
1. I think everyone in this battle needs to be honest with themselves about the negative consequences of all the paths forward. I hate to make this analogy, but this is feeling a little too much like Afghanistan to me right now, in that all of the choices have big downsides, and we each have to pick the choice we think has the smallest. Passing a bill with no public option will demoralize the Democratic base, tick off millions of Americans forced to buy insurance without the choice of that public option so many wanted, make the 2010 elections very problematic, embolden the big business special interests on the next big issues Democrats face, and create little downward pressure on insurance rates which will probably mean rising health care costs for the next several years. Going to reconciliation means serious delays as we wait for bills to be split apart, parliamentary rulings with a great deal of uncertainty to them, more negotiating over how to remake the bills and get the voters, further delaying tactics by the Republicans, more filibusters of the part of the part of the bill that can't go into reconciliation, less time for climate change and jobs and immigration reform, and the likely loss of important parts of the current legislative package. Killing the bill entirely means we lose all the good regulations and expansions of coverage in this legislation, create a devastating political loss for the President and Democrats in general, lose the chance to finally enshrine in America the idea that health care is a right not a privilege, lose momentum for future legislative fights, and quite possibly the blow the last chance in a generation to get anything big done in terms of health care. Whatever people are saying in public as they position themselves for the final days of battle, I hope they aren't fooling themselves that any of these paths is trouble free.
2. The details still matter enormously. Right now, way too many of the details favor the insurance industry. Assuming this goes to conference committee, we shouldn't just be focusing on the big things that have gotten all the attention, like the public option: progressives in the House should be fighting like tigers for the less visible but incredibly important things like improving the language on community rating, insuring people earlier, and taking more of the burden for paying for Medicaid off of the states. Some of those details may be a lot easier to improve than the high profile items.
3. One of the things progressives should absolutely extract before they even consider voting for this is a promise from Obama, Pelosi, and Reid that health care is revisited again, through reconciliation and in general, to keep improving the legislation as long as the Dems are in control. This should absolutely not be one of those deals where leadership says, "okay that was hard, we'll never go back to that issue again". Progressives should also demand a firm promise from Obama that the primary person doing the implementation of this bill in HHS should be a strong progressive, because the initial regs on this bill will be hugely important.
4. One final thought here: two of the progressive leaders I respect most on our current political scene are Howard Dean and Sherrod Brown, and the fact that they have taken diametrically opposite positions on the legislative tactics regarding whether to move the bill forward doesn't bother or surprise me in the least. This is a hugely complicated issue, and I think the good and the bad in this bill make it a close call, as do the specifics on legislative tactics. Progressives should not be attacking each other over the different calls we are all trying to make.
This has all become a mess, both policy wise and even more politically. Progressives have become divided among ourselves over how best to navigate the incredibly rocky shoals in front of us, but we should keep talking with each other and pivoting off each other as we try to improve this bill.
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