Healthcare Reform’s Days Are Numbered

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By now, I am sure most of you are aware of the bipartisan summit President Obama hosted recently. This week, we saw the President finally outline his plan for the next steps in healthcare reform. It is pretty much obvious now: passing healthcare reform through the process known as reconciliation is inevitable. For those of you who are unaware, reconciliation is the process where legislation can be passed in the Senate with only 51 votes instead of the 60-vote supermajority that has become almost a requirement today. While it is reserved for items dealing specifically with the budget or spending, apparently part of the healthcare bill is eligible. Of course, even doing that is easier said than done.

According to the New York Times, the plan is to have the House pass the Senate’s bill, Cornhusker Kickback and all, and then approve the package of amendments that President Obama and Congressional leaders have been working on through reconciliation to avoid the mess of the filibuster in the Senate. While that plan will work, and indeed most of the additions to the nation’s healthcare system such as the COBRA benefits and the Children’s Health Insurance Program have been passed this way, many people do not like the Senate’s version, both in and out of Congress. Did I mention the Cornhusker Kickback? That is in fact the least of the concerns with the Senate bill.

Part of the package of changes that Congressional leaders and President Obama want to see added to the bill would remove the Stupak Amendment, which would prohibit Federal funding of abortions. Naturally, Rep. Stupak is making all kinds of noise about the House losing the forty votes the amendment brought if this change does happen. However, the Huffington Post reports that the amendment is unnecessary in the first place, as nothing in the bill allows for direct Federal funding of abortions.  Now the question is, will this make Representative Stupak and the other anti-abortion Democrats change their minds?  Possibly, but I think they’ll be just as stubborn as the Republicans are in their opposition to healthcare reform.  If Rep. Bart Stupak is like just about any other member of Congress I have noticed in the news, he will try his hardest to keep his language in the bill, just to prove a point.  Further, there is the old “money is fungible” argument, which is certain to come up again if it hasn’t already.  While the bill stipulates only that the $1 of coverage going to abortions does so for plans that specifically include that coverage, Stupak will undoubtedly make the assertion that the provision is meaningless at best.  The line seems to be relatively clear to me, but this is Congress we are talking about.

There is another idea though that might break this potential mess.  Apparently, House Majority Leader Steny Hoyer has been talking to Rep. Stupak recently, and there may be a way out.  That would be removing the Stupak Amendment from the larger House bill with the promise of a vote on it separately.  Senator Baucus is on board with this as well, according to the post, there is no word on whether Senate Majority Leader Harry Reid is.  This is an interesting idea, and it would certainly work if the leaders get on board, but will the Senate do it as well?  Technically, since it would be its own piece of legislation, it does not have to, but I will make a bet with any one of you that if Democratic leaders choose this route, there will be immense pressure on the Senate to do so.  I think it is a good compromise; Stupak gets his vote, and in theory the other Democrats get their bill.

The Public Option Returns?

Complicating matters, there is a showing of support in the Senate now for, of all things, the public option.  Yes, that.  It is questionable whether it could legally fall under the reconciliation rules, but that would certainly make convincing the House a lot easier if the Senate acted first on it.  Personally, I am a fan of the public option.  Well, okay, I’m not unquestionably in favor of it, but if you have been reading my healthcare writing for a while, you know that I think a national choice run by some part of the government but with the requirement that it compete on its own merit would be great for the country.  However, I do also like the other ideas circulating through Congress, most notably the exchanges that are currently slated to be what we get if this whole scheme works.  That being said, the resurgence of the public option’s popularity is quite interesting; the number of Senators publicly signing the letter of support is not insignificant, in fact about 35 the last time I checked the reports.  Yet the White House still claims the public option is a nonstarter in Congress.  We may never know why, but this disconnect between the branches of our government is something that needs to be worked on.

But will it even matter?  Despite all the rhetoric, regardless of all the progress that has been made thus far, the fate of healthcare reform will ultimately come down to a single vote in both the Senate and the House.  If reconciliation does happen, the magic number in the Senate is 50, since Vice President Biden has the power to break tie votes, and nominally there are more than enough Democratic Senators to pass it along party lines.  Fortunately for the Senate, the Huffington Post is reporting that with Senator Begich’s endorsement of reconciliation, they have their 50 votes before the formal poll by the Majority Leader has even taken place.  While bipartisanship is nice, it is painfully obvious that it is pretty much dead if we are seriously talking about reconciliation.  The key to the Senate, then, is making sure the Democrats stay on board.  With the 2010 midterm elections rapidly approaching, many of the more moderate Democrats and those elected in conservative districts will be thinking very hard about whether to vote in favor of healthcare reform.  Personally, I think the odds are in the Democrats’ favor this time around; the very public one-man stand against unemployment benefits last weekend may have tipped the scales in favor of using reconciliation in the public’s eye.

The real key to passing healthcare reform, then, is the House of Representatives.  Kind of ironic, because they were the ones without the drama during the initial passing.  Currently, the magic number there is 216.  Unfortunately, they have less of a margin for error than the Senate does, and it appears that getting Representative Stupak to calm down his bloc of anti-abortion Representatives will be the key, though Speaker Pelosi will also have to deal with the wavering Democrats.  At this point, the outcome in the House is a bit of a toss-up, though it should get clearer which way it will swing as we approach the President’s deadline.  On a side note, that’s the other thing I’ve noticed about this whole process; President Obama and Congressional leaders seem to be very good at making things coincide with major holidays.  After all, the Senate passed its bill on Christmas Eve, and now the President’s deadline is the Easter break.

The Healthcare Reform’s Days Are Numbered by The New Age of Politics, unless otherwise expressly stated, is licensed under a Creative Commons Attribution-ShareAlike 3.0 Unported License.

Tags: Bart Stupak, bipartisanship, Democratic, Democrats, GOP, Harry Reid, Healthcare, House of Representatives, Party leaders of the United States House of Representatives, Politics, President Obama, public option, Republican Party, Senate, Steny Hoyer, United States Congress, United States Senate