We have not written much lately on the news regarding health care because there is really not much of substance to write about.
There is some to and fro from Senate committees and House committees on this and that but so far no “plan”, as we have understood the word prior to the debut of Chicago’s Barack Obama.
Obama however, contrary to what he denounced and demanded during the election campaigns, has made a threat to use a parliamentary procedure called “reconciliation” to dictate a solution.
Will the parliamentary procedure called “reconciliation” work? We’ll clarify the matter today.
First, here is the current situation:
President Barack Obama may rely only on Democrats to push health-care legislation through the U.S. Congress if Republican opposition doesn’t yield soon, two of the president’s top advisers said.[snip]
House Democrats today unveiled legislation totaling about $1 trillion that would expand health care to millions of Americans over the next decade by raising taxes on the wealthiest households. The Senate has yet to agree on a bill as Democratic lawmakers struggle to get Republican support. [snip]
Analysts and some veteran political practitioners have inveighed against a partisan approach on such a contentious issue.
They include two former Senate majority leaders — Robert Dole, a Republican, and Tom Daschle, a Democrat, who is a close White House adviser on health-care issues.
During a joint appearance in June as the two unveiled their own bipartisan health-care proposal, Dole said he believed Democrats could pass a bill by a party-line vote, even as he expressed disapproval of such a tactic.
“I hope it doesn’t come to that,” Dole said. “If there’s not a Senate Republican vote for the package, then the American people are going to be very skeptical.”
The Democrats have 60 votes in the Senate to 40 for the Republicans, and have a 255-178 advantage in the House, with two vacancies.
Daschle said he “couldn’t agree more” with Dole’s warning about the political fallout from a partisan vote.
Moreover, he expressed doubt that Democrats alone could prevail, because that scenario “assumes unanimity” he said, and that isn’t the case.
Tom Dashle, was supposed to be the Obama “Czar” on health care but apparently he cannot swallow the Obama prescription and even he is calling Obama’s bluff.
The Obama bluff:
Time is running short for the House and Senate to pass the legislation before their August recess, the deadline Obama has set. In entertaining the possibility of a party-line vote on health care, Emanuel cited “reconciliation,” a parliamentary procedure that a dominant party can use to prevent the other party from blocking legislation.
“It’s not the first priority, or the second priority, or the third priority. We think we can get it done without it,” he said.
Yet reconciliation “exists as an alternative vehicle, Emanuel said. “That’s what it was created for.”
In a lucid, illuminating, and therefore overlooked article, Mort Kondrake of the Capital Hill newspaper Rollcall, explains why “Reconciliation rules won’t work:
Liberal health reform advocates have talked about ramming a reform plan – including a Medicare-like public insurance option – through the Senate with only 51 Democratic votes. But a leading Senate player says it won’t work.
If an attempt is made to pass health reform under “reconciliation” rules – requiring just a simple majority vote – Senate Budget Chairman Kent Conrad (D-N.D.) told me, the bill would be so pared down, “you’d be left with Swiss cheese.”
Conrad also serves on the Finance Committee, which will mark up its version of health care reform in July.
Reconciliation rules, he said, require that a bill be scored as deficit-reducing over six years and that any substantive policy change in it also have a fiscal purpose.
The result, said Conrad, is that “you’d be left with a dramatically reduced package” that would fall short of comprehensive health reform.
“You would have a very hard time expanding coverage to the 46 million who don’t have it,” he said, and the “Byrd Rule” – requiring fiscal germaneness -could strip the bill of many of its policy provisions.
So, Conrad said, “health reform needs to be passed on a 60-vote basis, and that means it needs to be bipartisan.“
Long gone are the days when Obama promised to pass laws with 80 votes in the Senate – those were just words he lied to the public with.
Conrad said he expected it will require up to six Republican votes to pass health reform in the Senate, but only one Republican – Sen. Olympia Snowe (Maine) – has indicated she’d support any sort of public plan, and then only as a fallback. [snip]
But, Conrad pointed out, Sens. Edward Kennedy (D-Mass.) and Robert Byrd (D-W.Va.) have been absent from the Senate because of illness and at least two Democrats have publicly stated they won’t support a public plan.
They are Sens. Ben Nelson (D-Neb.) and Mary Landrieu (D-La.). And, Conrad said, “there are probably more.”
So, doing the math, even if Kennedy, Byrd and Franken were all present, Democrats would need two Republicans to break a filibuster – and would need more if moderates like Sens. Evan Bayh (D-Ind.), Mark Pryor (D-Ark.) and Blanche Lincoln (D-Ark.) opposed the public plan.
Why are the “reconciliation rules” not going to work to force-feed “reform” and what is the history of the “reconciliation rules”?
The difficulty of getting to 60 is what has inspired liberals – and the Obama administration – to contemplate using budget reconciliation rules to pass health reform with just 51 Democratic votes.
Last week, White House Chief of Staff Rahm Emanuel reiterated, “We want to pass health reform under regular order … but reconciliation is in reserve.”
The rules were set up in the Congressional Budget Act of 1974 to ease the way for deficit-reduction measures to pass if authorized in Congress’s annual budget resolution.
This year’s resolution did allow for health reform to be considered under reconciliation rules – but Conrad said advocates of the strategy have not studied its difficulties.
“The problems are two-fold,” he said. “Number one, everything has to be deficit-neutral – and actually have to produce $1billion in deficit reduction over six years.
“Since one of the six years is this year, and this year will almost be over by the time we do it, it’ll have to reduce the deficit over five years and every year thereafter,” he said.
“In the alternative, using regular order, it only has to be deficit-neutral over 10 years. That’s a big difference in what kind of reform you write.”
The second problem with reconciliation rules, he noted, is the Byrd Rule, named for former Senate Appropriations Chairman Byrd, making any provision in the bill subject to being removed if it does not have a budget effect – and requiring 60 votes to sustain it.
“When reconciliation was developed, it was solely for the purpose of deficit reduction. It was never intended for substantive legislation.“
What would the health care Swiss cheese look like?
Conrad said that “all kinds of things would be vulnerable to striking, including insurance market reforms, all the changes designed to encourage wellness and prevention – all those kinds of things.”
A key player in determining whether an item were struck would be Senate Parliamentarian Alan Frumin, who’d be under enormous pressure from Democrats to find that provisions satisfied the Byrd Rule.
“There’s no question in my mind that he’d call it like he saw it,” Conrad said. “He will not be giving liberal interpretations. He’s a stickler for precedent. … He’s impervious to pressure.”
Republicans have served notice that they would regard an attempt to use reconciliation rules for health reform as a “declaration of nuclear war,” leading to a procedural close-down of Senate business.
The Swiss cheese would not include the most important elements (wellness and prevention) needed for actual health care and instead would be a big payday for insurance companies.
“Nuclear war” over Swiss cheese. Obama is the mouse that roared.
“Mouse”? Try “Rat”.