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Anonymous
Guest
Health Care Bill Likely in October
The Democrats made a strategic decision about health care reform this week that has major implications for the elections of 2010 and 2012. The decision was fairly technical--to attach health care reform to the budget reconciliation if agreement has not been reached by October 15--but the political consequences are immense.
Very briefly, budgeting works like this. In February, the President proposes a budget, which President Obama has already done and which Congress has approved. But this is only step 1. Next the Senate and House committees dealing with taxing and spending hack on the President's proposal and come up with their own plans, which merely sets general spending limits for each of 19 broad categories of government expenditures. After much arm wrestling, the committee chairman come up with a single proposal in each chamber, which is then brought to the floor for a vote. Since the Senate and House versions invariably differ, a joint Senate-House conference committee then works out a compromise, called the budget resolution, which both chambers then pass.
If Congress so desires, language can be inserted into the budget resolution directing one or more committees to produce specific legislation by a specific date. The legislation produced by these committees is generally bundled into a single bill called the reconciliation bill. According to Senate rules, budget resolutions and reconciliation bills are subject to straight up-or-down votes. Filibusters are not allowed. The Democrats plan to use this process to get a health care reform bill through this year. In effect, as long as 50 Democratic senators support the bill, it will become law with a little help from Vice President Joe Biden if needed. Up to nine Democrats, such as Sen. Ben Nelson (D-NE) can oppose the bill and it can still pass.
Poll after poll has shown that Americans are very worried about their health insurance. People are afraid to quit jobs they hate because they are worried they won't be able to get health insurance after their COBRA coverage expires. The core of the problem, of course, is the insurance companies' desire not to insure anyone who is sick or likely to become sick. All other industrialized countries solve this problem through laws saying that health insurance companies must offer a standard policy at a standard price to anyone who asks for one. Cherrypicking good customers is illegal everywhere except the U.S. To prevent young healthy people from going uninsured until they suddenly get sick and then applying for insurance, other countries make carrying health insurance mandatory, the same way most states in the U.S. mandate that car owners have accident insurance on their cars.
The Democrats and Republicans differ hugely on their views about cherrypicking and mandates. Any bill the Democrats came up with containing both of these items would be filibustered to death in the Senate. However, now that Senate Democrats (with Obama's blessing) have decided to make health care reform part of the reconciliation bill, the Republicans will not be able to filibuster it. This will make them absolutely furious--even though George Bush used the reconciliation process himself on a number of occasions.
Now it is not certain that health care will have to go into the reconciliation bill. If Al Franken is ultimately seated in Minnesota, then the Democrats will need only one more vote to pass a health care bill the usual way (which in this session of Congress means invoking cloture). That vote won't come from Arlen Specter due to his tough primary, so the targets will be Sen. Olympia Snowe (R-ME), and to a lesser extent, Sen. Susan Collins (R-ME). Majority leader Harry Reid (D-NV) will undoubtedly spend a lot of time talking to these two women and trying to cajole them into voting for cloture on the health reform bill. However, since they know their votes aren't really essential (because if they vote against cloture health care reform will be dumped into the reconciliation bill which can't be filibustered) they are not in a strong negotiating position and may be content with small changes rather than having the bill go into reconciliation, in which case they get nothing.
If the Democrats manage to ram health insurance through Congress this year, they will be crowing about it in 2010 and 2012 as fulfilling a major campaign promise and Republicans will be dissing it as socialized medicine. But given the public's desire to see the health insurance system fixed, a bill this year is likely to help the Democrats, hence the decision to put health care reform in the reconciliation bill if all else fails.