Health Care Reform Impasse
Democrats clearly are not of one mind on how to proceed with health care reform (HCR) legislation as well as their overall domestic policy agenda after last week’s stunning loss in Massachusetts. In the House, liberal Democrats seem to be worried that Scott Brown’s election to the seat that Senator Kennedy held for 46 years would cause their party to shy away from a progressive agenda, while moderates cast the election outcome as evidence of the need to rein in federal spending. Tonight, January 27th, is President Obama’s second State of the Union address of his presidency. It will air at 9pm eastern time on most major network stations. Most likely his speech will provide more direction on the next steps for HCR and the domestic policy agenda for 2010. In the meantime, below are some of the options being discussed by both parties relative to the next steps on health care reform legislation. Please bear in mind that these are just the potential options on the table:
1) GOP Crossover: Democrats finish negotiations after Brown is seated, but work to obtain a 60th vote from a Republican Crossover.
Outlook: Nearly impossible at this point.
2) Ram a Bill Through Before Sen. Brown is Seated: Senate and House Democrats could rush to finish negotiations to merge their bills, and pass new bills in the House and Senate, before Brown is seated. A new bill would take 5-10 days for a CBO report, and the political dynamics are extremely challenging.
Outlook: Highly unlikely as the MA Sec. of State has said he will seat Brown quickly.
3) House Acquiesces to the Senate Version: House passes Senate-passed bill, verbatim, no changes. All the negotiations of the past month would be thrown out. The bill could be on the President’s desk for his signature with 24 hours of passage.
Outlook: Very difficult due largely to abortion and union “deal” struck last week on the Cadillac plan excise tax issue.
4) Budget Reconciliation: This means the bills must go back to Committees, many parts would be diced up under the Byrd Rule (Under the Byrd rule, the Senate is prohibited from considering extraneous matter as part of a reconciliation bill or resolution or conference report The Term “extraneous matter” is subject to considerable interpretation. The Byrd Rule is sustain/enforced against an “offending” title, provision or amendment unless its proponent can muster a 3/5 (60) Senate super majority vote to waive the rule.) and the non-tax provisions would expire after 5 years. The unions are pushing this strategy. Further, the “doc fix” will also need to be done in coming weeks.
Outlook: Politically, very difficult but not off the table.
5) Two-Bill;Two-House Strategy: The House may pass Senate bill IF they first get a “clarifying” or “corrections” side-car bill passed to “fix” everything they don’t like in the Senate bill. This would provide Democrats the assurance they need to vote for the Senate bill.
Outlook: As of this week, this option is being looked at as the most likely scenario, though very difficult. The caveat is that the House is being promised the opportunity to amend/improve the bill afterward through the budget reconciliation process, which only requires a standard majority but is a very tricky parliamentary maneuver (i.e the Senate Byrd Rule).
6) Clean Insurance Reform Bill Only: The House and Senate may realize the battle is over and may scale back significantly opting to push a streamlined Insurance Reform bill through the House and Senate.
Outlook: May be a potentially viable option for Democrats, as they shifted their rhetoric over the summer from “Health Reform” to “Health Insurance Reform”
7) HCR Dead: No bill passes in the year 2010. Democrats may decide to take a break from health reform and focus on jobs and the economy.
Outlook: Will know more as time progresses and political fallout is realized and Reid, Pelosi and the White House revisit their priorities. (Source: US Chamber; CQ Health Beat)
(NBCH Governmental Affiars update January 27, 2010)