KHN Morning Briefing

Summaries of health policy coverage from major news organizations

House Democrats Move Health Bill With Controversial, Complicated Strategy

House Democrats have started the clock to a landmark vote on sweeping changes to America's health care system.

The Washington Post reports that the House may try to pass the Senate health reform bill without voting on it by declaring it passed if the House passes an accompanying reconciliation bill that "fixes" the Senate bill. House Speaker Nancy "Pelosi (D-Calif.) would rely on a procedural sleight of hand: The House would vote on a more popular package of fixes to the Senate bill; under the House rule for that vote, passage would signify that lawmakers 'deem' the health-care bill to be passed." The tactic has been commonly used in the past, but never on something as "momentous as the $875 billion health care bill," The Post reports.

"'It's more insider and process-oriented than most people want to know,' the speaker said in a roundtable discussion with bloggers Monday. 'But I like it,' she said, 'because people don't have to vote on the Senate bill.' Republicans quickly condemned the strategy, framing it as an effort to avoid responsibility for passing the legislation" (Montgomery and Kane, 3/16).

USA Today: "Brookings Institution scholar Thomas Mann said the 'deem and pass' move being contemplated by House Democrats is not that unusual and has been employed to handle 'difficult partisan issues,' such as the ban on smoking on domestic airline flights. Mann said Congress used this procedure 36 times in 2005 and 2006, when the GOP was in charge, and 49 times in 2007 and 2008, after the Democrats had taken control" (Kiely, 3/16).

McClatchy: "However, using such a dicey procedure to enact President Barack Obama's biggest domestic initiative - the most far-reaching social policy change in decades - could inflame a public that's already annoyed at the legislation's tortured path and disgusted with Congress. … Legal experts also raised concerns. Michael McConnell, a professor of law at Stanford University, wrote Monday in The Wall Street Journal that such procedures are unconstitutional. He cited a 1998 Supreme Court ruling that once one house of Congress approves an 'exact text,' the other house must pass 'precisely the same text' before the president can sign it into law" (Lightman, 3/15).

Politico: "Instead of the typical wheeling and dealing to pick up much-needed support, Pelosi and her leadership team are warning members that the bill is final, and its language is set, so don't come seeking major changes or handouts for your district." The warning "indicates that House leaders plan to go to the floor with the reconciliation bill they have rather than making last-minute changes at the Rules Committee to attract more support." Thursday is the earliest that Democrats could vote on a final measure though the vote could happen Saturday or Sunday, "or later," Politico reports, "if leaders keep their pledge to give people 72 hours to review the final changes" (O'Connor and Allen, 3/15). 

Roll Call: "Pelosi, meanwhile, reiterated earlier statements that the Senate bill's immigration and abortion provisions could not be changed by the reconciliation bill, in a message clearly aimed at a number of lawmakers demanding changes that she says cannot happen. 'It has to relate to the budget. It has to be about the bottom line. ... We cannot deal with other language in a budget reconciliation bill,' she said."

"While the House ties itself in knots over how to proceed to the bill, Senate Democrats have been trying to make sure the bill is written in a way to avoid 60-vote budget points of order. Republicans have vowed to comb through the bill to find any failure to abide by strict reconciliation rules that require every provision to have a budget impact" (Dennis, 3/16).

The Hill: "Most, but not all, Democrats on the Budget Committee voted for the healthcare reconciliation package that cleared the panel 21-16 on Monday. Reps. Chet Edwards (D-Texas) and Allen Boyd (D-Fla.) opposed the package while every committee Republican rejected it. ... The Rules panel will be responsible for actually marking up the reconciliation language and for determining how to move that bill, which contains 'fixes' to the broad Senate-passed healthcare reform bill, and the Senate bill itself" (Youngman and Young, 3/15).

CongressDaily notes that Democrats also continue to wait for an analysis on the reconciliation bill from the Congressional Budget Office. They had expected one Monday, but did not receive it. "If the House stays on schedule for a final vote this weekend, the Senate would take up the bill as early as next week, a spokesman for Senate Majority Leader (Harry) Reid said" (Edney, 3/16).

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