KHN Morning Briefing

Summaries of health policy coverage from major news organizations

GOP Forces Second House Vote On Health Reconciliation Bill

Senate Republicans found a way to force a second House vote on a health reform reconciliation bill after identifying parliamentary flaws, including one in the calculation of a student loan provision.

The New York Times reports that Senate Democrats "had been hoping to defeat all of the amendments proposed by Republicans and to prevail on parliamentary challenges so that they could approve the measure and send it to President Obama for his signature. But the bill must comply with complex budget reconciliation rules, and Republicans identified some flaws." The challenge came as the Senate was meeting in the early morning hours of Thursday after an all-day Wednesday session. "The successful parliamentary challenge did not appear to endanger the eventual adoption of the changes to the health care legislation. And Mr. Obama on Tuesday already signed the main health care bill into law." One disputed provision involves expansion of federal Pell grants tied to the health reconciliation legislation. "The bill would establish an automatic increase in Pell grant awards, tied to inflation, for students from low-income families. The disputed provision would prevent any reductions in the maximum award." Sen. Kent Conrad, D-N.D., the Budget Committee chairman, said the problem was the formula for determining the maximum Pell grant awards (Herszenhorn and Pear, 3/25).

The Wall Street Journal reports that the provisions in question are no more than 16 lines in the bill. "Under the Senate's complicated parliamentary rules, the legislation at issue can't carry provisions that are unrelated to federal budget matters. The provisions at issue have been found to violate those rules, congressional aides said." The provision deemed most important is intended to "shield recipients of government Pell Grants, which benefit low-income college students, from the ebb and flow of changes in federal spending. The Pell Grant provision is in the bill because the health legislation also makes changes to the federal student-loan program." Passage of the bill still seems assured, however as "(u)nder an agreement, the Senate is expected to conclude action on the final piece of the Obama health bill by 2 p.m. Thursday" (Hitt, 3/25).

The Hill reports that Democrats defeated 29 amendments to the legislation suggested by Republicans in the hours leading up to the parliamentary ruling by Senate Parliamentarian Alan Frumin. In addition, Democrats and Republicans crossed the aisle on several amendment votes. "Democrats Evan Bayh of Indiana, Blanche Lincoln of Arkansas and (Ben) Nelson of Nebraska strayed frequently from their party during Wednesday night's voting." Nelson voted with Republicans 20 times out of 29 votes on amendments. "In 10 hours of voting, only three Republicans crossed the aisle to vote with Democrats - Sens. Susan Collins and Olympia Snowe of Maine, and George Voinovich of Ohio, who supported Democrats in blocking an amendment by Sen. Jim Bunning (R-Ky.) that would have allowed Medicare patients to opt out of receiving certain benefits" (Rushing, 3/25).

The Washington Post reports that lawmakers began the 10-hour vote-o-rama at 5 p.m. Wednesday. "The defeated amendments would have altered central elements of the health-care law. One would have rescinded more than $500 billion in Medicare cuts, a key source of funding to make health insurance affordable to an estimated 32 million additional people over the next decade. Another proposal would have eliminated an array of smaller provisions that benefit particular states or regions, provisions Republicans derided as 'sweetheart deals' whose only purpose was to win the support of specific Democratic lawmakers. Other amendments would have stripped the bill of tax increases that will affect individuals who make less than $200,000 a year - upholding Obama's campaign pledge not to raise taxes on the middle class, Republicans said - and erased a requirement that employers offer affordable coverage to their workers or face penalties" (Montgomery and Murray, 3/25).

The Hill in a second story reports that Wednesday "Senate Republicans ... backed away from a plan to offer hundreds of amendments to slow the passage of healthcare reform fixes under budget reconciliation. … 'We've decided that offering 200 or 300 amendments doesn't make sense' said Sen. Jim DeMint (R-S.C.), one of the Senate's leading conservatives. 'The leadership has asked us to focus on substantive amendments'" (Bolton, 3/24).

Roll Call reports that when voting on the bill gets underway, Democrats will count Sens. Joe Lieberman, I-Conn., and Jim Webb, D-Va., as votes for the health reconciliation bill. "Lieberman's decision to support reconciliation is noteworthy given his previous concerns over the Democratic health care reform agenda. Lieberman supported the underlying Senate bill signed by Obama, but not before forcing Democrats to eliminate a public insurance option and Medicare buy-in provisions under threat of filibuster. … Webb's support of reconciliation was more predictable, although he did vote with the Republicans on several amendments to the underlying Senate bill in December, when the law was debated on the floor" (Drucker, 3/24).

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.