House Votes 227-196 To Affirm Democrats’ Option To Use Budget Reconciliation Process To Fast-Track Health Care Legislation
The House on Wednesday voted 227-196 against a Republican proposal that would have instructed its conferees to reject the use of the budget reconciliation process to pass health care overhaul legislation, CQ Today reports. The House also named its conferees, three Democrats and two Republicans, who will meet with Senate conferees to reconcile their budget resolutions into a final version. The Senate has yet to appoint its conferees, and Senate Budget Committee Chair Kent Conrad (D-N.D.) said there is no definite timeline, adding, "There is plenty of work, certainly, to be done" (Clarke/Krawzak, CQ Today, 4/22).
The House included instructions in its budget resolution to allow the use of the reconciliation process to pass health reform legislation, but the Senate, which did not include the orders in its resolution, has been "reluctant to authorize it," the New York Times reports (Pear, New York Times, 4/23). Democratic leaders and the Obama administration would support using the procedure if a bipartisan compromise cannot be reached on overhaul legislation (Clarke/Krawzak, CQ Today, 4/22). Sen. Jeff Bingaman (D-N.M.) said, "It may be a struggle to get" the 61 votes required to bypass reconciliation.
According to the Times, reconciliation would allow Democrats to "overcome Republican objections to a big increase in federal spending and in the role of government," but "it could fundamentally alter the political dynamic of the health care debate, detonating an explosive reaction among Republican senators who have been working with Democrats on the issue." Senate Health, Education, Labor and Pensions Committee ranking member Mike Enzi (R-Wyo.) said that if Democrats use reconciliation to pass health care legislation, it would represent "a declaration of war." Neil Trautwein, a vice president of the National Retail Federation, said, "If Democrats push a health bill through the Senate using budget reconciliation procedures, the bill would lack Republican support and would lack the support of key constituencies -- certainly the business community," adding, "Health care reform would crater for this year" (New York Times, 4/23).
Senate Republican Conference Vice Chair John Thune (S.D.) said, "I suspect that there is going to be an awful lot of resistance, and we will exercise our prerogatives so that the rules of the Senate are respected." According to Roll Call, some senior Republican aides "say it is too early to discuss retaliation for something that might not occur; they prefer to focus instead on trying to shape a bill that they can embrace." However, "other key Republican senators were candid that reconciliation, while difficult for them to stop, would prompt them to try to trip up Democratic priorities -- large and small," Roll Call reports (Drucker, Roll Call, 4/23).
Republicans also say that reconciliation is not intended to be used for sweeping policy measures, such as health care overhaul (Taylor, AP/Minneapolis Star Tribune, 4/22). Senate rules state that reconciliation can be used only for actions intended to produce a change in federal spending or revenue. According to the Times, provisions aimed at regulating the insurance industry or improving quality of care could be challenged as "extraneous" under these rules (New York Times, 4/23). Conrad said Republican leaders have "had many discussions" with Senate parliamentarian Alan Frumin about how the rules would apply.
The Hill on Tuesday examined Frumin's potential role in creating a final version of overhaul legislation if the fast-track process is used. Frumin would decide which proposals could be included in a reconciliation vote (Alarkon, The Hill, 4/22).
Ways and Means Hearing
In related news, the House Ways and Means Committee on Wednesday heard from six witnesses discussing the implications of creating a public health plan, according to CQ HealthBeat. Princeton University economist Uwe Reinhardt said that it would require "strong rationale" to deny U.S. residents the option of buying government-sponsored health insurance after the recent drop in public confidence related to the recession. He noted that if a public plan was not established, strong regulations would have to be placed on private insurers. Consumers Union analyst William Vaughan said insurance policies should be simplified to allow easier comparison by consumers.
David Boris, a small-business owner, said that private health plans have been unable to contain costs and that "we need a public plan that will re-energize true competition in the marketplace" and "provide a backup if the private market doesn't work." Urban Institute senior fellow Linda Blumberg said that a public plan would provide a "very promising catalyst for cost containment."
Kenneth Sperling, an analyst with Hewitt Associates, said introducing a public plan could force private insurers to pay providers at significantly higher rates to compensate for underpayments by the public plan. Republicans on the panel expressed their disapproval at what they called bias in selecting the witnesses (Reichard, CQ HealthBeat, 4/22).
House Ways and Means Committee Chair Charles Rangel (D-N.Y.) and ranking member Dave Camp (R-Mich.) at the meeting agreed to hold talks between their respective staffs, according to Camp spokesperson Sage Eastman. Camp said to Rangel during the hearing, "It is time for our staffs to start meeting, and, more importantly, start negotiating," noting the bipartisan meetings held by members of the Senate Finance Committee. Camp said, "I think there is broad agreement on the principles of any successful health reform: lowering costs, increasing access, ensuring portability, and prevention and wellness, among others" (Edney, CongressDaily, 4/23).
White House Meetings
House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry Reid (D-Nev.) met with President Obama on Wednesday to discuss strategy in advance of a Thursday meeting between Obama, Vice President Biden and congressional leaders. The meeting covered issues including health care reform, aides said, but neither Pelosi nor Reid would comment on the meeting. Sen. Richard Durbin (D-Ill.) said he expects Republican leaders at the meeting on Thursday to seek compromise. He said, "A few of them have stepped forward, and we really appreciate that" (Hunter, CQ Today, 4/22).
- David Broder, Washington Post: What Obama already has achieved in his presidency "is no more than the overture to the first act of this opera," with "big stuff ... still to come," including the "soprano [singing] her signature aria": health care reform, Post columnist Broder writes. He continues, "Obama had a few stumbles in assembling his Cabinet and, as a result, lost the services of one potential major asset, Tom Daschle, his original choice to manage his health care initiative." The "challenge" for Obama to juggle his schedule and wide-ranging initiatives "will become greater as Obama's initiatives move to Capitol Hill, where a single senator can throw up a roadblock, and when the inevitable foreign crisis explodes," Broder writes. However, "the overture has gone well, and so far, the cast seems to know its parts," Broder concludes (Broder, Washington Post, 4/23).
- E.J. Dionne, Washington Post: "The biggest difference between now and the last time around" for health care reform efforts "is the emphasis on creative compromise in place of creative obstruction," Post columnist Dionne writes, adding, "Because of its defeat in 1994, there will be a temptation to treat every dispute -- notably the recent reports of contention over the inclusion of a government-run option in a final bill -- as the first step toward the collapse of the process." He adds, "Public-plan advocates should stay at the table to keep things moving," because "[t]omorrow isn't always defined by yesterday" (Dionne, Washington Post, 4/23).