KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Senators Return To Full Agenda, Health Debate Front And Center

Health care still dominates the Senate agenda, and some advocates are pressing for passage of a bill under 'reconciliation' rules.

"The focus on health care as Congress reconvenes Tuesday after its monthlong recess is nearly all-consuming," The Associated Press reports. "At stake, beyond the future of health care, is an accomplishment Democrats need to convince voters they deserve to remain in power." Financial legislation, consumer protections and clean energy are also still on the table in the Senate (Abrams, 9/8).

USA Today: "'When we bite off more than we can chew, we don't succeed,' Sen. Lamar Alexander, R-Tenn., said in an interview. 'Most people who have watched Washington know it can only do one big thing at a time.' ... Although the House has made progress on [health care], movement has been slower in the Senate. Senate Banking Committee Chairman Chris Dodd, D-Conn., a key player on regulation, was thrust into the health care debate this year after the health committee chairman, Sen. Edward Kennedy, D-Mass., was diagnosed with brain cancer" (Fritze, 9/8).

NPR: "During a meeting last week with reporters, Sen. Lamar Alexander, a Tennessee Republican and chairman of the GOP conference, said that Democrats need to pick one big initiative to deal with this fall: health care, climate change or financial services regulation. His comments came a day after Democratic Sens. Barbara Boxer of California and John Kerry of Massachusetts reported a delay in finishing the Senate climate bill they're writing. They said that the death of Massachusetts Sen. Edward Kennedy and Kerry's own August hip surgery made their promised early-September delivery impossible" (Halloran, 9/7).

McClatchy/The Sacramento Bee reports that the public option "promises to be the first big test of Democratic muscle… California is one of 15 states where both senators are backing the public option. But so far, Senate Democrats have lined up only 45 votes for the landmark proposal, according to Democracy For America, a group that supports the idea and is tracking votes. That's far short of the 60 required to stop a Republican filibuster" (Hotakainen, 9/8).

Reconciliation could be a possible alternative, but Politico asks whether it's "really the silver bullet that some seem to think it is." The "rarely used legislative maneuver" is "designed to apply only to bills on spending, taxes or both. Under it, legislation is fast-tracked, so amendments are limited, and debate is closed after 20 hours. It requires just a simple majority of 50 senators for passage, not the 60 votes needed to thwart a filibuster." If Democrats choose to use reconciliation, "most experts say the proposals by Senate Finance Committee Chairman Max Baucus (D-Mont.) to pay for health care overhauls would easily fall under reconciliation guidelines."

But one potential problem is that "[a] reconciliation bill cannot increase the deficit beyond the budgetary window… The Obama administration and congressional Democrats have vowed to pay for health care reform entirely through tax hikes and savings. But if they miss their mark in the out years, it could mean that a sunset would be placed on some sections - and that would provide a similar opportunity for Republicans down the road to dismantle some of the reforms." Meanwhile, "[w]hile the financing aspects of reform may be a natural fit for reconciliation, a mandate that individuals buy health insurance, a ban on denying coverage based on pre-existing conditions and other insurance industry reforms could be disqualified by the Senate parliamentarian" (Cummings, 9/8).

Related KHN story: Democrats' Strategy To Avoid Filibuster Carries Serious Risks

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