The reconciliation farce

If you listen to the news, you probably know that both the House and the Senate have passed health care bills; that the two bills differ; that the Senate Democrats no longer have a filibuster-proof majority; and that rather than allowing even the slightest bit of Republican input to revise the bill—just enough to pick up one Republican vote—the administration and the Democratic leadership on the Hill have opted to use the budget reconciliation process to solve the problem. There’s been a fair bit of handwringing over that, but it’s ostensibly what they’re going to do.

“Ostensibly” being, I think, the key word, because I’m not sure it’s ever going to happen, even if the House passes the Senate bill (which is far from assured at this point). Jeffrey Anderson laid out the reasons why two weeks ago, though most people don’t seem to have caught on:

Senators want nothing to do with “reconciliation”—whether politically or for what it would do to their chamber—and they already like their own bill (which the House would then already have passed) just fine. The President would then already have gotten a bill through both chambers, and while House members would complain powerlessly, he would dip his pen in the ink and visualize himself in the history books. He might even try to score a few extra political points by saying, As you know, we intended to use the reconciliation process to make a few small changes to the Senate bill. While I know that there was some disagreement from some people, I think that that process would have been entirely appropriate to pursue. But some people are uncomfortable with it, and I think that’s a legitimate concern. It’s important to remember that our democratic institutions deserve the benefit of the doubt. Also, the American people understandably think that we’ve been focused on health care long enough. So that’s why I am making the decision not to pursue “reconciliation.” Instead, I am moving on to a jobs bill. . . .

House members would be left holding the bag. Target squarely on their chests, they would now get to face their fuming constituents after having passed a $2.5 trillion bill that would allow public funding of abortion, would send $100 million to Nebraska, $300 million to Louisiana, $100 million to Connecticut, would exempt South Florida’s Medicare Advantage enrollees from annual $2,100 cuts in Medicare Advantage benefits, would raise taxes, raise deficits, raise health costs, empower Washington, reduce liberty, politicize medicine, and jeopardize the quality of health care. Most of all, they would feel the citizenry’s wrath for having voted to pass a bill that only 25 percent of Americans support.

Anderson’s argument was only strengthened when the Senate parliamentarian ruled that not only must the House pass the Senate bill as is before reconciliation could be used to amend it, the President must sign it into law. That sounds more than a little fishy to me, but there it is: if the House passes the Senate bill, it will have to become law before anything can be done to change it. Figure the odds, at that point, that either the President or the Senate lifts a finger to do so. Why should they? The Senate Democrats, as noted, are content with their bill, the President will be content to have signed sweeping health care legislation, and both will want to put the whole long, bruising slog behind them; why reopen the battle unnecessarily to consider making changes Senate Democrats won’t vote for anyway?

For all the talk about trust, there’s no doubt in my mind: if the House passes the Senate bill, that’s the end of it. If House Democrats get hung out to dry for it, as far as the Senate and the White House are concerned, that’s just the price of victory.

Posted in Medicine, Politics.

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