President Barack Obama listens to a question during the Organizing for America National Health Care Forum at the Democratic National Committee headquarters in Washington on Aug. 20. The last congressional panel working on healthcare legislation – the Senate Finance Committee – seems ready to give up on its bipartisan efforts.
(Alex Brandon/AP)Photos (1 of 1)
How far will Democrats go to pass health reform?
They're talking about using the budget reconciliation process for some parts, but it could be risky. Part 2 of two.
By Linda Feldmann | Staff writer/ September 1, 2009 edition
Washington
It’s called “reconciliation,” and yes, it’s Washington jargon. But anyone who wants to understand where healthcare reform might be heading when Congress resumes next week needs to pay attention to that word.
The last congressional panel working on healthcare legislation – the Senate Finance Committee – seems ready to give up on its bipartisan efforts. Two of the committee’s three Republicans working as part of the so-called Gang of Six have made disparaging comments lately about the outlines of reform, leading many Democrats to assume that the effort is effectively over.
But there’s virtually no chance that the more-liberal reform plans can make it through the Senate under normal rules, which require 60 votes to halt a legislation-killing filibuster. So Democrats are increasingly talking about going it alone and using the budget reconciliation process to pass at least parts of the reform.
The crucial difference is that passage under reconciliation requires a simple majority vote. One key health reform the Democrats might try to pass via reconciliation is creation of a “public option,” a government-run insurance program designed to compete with private insurers and bring down costs.
Last week, Sen. Jeff Bingaman of New Mexico, one of three Democrats in the Gang of Six, told a town-hall meeting in Albuquerque that he sees reconciliation as a possibility.
“If we are unable to [pass legislation] any other way, that is an option,” he said.
Reconciliation is a 35-year-old procedure used in congressional budgeting. To qualify, a bill must have a demonstrable impact on the federal budget, either by saving money or costing money over the life of the budget (currently, five years). Democrats believe the plan for a public insurance option would satisfy that criterion.
Republicans call the possible use of reconciliation on major parts of healthcare reform an abuse of the legislative process. But the record shows that the technique has been used for legislation that had policy purposes broader than changing spending or revenues.
One example is the 1996 welfare reform, passed by the GOP-controlled Congress and signed by President Clinton.
Still, going the reconciliation route for the most controversial parts of health reform is risky.
“Doing sweeping social change without broad bipartisan support is always shaky,” says Norman Ornstein, a resident scholar at the American Enterprise Institute in Washington.
And it’s not even certain that the Senate parliamentarian would allow the public option to be considered under reconciliation. It’s also not certain that the Democrats could garner a simple majority, given the controversy that reconciliation would spark. Some conservative Democrats are worried about reelection or might object on principle.
Another downside for Democrats is that because Congress opted for a five-year budget, any pieces of health reform implemented under reconciliation would sunset after five years.
Yet another downside: It sets a precedent. “Republicans have used reconciliation in big ways before, but using it for one-sixth of the economy would really change the character of the whole procedure,” says John Pitney, a political scientist at Claremont McKenna College in Claremont, Calif.
When the Republicans inevitably have a majority in Congress again, they may not hesitate to use reconciliation on major legislation.
But Democrats are under pressure to act by year’s end, as the 2010 election cycle heats up. And as President Obama’s popularity declines, chances are the Democrats will have smaller majorities after 2010.
For now, though, what can Republicans do? Pound away on public opinion. The less popular Democrats’ version of health reform, the less likely fence-sitters in the Senate will be willing to vote for it.
But all Democrats need is 50 senators. Vice President Joe Biden, as president of the Senate, can come in and break a tie.
Part 1: Key Republicans bail on ‘Obama-care’; Dems’ options narrow.
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Comments
2. fed up | 09.01.09
i hate how a simple idea of affordable health care can be twisted around by those on the right to seem evil.
it is evil to put money and power before the idea of helping others
3. c s grant | 09.01.09
I am tired of the republican lies about health care and I am tired of the news media for propagating it!
4. Steve863 | 09.01.09
Everyone is missing the point of ObamaCare. It is not about health care. If it were they would fix the parts to include the 14 to 20 million people not insured and they would address the high cost such as Tort reform (lawyers who get richer than rich suing doctors). This is about power and control. It was the foundation for the NAZI party followed by controlling the banks and then all businesses. Sound familiar? This is all about the Democratic National Socialist Party. By the way, NAZI stands for National Socialist Party.
5. John Freeman | 09.01.09
“Doing sweeping social change without broad bipartisan support is always shaky,”
The National Socialists in Germany tried this back in the 30’s, look where it led them…
6. Bill | 09.01.09
Ok, Dcrump. A French Revolution. You mean guillotines chopping off heads and mobs tearing people to pieces. Great.
You don’t speak for the “American people.” When you say “we as a people” you mean an obnoxious minority of anti-government reactionaries spreading lies and poisoning public discourse. Your people lost the election. You lost the White House and both houses of congress. So keep your violent rhetoric to yourself and get a life.
7. Sara | 09.01.09
President Clinton’s 1996 welfare reform was a huge success and did a lot of things that Republicans would be happy about, if they cared enough to look at the facts and check their egos a bit. I have no doubt that if we pass this health care reform, in 13 years people will be saying, “Wow, that actually did quite a bit of good.”
8. Panda Kahn | 09.01.09
Why is it that a private, for profit, corporation can have a “death panel” that denies coverage for an insured person. Why do my health care decisions have to be based upon the profit or loss of a multinational corporation and not my doctor and myself?
Should the current administration fail to pass health care reform and create a public option, something I will immediately sign up for, will all of these “FEED UP AMERICAN PEOPLE STARTING A FRENCH REVOLUTION” contemplate the same acts of violence against those who have bankrupt the system so as to insure the profits of the health care industry and the status quo?
All I am asking for int his debate, other than a level of civility that those on the right seem incapable of, is for the right to affordable health care insurance that does not bankrupt myself and family, and that can not be canceled when a private corporation decides I am not profitable enough.
I trust my government to protect my interests more than I trust a company with a bottom line to protect my interests over it’s profits.
9. reality | 09.01.09
big money AND republicans NEED TO LOOK OUT THEIR WINDOW AND IMAGE FROM HORIZON TO HORIZON FILLED WITH ALL OF THE FEED UP AMERICAN PEOPLE STARTING A FRENCH REVOLUTION IF THEY don’t PASS THIS AND BYPASS WHAT WE AS A PEOPLE HAVE VOICED nationwide.
There fixed that for ya!
11. Jackson Greer | 09.01.09
I don’t understand where the idea that Health Care reform is evil even comes from… This is something that cannot be painted that way.
12. Steve863 | 09.01.09
Evil is something that takes away liberty and freedom by disguising it as something that sounds good and helps other. When are libs ever going to look at the results of your good deeds and ideas? Sub prime housing to get more people into housing. Sounds great and tastes good, but made the country very sick. Welfare reform, sounds great and tastes good, but made the problem worse. Education reform, sounds great and tastes good, but made made the problem worse. Even the Cash 4 Clunckers sounds good and tasted great for 450,000 people. Let’s wait to see car sales for the next few months or what happens when that $300 per month is now being sent to a lender and not spent on services and goods. This type of Government interference has negative impacts later. Roosevelt extended the recession with his spending. Libs act so smart but feelings don’t make knowledge.
13. Edison | 09.01.09
Destroying the most technologically advanced healthcare system in the world is what is at stake here.
Unless you’re in love with the wait lines at your local BMV, social security administration office (take a ticket and wait to be called), or the post office, then you’d know that what the free-market gives us is personalized service within a reasonable time-frame. The government has never done that and never will.
We do have something to fight for, and unless we want to see our healthcare system drop in terms of world prominence, just as our public schools have in the hands of inept bureaucrats, we have to stand up and make our voices heard.
14. Gabriel | 09.01.09
No one has made AFFORDABLE health care seem evil. Everyone with a practical mind can see how affordable health care will help Americans and save them money; however, if the government regulates health care (as they do many other things which can least be said could be run better), it will practically be “free”, as they say, to so many struggling people; however, you can not render to MASSES of people free services. Unfortunately, the money has to come from somewhere. Someone has to pay for that “free” service. Health Care does need reform, but not in such a radical way. There must be a better solution.
15. Walker | 09.01.09
Wow, Dcrumpton sure sounds ‘feed’ up about health reform. Nice contribution, D.
“But Democrats are under pressure to act by year’s end, as the 2010 election cycle heats up. And as President Obama’s popularity declines, chances are the Democrats will have smaller majorities after 2010.”
Why are just Democrats under pressure? Are you saying Republicans don’t think ANY reform is necessary? If that’s true, then why are there 3 Republicans and 3 Democrats from the Senate Finance Committee negotiating the deal? And if it’s NOT true that Republicans don’t think any healthcare reform is necessary, then why did ALL THREE Republicans (Grassley, Snowe, and Enzi) drop out, publicly eviscerate the bill, and refuse to continue negotiating? They don’t seem very committed to giving all Americans quality, affordable healthcare… but like it or not, they and all Republicans are under JUST AS MUCH PRESSURE as Senate Democrats to pass legitimate reform. No free passes for these 3 cowards, good luck getting re-elected.
16. steves | 09.01.09
Dr. Goebbels would be very proud indeed of Republican efforts to spread fear and lies about healthcare, and, if that were not enough, in the end call healthcare proponents nazis! Das propaganda effort is alive and well in Amerika! Were the consequences not so serious, the humor would be priceless.
17. G | 09.01.09
I also want free health care, green grass that never dies, perfect sunshine, and all the happiness that’s possible, but in reality, which is what we live in, it’s not possible. The world is based on money. If someone doesn’t benefit financially then the idea is discarded. I’m not saying there are not exceptions, and I’m not saying it SHOULD be this way, but it is. Unfortunately the world is based on profit, not on your life; therefor, you must make laws and act in accordance with this fact.
18. Bryan C | 09.01.09
We don’t need this, we have Medicaid (government run health care) already! Ask anyone on Medicaid how “good” the quality of care is, then ask yourself if that the **** you and you families want to go through.
Here, an independent journalist trying to get medical assistance in Canada (the purported “Mecca of Medical” according spin doctor Micheal Moore)
http://www.youtube.com/watch?v=q2jijuj1ysw
List is collection of news articles about how Universal (socialized) medicine REALLY works in the countries that have it:
http://www.angelfire.com/pa/sergeman/issues/healthcare/socialized.html
We live in the internet age, do your research so you can’t be lied to as easily!
19. Jerry Powell | 09.01.09
Please understand that government, whether it is controlled by right, left or center is “socialism”, pure and simple. Public schools, and essential services such as police, fire and military are all “socialist” services. Can we get a private version of those services? Clearly yes. Why would we not want a “socialism” version of health access? Are we afraid that some people are not worthy of health and basic well being?
20. joyce | 09.01.09
Everyone - have you all not wondered when obama took office — why he hurriedly passed a lot of issues - became owner of car companies/became head of some major banks/ and now the biggest of all health care reform –What does this look like to you ? Have you ever had a president who got through all these major decisions without any discusion/votes/etc. in this small amount of time? The sad plan to get this going is that the american people won’t even know what hit them - which is Socialism. Do you not see this? Keep the government out of our personal live and bring liberty back the way our forefathers wanted it for the United States!! How did we start letting this happen?
21. Bryan C | 09.01.09
We don’t need this, we have Medicaid (government run health care) already! Ask anyone on Medicaid how “good” the quality of care is, then ask yourself if that the **** you and you families want to go through.
Here, an independent journalist trying to get medical assistance in Canada (the purported “Mecca of Medical” according spin doctor Micheal Moore)
http://www. youtube .com/watch?v=q2jijuj1ysw
If it still sounds like fun, here’s a list is collection of news articles about how Universal (socialized) http://www. angelfire .com/pa/sergeman/issues/healthcare/socialized.html
We live in the internet age, do your research so you can’t be lied to as easily!
22. Rob | 09.01.09
So many comments are just silly, like calling it Obamacare or slamming reform of the system by calling it socialism, (given that nobody seems to propose eliminating or cutting Medicare benefits) but there is merit to the argument that there is little in the current proposals that would really make the system more responsive. We do need tort reform and administrative improvements. Our current system is the least efficient in the world on a per person basis, without having high user satisfaction
24. GF | 09.01.09
No sir, you are indeed wrong. Socialism is an economic system based on state ownership of capital. Moreover, it is the state regulating the industrial aspects of the state. Therefor, police, military, ect are not “socialist” services as you have stated.
25. Rob | 09.01.09
So many comments are just silly, like calling it Obamacare or slamming reform of the system by calling it socialism, (given that nobody seems to propose eliminating or cutting Medicare benefits) but there is merit to the argument that there is little in the current proposals that would really make the system more responsive. We do need tort reform and administrative improvements. Our current system is the least efficient in the world on a per person basis, without having the highest user satisfaction
26. robert m | 09.01.09
I love it when you numb skulls throw in the nazi party…both left and right. Yes we need reform. Yes the Government is famously poor at running anything. We can live with a lousy post office. We can live with the DMV. But please dont make me sit and wait for my number when it comes to seeing a doctor. ..and it will come to that. The fact is THERE ISNT A COUNTRY OBAMA CAN POINT TO AS A SUCCESS OR HE WOULD HAVE DONE IT BY NOW. I lived on the border and Canadians come over for their health needs all the time. REFORM not rebuild.
27. Al | 09.01.09
It seems to me that everyone is missing the point which is, “We can’t afford to fix the broken system that we have for paying for health care. We can’t even afford to cover twenty or thirty million new beneficiaries.” The reason that this is so is really basic. We can’t afford both guns and butter.
Our wars and our empire bankrupting our country - both morally and financially. We can’t afford to do health care reform until we stop trying to force our will on the rest of the world. Bringing our troops home from 130 countries would save us about 200 billion dollars every year.
28. Anonymous | 09.01.09
Yes I WILL commit acts of violence if the Public
“Option” is passed. A government that denies the voice of the people is one that needs to be overthrown by force. This is just the straw that breaks the camels back in a string of abuses by the Federal government by BOTH parties.
29. KW | 09.01.09
I had one of the worst kind of bone fracture years ago and was sent in an ambulance vehicle to a Toronto Hospital. Then for the next 6 hours without water, food and pain killer, while waiting in the emergency ward, I suffered severe pain from the normally undetectable vibration of the ground caused by to the outside traffic on the street and had to beg for pain killer. Finally a nurse came to give me a shot of codeine. I was left to wait again for another 7 hours in order to be X-rayed but after how bad the fracture was shown to the surgeon who made the decision to operate me immediately. Unfortunately, after waiting for another 2 hours I was told that there was other more life threatening operations required of all available surgical teams so I was put on cast and sent home to sit till the hospital called me back for surgery. The next 5 days’ SITTING was the long ever confinement I have had in my whole life. Very fortunately, during those 5 days of being confined, for an unknown reason I lost the sense of pain. However, after placing titanium plates and more than 10 titanium screw to fix my bone, for the next 5 years I was immobile from my shoulder to my elbow. This is how well the Canadian Health care.
30. J | 09.01.09
I hate to break it to you Republicans but we already have socialized health care. Today. Right now. Long before Obama showed up. It’s called: the emergency room.
If someone has a heart attack and calls 9-1-1 it doesn’t matter if that person is rich, poor, middle class, is an illegal dayworker, a legal immigrant or born and bred in the US, has health insurance or doesn’t have health insurance. The emergency room is available to everybody.
Now, since the emergency room is the most expensive care around, it makes fiscal sense to avoid emergency room costs as much as possible. So how can you do that? Force EMTs to ask for people’s insurance cards before trying to save them? I’m sure if you have a heart attack the first thing you’re going to want to do is dig out your insurance card _before_ calling 9-1-1.
The smart thing to do is to make health care more accessible. You won’t be able to deal with the out-of-the-blue stuff that randomly happens to people. But with universal health care you can avoid preventable health care costs.
For example, suppose you’re an unemployed and uninsured late 50 year old and suddenly you have a heart attack. The paramedics come, rush you to the emergency room with emergency quintuple bypass surgery. But because you’re unemployed and uninsured you can’t pay the bill. The cost of the ambulance ride, emergency room and heart surgery gets absorbed by us, the taxpayers.
But if that same individual _had_ access to a doctor sooner, the ambulance ride and emergency room costs could be avoided. That individual could’ve had routine tests to detect the obstruction and the surgery could’ve been done in a more orderly fashion.
Just ask David Letterman. He had quintuple bypass surgery in 2000 because a _routine_exam_ discovered his blocked arteries. Letterman didn’t go in complaining about chest pains, it was part of his annual routine. Imagine if he was just an average unemployed, uninsured person who didn’t have access to that procedure. He’d never know he had blocked arteries and if he’s fast enough to dial 9-1-1, we all pay for it.
We taxpayers _ARE_ paying for the uninsured’s costs anyway. The question is do you want to do is sooner (universal health care) or later (the emergency room). Given that “later” costs much more money, I’m all for “sooner”.
As the old saying goes: A stitch in time saves nine. You’d think Republicans were more familiar with concepts from the 1700’s.
31. John | 09.01.09
Sara, Amazing how some people read only what they want to read…The ‘96 Welfare Reform was passed by the GOP controlled Congress! As a Liberal you want to give Clinton all the credit for it, even though the GOP had a major hand in the legislation.
32. Jerry Powell | 09.01.09
OK. I buy that (I just looked in Webster, and you are definitionally correct about socialism). However, don’t miss my point. Health care access is as much a protection of persons and property as the other goverment controlled services.
The issue is accountability and decency. We are already paying way more than we should because of a broken system that we must fix now. There already is “rationing” and no choice for far too many people. Properly managed and funded (yes - there is no free lunch), it can cost all of us far less and provide far more.
Instead of railing against it, and shouting to do nothing, help us do the right thing in the right way. Nothing is perfect at the beginning. But we absolutely need to start somewhere. And sneaking in obnoxious provisions to undermine the process and make sure it does not pass is very inappropriate in any rule book. Our leaders seem to lack accountability. Too many tails wagging the dog. We need a voice of reason to replace the animosity.
33. David L | 09.01.09
Would people listen to the far right if they attacked Medicare as “socialist”? Obama should extend Medicare Part A (hospital coverage) to everyone, and leave the insurance companies to haggle over doctors bills and the cost of drugs. Throw in 4 Medicare paid visits to a primary care doctor per person per year (one wellness, 3 illness) and you have covered the catastrophic costs and the basic wellness issues of the population without taking on the powerful doctors and insurance lobby. Let the government run (pay for) the hospitals, but leave the doctors on their own. Maybe even encourage Medical Savings Accounts to pay for the doctors bills and drugs as a sop to Republicans and because it might even save money. The insurance companies should negotiate compensation for docs, and negotiate with the pharma companies, and if the government wanted to really promote change it could set up some not-for-profit collectives of physicians/nurses/etc to offer health care on a capitated basis…
34. Edison | 09.02.09
The “right thing” to do, however, isn’t to toss the whole system to a government that has no capacity to balance a budget or implement world leading services (public schools and amtrak for example).
The right thing is to actually create more free-market alternatives so that we can get affordable, personalized services.
There is a reason I shop at a grocery store and choose which foods best serve me and my budget. Not only do I get more choice, but other grocers can compete for my business.
Since most health insurance isn’t portable from one job to another because it is tied to a place of employment for irrational reasons from a bygone era, we aren’t able to have necessary controls which would allow us to name our price on a free market.
We need reforms that create free market competition and give us more control. We don’t need more government control.
Our healthcare would be as efficient as a local grocer by now if the government wasn’t involved in this whole mess.
35. theresa B from Texas | 09.02.09
It is unbelievable how far leaning this article is to the right! The entire Republican party seems to have a new opinion of the reconciliation process since they’ve been relegated to the minority. House Majority Leader Steny Hoyer has compiled a list of all the times the Republicans in Congress have used the budget reconciliation process to push their own agenda:
* 2005 - Legislation That Reduced Spending on Medicaid and Raised Premiums on Upper-Income Medicare Beneficiaries
* 2003 - President Bush’s 2003 Tax Cuts
* 2001 - President Bush’s Signature $1.35 Trillion Tax Cut
* 2000 - $292 Billion “Marriage Penalty” Tax Cut (VETOED)
* 1997 - Balanced Budget Act
* 1996 - Legislation to Enact Welfare Reform
* 1995 - “Contract With America” Agenda
I’m not going to ask the Republicans to be consistent. After all, the Democrats in Congress aren’t being consistent either; these sort of political games are just part of the nature of our system. But let’s just keep in mind that these accusations fly around every two years; there’s nothing remotely unusual about the current debate over whether Congress will use the reconciliation process.
36. Jerry Powell | 09.02.09
Asserting “I will commit acts of violence…”, pardon me for being blunt, is psychotic and very uneducated. Why aren’t you already committing violence because of Medicare? Or maybe you are. Why not go out and beat up helpless seniors? It is the same thing.
Medicare covers those the insurance companies refuse to cover because it is not profitable. Why should they be allowed to cherry-pick their premium payers and leave others out in the cold? That is the real bottom line objective of health care reform - make sure everyone has access. The objective is to help, not to hurt.
Committing violence will never help anyone or anything. That is plain moronic. Life is way to short to waste it trying to hurt and steal from others. The insurance companies, and the preventers of health reform by association, are stealing from all of us.
37. Tesla | 09.02.09
Well said Edison. Mr. Powell, it is true that our health care is the most advanced in the world. It is also true, however, that the system is flawed, for many people get shorthanded in this great health care, but as you said, affordable health care to all would be preferred if it was “properly managed and funded.” But I do not look to the government to take this much control in such an important issue, (though, it is our first instinct to believe so). You must look at what the country is doing with other things financially beneficial to the public, as Edison has said. This health care reform is not so much a reform as it is a total makeover. This is too much “change.” When you start something new in such a large system, you must first take small steps and see how things work out. Such a hasty handover will surely end poorly.
So many look to the government for help, when those in power are there for themselves. The help we seek is in ourselves–the public. The government should not be telling you how it should be, the public should be telling the government what it needs. Does it make sense that you should let a separate entity govern another when both have their own wants in mind? This is why our forefathers built this country. They made it for the people, but very quickly the government is putting its own wants before those it serves–You and me.
38. Isaiah | 09.02.09
These people who oppose healthcare reform are extremely misguided and/or misled by the rightwing conservatives in the media and congress. Why would they trust insurance companies over government. That fact is that I live in Massachusetts and the government health care is the best option there is. We pay for it anyway, we might as well give them the power to reduce its cost. Go Obama!
39. Jim Childers | 09.02.09
Repubs depend on people like rush bimbo, and whimpy beck to spew their venom as they sit quietly by and watch. With a broader information age numbers have certainly increased over all but so has education at least education to the reality of truth. More and more people are seeing you can’t believe everything you see and hear from their television. But with the internet a world wide educational system is now available with varying views from just about every angle on just about every subject. Now people and actually kick in their brain and begin to figure it out for themselves. When the republicans wanted to do away with the education department they fail to realize the power of the internet. No longer can they keep the people in the dark and ignorant. This is their worst enemy and their worst fear.
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1. DCRUMPTON | 09.01.09
OBAMA AND HIS LIBERAL DEMS NEED TO LOOK OUT THEIR WINDOW AND IMAGE FROM HORIZON TO HORIZON FILLED WITH ALL OF THE FEED UP AMERICAN PEOPLE STARTING A FRENCH REVOLUTION IF THEY PASS THIS AND BYPASS WHAT WE AS A PEOPLE HAVE VOICED AT TOWN HALLS.