The following alternatives were prepared by the staff of the U.S. Chamber and are contained in an e-mail to committee members. The general consensus is that the Democratic Congress is caught between a rock and a hard place. If they ram the current version of reform through, they risk the ire of many, many Americans in November. If they play procedural games it may be no better. If Congress does nothing, then they really upset many in their liberal base.
1) Ram it through. This would require the Senate and House negotiators to finish negotiations to merge their bills (which have been going on for months), as soon as possible. They would then need to send the merged bill to the Congressional Budget Office, who would take 5-10 days to score the costs of the probably 3,000 page bill. Then the House and Senate would both need to vote on the merged bill, before Senator-elect Brown is sworn in.
This is probably impossible. Not only is there a lack of political will (many members are now afraid they will lose their seats if they vote for health reform), but the timing seems unrealistic. There had been speculation that Massachusetts Secretary of the Commonwealth William Gavin would drag out certifying the election for 15 days in order to buy time, and that U.S. Senate Majority Leader Harry Reid would delay swearing Brown in. However, both have refuted that notion and the process has already begun. Further, Senator Jim Webb (D-VA) made a statement last night that no action should be taken on health reform until Brown is seated. Therefore, this may be an option, but it is effectively dead.
2) Reconciliation. This is the process in which a bill could be passed in the Senate by a simple majority – 50 votes, with Vice President Biden to break a tie. It would entail sending the bills back to Committee where they would again be amended, debated, etc. There is just about zero will to do this. Worse, many provisions in the bill (for instance, a ban on pre-existing condition exclusions) could be stripped from the bill by a simple 1-Senator objection. Worst of all, the non-tax provisions of a reconciliation bill could expire in 5 years, meaning this entire endeavor would have to be repeated.
There have been some House members who have enjoyed making threats to do this, but in the Senate this seems an incredibly unlikely choice of paths, one fraught with problems that would enrage the populace.
3) Cross the aisle. With Senator-elect Brown promising to be the 41st vote against the bill, Majority Leader Reid would need to convince a Republican to join the remaining 57 Democrat and two independent Senators to pass a new bill. The obvious targets would be Voinovich, Collins, and Snowe – all of whom have been pretty clear that they will not support. Voinovich staff insist that his visit to the White House yesterday had nothing to do with health care, they were only discussing ways to lower the deficit.
4) Roll the House. Since the Senate already passed one bill, and since they may not be able to pass another, the last resort may be for the House to pass the Senate bill verbatim, with no changes. This would mean all of the negotiations that have happened over the past month would be thrown out, and many House members would have to vote for a bill they literally hate. Remember, many House Democrats believe the Senate bill was actually written by insurance companies. However, House Majority Leader Steny Hoyer may have best summed up the position of many House Democrats: “The Senate bill is better than nothing.” But Bart Stupak, an influential pro-life Democrat in the House, had another view on the Senate bill this morning: “There is no way that bill is going anywhere…. I bet it wouldn’t get 100 votes.” Note that it would need 218.
START OVER! The President could always walk across the street and ask the Chamber how to write a health reform bill that Americans would support.
While I doubt it will happen, the best alternative is to quickly start a real bipartisan effort to modify this legislation, perhaps look for stages of implementation and educate Americans as to what it will really take to “reform” health care, how much it will cost and why. Let’s start by getting representatives for all players in the room at the same time without a member of Congress or the administration present. Let’s lay our cards on the table and fix what is broken in a manner that does not gore anyone’s ox more than any other.
I was in a diner this morning listen to several conversations going on at the various tables. Not surprising, the topic was the Massachusetts election and health care. Frankly, I was a bit shocked at the dislike being expressed for both the current administration and the health care bill. I was also a bit surprised at the level of knowledge displayed about what is going on in the health care reform effort, especially the various deals being made. For reference the diner was in North Jersey, hardly a Republican stronghold.
Let’s not forget that Massachusetts is the one state with experience in health care reform, where coverage is mandatory, where the government runs exchanges and subsidizes some segments of the population. This experience has expanded coverage, but it has done nothing to control costs and now the State is looking at changes in the delivery system to help control costs. In other words on a limited basis it provides an early view of what is ahead with the proposed federal legislation, facts that are pretty well confirmed by the CBO in its various assessments. As I have pointed out many times, the people who come up short are those who already have health insurance especially those Americans with employer based coverage. That view may be the most misunderstood by many members of Congress and given these people are the great majority of Americans, that is a problem.
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