The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

The Never Ending Story That is Health Care Reform Continues

Posted by Alan on March 2, 2010


President Barack Obama is scheduled to announce his final health care reform package tomorrow (Wednesday). This is the version of reform the President hopes Democrats in Congress will embrace and enact through a process that would side-step the inevitable Republican filibuster of health care legislation. Passage is far from assured. There are still several parliamentary maneuvers available to the GOP to slow the legislative process down. And it’s unclear whether Democrats can muster a majority behind any single bill to pass health care reform even if no super majorities are required.

Yet there are indications Democrats could be successful. For example, the House passed its health care reform bill by the slimmest of margins – 220-215 – last November. Only one Republican voted for the bill and he has indicated he won’t bolt his party again. Given that 218 votes are need to pass legislation in the House, this doesn’t give Speaker Nancy Pelosi much room for error. However, according to the Associated Press, “at least nine of the 39 Democrats” who voted against the health care reform bill in November are now “undecided or withholding judgment until they see Mr. Obama’s final product.”

That same Associated Press story also reports that the President is thinking of incorporating four Republican proposals raised during the bipartisan health care reform summit last week. These are: 1) using investigators disguised as patients to uncover fraud and waste; 2) increasing payments to Medicaid providers; 3) strengthening and expanding Health Savings Accounts; and 4) expanding the medical malpractice reform pilot programs already in his bill.

It’s not that the President thinks including these provisions increases the likelihood of any Republicans supporting his health care reform legislation. But it would provide Democrats with a useful talking point during the firestorm that would follow passage of reform legislation by a simple majority vote in the Senate. Democrats will be able to say something along the line of “We met with Republicans and had an open mind, even incorporating some of their cost saving ideas into the final package. And our package already included several provisions Republicans had supported now or in the past. Their unanimous opposition, consequently, obviously reflects politics more than policy so we had to find away around the filibuster. What we did was fair, legal and within the rules.” Or something along those lines.

What all this means is that there’s still several chapters to go in the never-ending story that is health care reform.

  • Will Democrats find a way to bring health care reform votes to the floor of the Senate?
  • Will the House vote first or wait until after the Senate takes action (if it ever does)?
  • If a vote is taken, will there be sufficient votes to actually pass a bill?
  • If Congress does enact health care reform legislation, how soon after the President signs it into law will it take before the first law suit is filed?
  • Which party will suffer at the polls this November for the the procedural games both have played?

And on and on. Stay tuned.

6 Responses to “The Never Ending Story That is Health Care Reform Continues”

  1. W... said

    I am all for the idea of real health care reform, but I am not willing to accept a pill which the congress and senate themselves are not willing to swallow. If they are not willing to include themselves, I would consider their plan simply bad medicine… It is interesting when the public expresses their concern and distain for this plan, those pushing it step back and sugar coat is hoping it will go down that much easier.

    I think the politicians on both sides of the fence need to step back and realize this isn’t going to be fixed in a couple of years. It needs to be carefully evaluated. The goverment has one medical care failure. What makes them think they can fix everything “at one fell swoop.”

  2. Rick said

    Alan, what information do you have on the Senate’s inclusion of a commission to control Medicare costs and a provision to push private insurers to adopt Medicare reimbursement rates? This provision has moved Rep. John Adler (D., NJ) from no to undecided.

  3. JimK said

    Re: lawsuit

    While the subject of a lawsuit has centered around the individual mandate provision of the current healthcare proposal given the fact that the Patient’s Choice Act co-sponsored by Republican Senator Tom Coburn also includes a provision for mandated coverage it is uncertain who would initiate this lawsuit.
    In addition, the Republican Party has repeatedly called for the privatization of Social Security. Therefore, unless the Republican demand for social security privatization also includes a provision to make social security voluntary, any Conservative argument that draws its essence from the principle that the government cannot mandate an individual to purchase services from a private corporation is at the very least hypocritical.
    In addition, under Kelo v New London (545 U.S. 469) the Supreme Court has already passed that point in the slippery slope where it is not unconstitutional for a government entity to declare that a pressing public need can deprive individuals of there property for the benefit of another private entity. In Kelo, the Supreme Court allowed the Connecticut Town of New London to seize privately held land under Eminent Domain for the benefit of a commercial developer.

    Summary of the Patient’s Choice Act

    Click to access PCAsummary2p.pdf

  4. I think the administration has an uphill battle to get this passed. It will be interesting to see the outcome of this.

  5. If the Democrats are able to pass a bill, they will definitely try to make use of talking points that communicate to the public some bipartisan behavior on their part. They will need this to counter all of the Republican messaging that would surely follow.

  6. I hadn’t considered the lawsuit possibility. What kinds of legal actions do you imagine could be forthcoming if some bill, by some miracle, does eventually pass? What are the odds that such a suit might ultimately makes its way to the Supreme Court where today’s 5 “non-judicial activist” judges are likely to do anything in their power to continue boosting the interests of the most powerful while diminishing the hopes of the most powerless in our society?

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