The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Health Care Reform Twisting and Turning

Posted by Alan on March 11, 2010

This is the part of the national roller coaster ride more commonly referred to as reforming America’s health care system where the twists and turns come fast and the responses are increasingly furious.

Yesterday’s post described attempts to deal with the lack of trust between Senate and House Democrats. To summarize: House Democrats don’t want to approve the Senate’s version of health care reform without guarantees that the Senate will and can pass clean-up legislation changing that legislation. House Democrats fear a failure by the Senate to pass the clean-up bill will leave them forced to defend a vote for a clearly flawed bill.

Well, the challenge of reassuring House Democrats the clean-up legislation will pass just got tougher. According to David Drucker of, the Senate Parliamentarian has ruled that the Senate’s health care reform legislation must become law before the Senate can consider clean-up legislation. And the only way the Senate bill can become law is if the House passes it – as is. One might think this means President Barack Obama’s health care reform legislation is dead.

One might be wrong. Senate Majority Leader sent a letter today to Senate Minority Leader Mitch McConnell that formally informs Senate Republicans that the Senate will consider the health care reform clean-up bill under the rules of reconciliation (meaning it takes a simple majority to pass the bill). This can be taken as a show of confidence that Senator Reid believes the House will be passing the Senate’s health care reform bill.

House Speaker Nancy Pelosi is also expressing confidence that Democrats in her chamber will pass health care reform. And based on the optimistic statements made by several participants and reported by the Associated press after a meeting between the Administration and House Democrats today, progress toward passage of health care reform is, indeed, more likely today than yesterday. No one is saying it’s a done deal yet, but clearly the effort is intense and continues.

A critical development will be the Congressional Budget Office’s analysis of changes proposed to the Senate Bill (what will become the content of the clean-up legislation). The CBO report will have a substantial impact on those Democrats on the fence about the comprehensive health care reform package put forward by the Administration.

But more twists and turns await.

  • Can the House Leadership find a procedural path that would allow the House to pass the Senate’s version of health care reform but make it’s enactment subject to passage of the clean-up bill?
  • How many Democrats who voted for health care reform when it passed the House will now vote no because the Senate’s abortion language will prevail in the final product?
  • Will liberals insist on a public option as a price for their vote?
  • Will moderate Democrats who voted against the House bill vote in favor of the more moderate Senate version of reform?
  • What will be the impact of the inevitable demonstrations House Democrats will face during the upcoming Easter recess?

And the list goes on. The only thing for certain is that no one knows for sure, after all the twists and turns, where we all wind up.


3 Responses to “Health Care Reform Twisting and Turning”

  1. Roxann Breazile said Huffpost – Senator Judd Gregg(R) uses uncertainty about the reconciliation process to influence House Dems. Gregg says that if the House passes the Senate version that the GOP will use every conceivable roadblock in reconciliation–even keeping in controversial earmarks–to make the law unpalatable. This latest round of political infighting has certainly been an eye-opening civics lesson.

    • Nosedoc said

      If the Byrd Rule needs to be waived for any portion of the bill that involves a policy change rather than a budgetary issue, the requirement is 60 votes for the waiver, and the 41 Republicans have already vowed not to waive the rule for any applicable portions of the bill, I don’t see all that much of the bill getting through reconciliation–certainly not enough for the Democrats to proudly declare “victory”.

    • Never, ever let it be said that a person who considers themselves “educated” in the wacko world of politics can’t learn something new every day!

      Thank you Roxann, and Doc, for “pushing me” to learn further!


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