More on pass-and-patch.
House Democrats, understandably, are wary of passing the Senate bill with only promises that the Senate will then take up and pass a reconciliation fix.
Republicans are fueling their fears, by threatening to do whatever it takes to stop the reconciliation patch from passing. As Greg Sargent reports, that includes offering endless amendments.
However, this is where it gets tricky for the Republicans. It's one thing to prevent health care reform from passing. It's quite another to prevent improvements to a health care law from passing. What will the patch contain? First of all, it will repeal the (supposedly) noxious deal with Ben Nelson on Nebraska and Medicaid. Second, it will reduce the excise tax. Third, it will presumably remove lifetime caps. Beyond that...well, if the Democrats are reasonably intelligent, they'll cram the patch with as many goodies as possible. The biggest one, in my view, would be a straightforward appeal to seniors. I believe that the Senate bill partially eliminates the doughnut hole; the patch should finish the job. Granted, the patch may have other things in it that are less clearly popular (for example, shifting the exchanges from the Senate to the House version, assuming that would get Senate approval and survive the Byrd rule). But the biggest vulnerabilities, such as the individual mandate, would already be law.
If Republicans want to delay a bill which lowers the excise tax, removes the Nelson thing, eliminates lifetime caps, and closes the doughnut hole...it seems to me that Democrats would be more than happy to take on that debate. Republicans can cry all they want about a government takeover of health care, but the "takeover" won't be in the bill on the Senate floor. It will already be law.
What's difficult for House Democrats, however, is that this strategy only works if they take a leap of faith and pass the Senate bill first. If they hold it hostage to the Senate, than Senate Republicans can hold the reconciliation bill hostage as well. If, however, health care reform is already the law of the land, the Senate Democrats will have far more leverage. After all, they can always threaten that if Republicans won't allow them to act, they'll just drop the bill and allow the law to stay in effect. Not take effect, but stay in effect.
(Of course, this strategy works a lot better if Dems can keep unpopular items out of the bill. For what it's worth, however, Senate Democrats have already proven that they can stick together to defeat GOP feel-good amendments, so there's some hope that they could do so again).
For what it's worth, the House could pass the reconciliation patch the same day that they pass the Senate bill, allowing them to at least claim that they voted for the things they want to run on. Overall, however, it seems to me that the logic of the situation calls for Democrats to take the leap of faith, pass the bill, and then trust the Senate to pass the patch.