Pass Then Patch

Last week, I pushed the idea that the House should act first on health care reform, by passing the Senate bill and the reconciliation patch even if the Senate had not agreed to act -- because, I argued, unlike the usual cases in which the House felt betrayed by Senate inaction, in this situation the House could be in a good bargaining position by making health care reform law and then sending over a patch.  I also argued that liberal bloggers and activists were siding with the House in their claims that it was the Senate that needed to go first because liberals assume (based on lots of evidence) that it's always the Senate that's the problem.

And last week, I thought momentum was building for my position.  But none of the reporting or comments on Nancy Pelosi's interview yesterday that I've seen have challenged her assertion that the Senate has to act first.  Here's Pelosi:

[I]t won’t happen by the House simply taking up the Senate bill. “Our members will not support the Senate bill,” Pelosi said. “Take that as a fact.”

And apparently everyone does take it as a fact -- Greg Sargent,  Nick Baumann, Steve Benen, Jonathan Cohn.  Here's how Matt Yglesias puts it:

If the Senate gets its act together and passes a “sidecar” bill of modifications under reconciliation order, then the House will pass the sidecar and pass the original Senate bill and everyone will look like geniuses. If the Senate doesn’t get its act together, then everyone will look like idiots.

But...why?  That is, why let the House off the hook? 

Once again: If the House goes first, passing both the Senate bill and reconciliation, the Senate is then presented with a health care law and some proposed fixes -- fixes such as the repeal of the Nelson deal, switching to taxes for rich people instead of the excise tax, eliminating lifetime caps, all of which should be fairly popular.  But the real key is that Senators would no longer be making a choice between health care reform vs. no health care reform; they would be making a choice between health care reform with Nelson, and health care reform without Nelson.  Democrats should flock to such a bill; Republicans will presumably oppose it anyway, but even that is good: the debate will no longer be over such things as the individual mandate or the exchanges, but over a much less complicated bill filled with goodies.   Not to mention that Republicans will be, should they oppose that bill, actually supporting the continuation of the Nelson deal. 

Now, I don't know what Members of the House are telling Pelosi, but if it's true that they are telling her that they will vote for pass and patch, but only if the Senate acts first, then they are making a real mistake.  Sure, voting for the Senate bill is ugly; they're going to have to bite the bullet and vote for the Nelson deal, and the Cadillac tax, and various other things they don't like.  But the truth is that sooner or later, one way or another, they are going to have to vote for that bill if health care is to become law -- including pass and patch with the Senate acting first. 

The danger, I suppose, is that the Senate lets them down again, even if they send the Senate a very appealing bill.  Is that really so bad? After all, they will be able to brag about the good things in the bill they passed, and also brag about voting for the patch bill -- and they can blame the Senate for not passing it.  Moreover, if the Senate can't pass the patch once the House turns the tables on them by making the Senate bill into law, then it's highly unlikely the Senate would ever have acted without that incentive.  So pass then patch gives Democrats in the House their best shot at health care, and their best shot at the best health care bill they can get.  Most likely the Senate will realize that the patch they are being sent is actually, as a stand-alone bill (which is what it would be at that point), a clear winner.

And then they can start planning the push for a public option through reconciliation if their majority survives the 2010 elections.