Tuesday, January 26, 2010

What Exactly Are You Blocking?

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.


  1. Congressional Democrats were elected to represent their constituents, not pander to the far left-wing of the Democratic Party. According to a Gallup Poll, “55% to 39%, Americans say the president and Congress should now suspend work on the healthcare bill and consider alternatives rather than trying to pass the current version.” Check it out: http://www.gallup.com/tag/healthcare.aspx. Instead of pushing a desires to control everyone’s healthcare, perhaps Democrats should consider going back to their original premise….which was to lower the cost of healthcare and make it possible for anyone who wants coverage to purchase it… just a thought.

  2. This scenario seems somewhat unlikely. You neglect to mention that what the Democrats will be doing is saying, "We went ahead and passed a bad bill that polls very poorly. And now we're desperately trying to fix our unpopular bill by using a complicated budgetary process deliberately designed to bypass the 60-vote threshold. The reason we have to do this is because a deep blue state elected a Republican to the Senate who signature campaign promise was to 'be the 41st vote'. Furthermore, though a recent CNN found that an overwhelming 70% of respondants cheered the loss of the filibuster-free Senate, we don't think that the overall message of the entire affair is to pursue bipartison consensus on an incremental set of reforms. Trust us, you're gonna love this bill...in 3 - 5 years maybe when it is actually operational."

    This is logical? I don't think it is the Republicans that will be experiencing the general pushback.

  3. Jana,

    Your arguments are all about health care as a bill. I'm arguing that if it's a law, all of that changes. In that case, the choice for the Senate isn't whether or not to enact health care reform; it's whether or not to improve the current law.

    Moreover, it's really not hard to imagine the patch bill being far more popular than the current Senate bill. For one thing, the patch bill will eliminate the Nelson thing; opposing it would mean protecting the Nelson thing. Now, pols can argue anything they want, so there are no guarantees that the GOP won't make claims that make no sense at all....but remember, the big substantive part of the bill is going to be a shift from one tax structure to another - and it's a shift that presumably will poll well (reducing the Caddilac tax and adding a tax on rich people -- the latter usually polls well). The bill won't have a public option, won't set up complicated exchanges (because they'll already be law), won't impose individual mandates (ditto), won't set up a Medicare commission (ditto)...and on and on. Sure, Senate Republicans will take the opportunity to bash the health care law, but since that won't be up for a vote, it's not clear to me why Dems wouldn't generally support the patch.

    (Oh, and by the way, I do think it's very likely that if this thing becomes law, it will quickly become about as permanent and well-liked as Social Security and Medicare. Not down the road, but right away).

  4. I can feel that you have put in hard efforts. Good job!!


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