Archive for September, 2009

When is reconcilliation not reconcilliation?

Reconciliation on healthcare reform…that has a nice ring to it, doesn’t it? Everyone in government will get together and seek out a consensus on what is best for the country. Reconciliation is a seldom used and rarely publicized legislative procedure.

Ah, if only it were so. As with so many things in Washington, “reconciliation” doesn’t mean what it means. Reconciliation is a parliamentary procedure that a dominant party can use to prevent the other party from blocking legislation in the Senate. Invoking reconciliation would allow Senate Democrats to pass a health- care bill with a simple majority rather than the 60 votes needed to overcome stalling tactics.

Bottom line, the Democrats are going to cram healthcare reform through with or without the support of Republicans and, if necessary, without the support of all of their own troops. As the two sides dig in their heals and move farther apart, an up or down vote of only 51 wise men could shape healthcare in this country for years to come.


Will the Baucus plan garner any Republican support?

Max. Baucus (Dem – Montana) the chairman of the Senate Finance Committee will unveil his Healthcare Reform plan later this afternoon. Thus far, despite intense negotiations within the “Gang of Six”, a group of three Republicans and three Democrats, the Republicans are not on board. Although it is unlikely that a final bill that clears conference between the House and the Senate will bear any resemblance to this first draft, it is interesting to note some things that the bill contains and some that it doesn’t.

• There is not public option in the package. The bill goes with private, nonprofit health insurance cooperatives, which would compete with private insurers. Republicans point out that a public option could still be inserted down the road.
• Bacus claims that the bill provides no government funding of abortion. Republicans claim that the bill is actually silent on the issue and silence on a legal procedure (abortion is not regarded as an illegal medical procedure) allows state funding using federal subsidies.
• The bill excludes illegal immigrants from access to government subsidies or plans. Although this addresses one of the Republicans demands, hospital administrators point out that Emergency rooms will continue to provide high cost, un-reimbursed healthcare to any one who shows up at their doors. This will leave huge financial burdens on the books of medical facilities.
• Baucs claims that the bill is revenue neutral. Republicans are skeptical as are seniors in that most of the funding for expansion of care to those not currently covered will come from cuts in Medicare funding.
• The bill contains no employer mandates for coverage and does not require citizens to secure coverage by any date certain.

The legislative process is a complex one. And this long awaited Senate starting point is just that…a starting point. Bacus will establish a deadline for amendments, and there will be a torrent of them. Once the amendments have been offered, he can pick and chose which he wants to incorporate into the committee version. Then the committee (13 Democrats and 10 Republicans) will debate the bill and in all likely hood vote out the bill to the Senate floor. The full Senate will then debate the bill and vote on a final Senate bill which would then go to conference (controlled of course by the Democrats in both houses) where other changes could be inserted. The final bill goes to the President for an up or down process.

There is still a long road ahead and there are no guarantees that any final bill will have anything approaching bipartisan support.


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