President Obama has sounded the train whistle signaling that health care reform is his fast-moving vehicle. A new, revised bill will be attached to the annual budget reconciliation measure, which requires a simple majority vote for passage. After his healthcare summit, the President urged Congress to “finish its work” and vote on a new revision of comprehensive health care legislation. In an effort to include Republican ideas, the bill will include state grants for medical-malpractice reform, and measures to curb waste in Medicare. Senate Democrats will send the revised measure to the Congressional Budget Office for a cost estimate that will be presented to the public.
Yet, politicos and politicians are saying that health care reform via “reconciliation” is not in the best interest of voters. They are focused on the process, rather than on the policy.
Here’s a brief history of reconciliation: Since 1982, major changes to the health care laws have been passed through the budget reconciliation process. It’s a good provision that was designed to keep spending and taxes within the parameters of the budget blueprint, a task made easier by an expedited process that prohibits filibusters and limits debates to 20 hours. This change also had the effect of lowering the threshold for action from the 60 votes necessary to close debate to a simple majority.
Key measures that have changed health care laws through reconciliation bills are: the 1985 Consolidated Budget Reconciliation Act (COBRA), which allowed laid-off workers to continue their employer-sponsored coverage; and the Budget Act of 1997, which created the Children’s Health Insurance Reform. In fact, 17 of 22 bills passed under the reconciliation process have been pushed by a Republican-controlled Congress or under a Republican President. In 1996, reconciliation was used to enact other sweeping welfare reform via the Republicans’ Contract with America. Again, in 2001 and 2003, Republicans used reconciliation to pass President Bush’s tax cuts. So, there is a precedent. In fact, what is in play in the basic notion that majority rules.
Soon, the Senate leadership will pass another bill by inserting it into the text of the budget reconciliation bill. This tactic is a legitimate alternative to the standard rules for lengthy debate time, disabling filibusters and the 60-vote threshold for action. .
There also is a pesky notion that Congress has been rushing and that reform is being jammed down America’s (and industry’s) throats. Here is the true story: In 2008 and 2009, the Senate Health, Education, Labor, and Pension Committee held 14 bipartisan roundtables, 13 hearings and 20 walkthroughs. In June and July of 2009, the committee spent 13 days and more than 56 hours marking up health care legislation. Further, the Senate Finance Committee held over 50 meetings and 17 roundtables, summits, and hearings. Even with that said, some folks cry about unfairness to the minority in Congress. No need to feel bitter or rushed anymore: this process has been a thoughtful one. And with regard to the fear of a “federal takeover of health care,” the proposal is actually not a government-run program, but a state-run health insurance exchange. It will create choice and competition in health care.
The truths are out there. The government is not a monster designed to squash our liberties. Perhaps with an understanding of the legislative process, voters might become more engaged, willing to promote positive policy ideas and less fearful of or angry about change.
As for health care reform, the majority in Congress supports it, they have worked on developing ideas with the public for a year or more, the President has put his name on the overhaul, and with a simple majority vote in both bodies, a bill will be enacted and signed into law. While it’s not the most streamlined bill, and while it does not provide a public option, these are the rules, just as we had them under the Republican majority. So, let’s play by them: know what the substantive issues are at play by reading, listening and talking to the sources.