I didn’t write an appreciation of the passage of the Senate health care bill, or a frilly piece about how it’s the greatest progressive achievement since the establishment of Medicare, or some other such paint-by-numbers story. I’m not much for spiking the ball in the end zone at the end of the third quarter. There’s still a process to turn two very different bills into one that can pass the House and the Senate and reach the President’s desk. It does nobody any service to spend the next month slapping high-fives and telling everyone to clap louder, not when the differences will tangibly affect millions of people and the access, quality and cost of health care they can receive. If that was all that was left for activists, we would have a huge loophole on annual limits, legal immigrants would be barred five years from Medicaid and the exchanges, nationwide plans could evade state regulatory requirements, and a host of other disappointments. So stepping off the gas would be a big mistake at this time.
There’s a fair bit of confusion about what’s next. Although the term “conference committee” is a proper catch-all phrase for where House and Senate Democrats will go at this point, it’s probably not entirely accurate. The House and Senate will not both return from Christmas break until mid-January, so they wouldn’t even have the opportunity to vote on a formal conference, and the conferees, until then. But that’s assuming they’ll go that route. As David Waldman explains, there are a number of options:
Because the Senate will be sending back a different legislative vehicle than the House sent to them (the Senate will be sending back H.R. 3590 rather than the House-passed H.R. 3692), the House will have the opportunity to choose from among the following options:
Agree to the Senate amendments to H.R. 3590, in which case they’re done and the bill is ready for signature;
Further amend H.R. 3590 (as amended by the Senate) and send it back to the Senate, with an insistence on its position and requesting a conference;
Further amend H.R. 3590 (as amended by the Senate) and send it back to the Senate without further comment, letting the Senate decide to accept the House amendments and finish the bill, or alternatively insist on a conference;
Simply disagree to the Senate amendments to H.R. 3590 and move immediately to go to conference on the two different versions of that bill, or;
Do nothing right away on the floor, but instead begin informal negotiations on a package of amendments acceptable to both a majority in the House and 60 Senators.
The informal negotiations will probably start as early as New Year’s, or maybe even earlier over the phone. The most hopeful scenario for the White House is that the House and Senate reach agreement on a final bill pretty quickly, the House amends the Senate bill and passes it, and the Senate passes that new House version as amended. That wouldn’t be a conference committee per se, although there would be meetings aimed at reconciling differences. Because this would be easier to push through the Senate, requiring less cloture votes and such, this is probably the way the two chambers will go, although it depends on reaching a quick agreement.
Because HR 3590 was a completely different bill, originally about the homebuyer’s tax credit, virtually everything is on the table, with the negotiations not limited to where the House and Senate health care bills differ. But I wouldn’t expect some brand new compromise, a la the Medicare buy-in, to swoop in at the last minute.
The White House has vowed to get heavily involved in the process, aimed at reaching a resolution before the State of the Union address in late January or early February, although they have acknowledged that the timeline could slip.
This is not to describe what will be in such a compromise, but how it will mechanically play out.



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good thing too, because it wouldn’t be true. either version (house or senate bill) will be a big win for neoliberals and a big loss for progressives. but small differences in the final bill can be a big difference in someone’s life, so the least we can do is fight for those small differences and use the opportunity to explain what a progressive solution would be.
That is an informative thread. Wonder if Krugman read it. You mean that a better bill may yet get signed into law. Jane’s KILL THE BILL sounded like a good idea. as it was so bad.
re krugman, hipparchia has a hilarious take down: Paul Krugman and the Bull Profile Series
People that know what they are discussing as does Dr. Marcia Angell is well qualified to analyse the approaches to solutions better than Paul as her field is medicine. I enjoyed reading the hipparchia thread from a standpoint of learning it is not only about the cost burden but adequate medical treatment. I am a believer that insurance companies are skinning the sick and that profit can pay for single payer. The medical community has been devided into corporate businesses that doctors own. Hospitald have leased out departmrnts to these businesses that have their own billing system. The medamorphis from medicine to business is nightmaring more households daily. I am lucky to have veterans service and recently was approved for Cen Cal. Very lucky as $1,000.00 a month does not make me a good target for big medicine and big pharma. I decided long ago prevention was the best path. Thank you for the link Selise.
I like your idea, but I am not sure I understand you correctly. Could you give an example?
Why wouldn’t the WH’s “most hopeful scenario” be that the house accepts the senate bill as is, and votes it out to the president? It is clear the senate bill has been the WH’s bill from the get go.
Also, why not post on what the progressive strategy should be from here out?
a progressive solution is some version of comprehensive universal healthcare. see, for example, single payer national health insurance (improved and expanded medicare for all) based solutions:
http://www.johnconyers.com/hr676faq
http://www.pnhp.org/facts/single-payer-resources
for info on conservative, neoliberal and progressive thought re healthcare see:
http://www.cognitivepolicyworks.com/wordpress/wp-content/uploads/2009/06/logic-of-the-health-care-debate.pdf
excellent!
p.s. i think marcia angell is great — very smart and a big supporter/advocate/activist for single payer national health insurance.
Just who will be in conference committee to fix the bill any Progressives at all?
How about republishing the original post about the Progressive Caucus’ letter re: The Public Option, Jane? Or an updated recap? Have to admit I’m wondering what Donna Edwards is thinking these days.
Didn’t we donate a bunch to their campaigns, around the time of the letter?
I did, it’s a good thing when polititians take a stand for what they believe in…
Yet to be determined from either house…! HoJo better not be any where near the door…!
Valerie Jarrett:
Under the radar, Obama pushes for Patriot Act renewal
http://joshfulton.blogspot.com/2009/12/under-radar-obama-pushes-for-patriot.html
I feel so much better knowing that he isn’t losing sleep. s/
Don’t count of a “better bill being signed into law”. It will be the Senate bill plus or minus a few things – the House has already capitulated.
Eli is upstairs!
Cloture Is Now Officially Meaningless
“The White House has vowed to get heavily involved in the process”
Is this a promise or a threat?
Wrong, they must be made to be afraid.
I’m still with Jane’s “KILL THE BILL” scenario. If the White House and Emmanuel get heavily involved in the process we’ll all be stuck with this pro-insurance company and anti-citizen joke of a bill. There is enough here for the insurance companies to accept it, and that spells problems. This should be a red flag for all of us that the insurance companies are okay with the bill.