After weeks without clarity, it appears the top leadership in the Democratic Party is committed to using the budget reconciliation process to make changes to the health care bill so it can pass both chambers of Congress. And the White House supports the action as well.
President Obama, House Speaker Pelosi and Senate Majority Leader Reid are preparing to begin the reconciliation process after next week’s bipartisan White House health care summit. “They are coming out of the summit guns-a-blazing and they’re committed to reconciliation,” said one Democratic insider. All three are dedicated to comprehensive reform, but Reid and White House chief of staff Rahm Emanuel are cautioning that “it’s going to be a heavier lift than a lot of people expect it to be,” said a senior Democratic official. “It’s going to cause political problems.” Not the least of which is how Democrats pivot to reconciliation, a procedure Republicans view as a partisan ramrod, shortly after Obama hosts the GOP to talk about bipartisan solutions. Right now, Democratic leaders are considering a $200 billion reconciliation bill that includes more affordability subsidies, the union-tweaked Cadillac tax and filling in the gap in seniors’ drug coverage, which would be paid for primarily by additional Medicare cuts and an increase in Medicare payroll taxes above those in the Senate bill, an insider said.
I’d only go by this “insider” take because it matches what we’ve been hearing all along – affordability credits, reducing the excise tax, filling the donut hole, paid for with an increase in payroll taxes on the wealthy. And if Rahm Emanuel is cautioning about something, you can pretty much guarantee it’s the right move.
The report cautions that the votes aren’t quite there for the bill, but when Evan Bayh is consenting to using reconciliation, you can be pretty sure that at least a simple majority in the Senate will agree as well. The reconciliation whip count shows 34 so far in favor of the process, 4 maybes and just 1 no (Blanche Lincoln), so this is not all that heavy a lift, particularly if Republican intransigence and obstructionism can be demonstrated.
The President will propose a comprehensive bill in advance of next week’s health summit, and the changes from the House and Senate base bills will be entirely budget-based, clearly suggesting reconciliation as the answer. Will that include the newly-resurgent public option? Ezra Klein reported yesterday that there’s “sharp resistance” to any public option comeback in the White House. But then Kathleen Sebelius told Rachel Maddow the White House would push for it if the Senate included it in their reconciliation bill:
Eighteen Senators have signed a letter asking Harry Reid to push for the public option using reconciliation, which would allow Democrats to pass it with just 51 votes. (Republicans may be able to slow or halt the processing with procedural objections.)
Appearing on MSNBC tonight, Sebelius said the administration would back that decision.
“Certainly. If it’s part of the decision of the Senate leadership to move forward, absolutely,” she told Rachel Maddow.
I don’t think those two stances are all that contradictory. We know the White House wants a bill in the end, and they’ll resist anything controversial that might leave them with no bill. But they’ve consistently allowed Congress to take the lead, and they know Reid won’t touch the public option unless he has majority support, so they’ll back it on the back end.
All we’ve learned is the path forward: a reconciliation sidecar, with the Senate bill as the baseline. We do not know if such a strategy will pass, particularly in the House, because nobody wants to talk about the other roadblock. From the NYT piece:
Democrats said it was still unclear how the president would deal with other disagreements, including the issue of insurance coverage for abortions.
Abortion remains “a wild card,” said a Democrat on Capitol Hill.
Ignoring that element does not make Bart Stupak disappear.