Today, President Barack Obama will deliver a speech to Congress outlining his plan to move forward on health care reform. The president is expected to advocate the use of budget reconciliation.
Art Levine of Working In These Times warns that some centrist Democrats are already getting cold feet on reconciliation. Sen. Kent Conrad (D-ND), chair of the Senate Budget Committee, went on TV to declare reconciliation impossible. These guys just don’t get it. It’s reconciliation or defeat. There is no other way. Without reconciliation, the bill dies. Without a bill, the Democrats get massacred in the mid-term elections.
Health care reform to date
Quick recap: The House and the Senate have both passed health care reform bills. The original plan was to merge those two bills in a conference committee and send the final version back to both houses of Congress for a vote. However, the Democrats lost their filibuster-proof majority in the Senate when Republican Scott Brown defeated Martha Coakley in the special election in Massachusetts.
Once they recovered from their shell shock, Democrats reluctantly converged around Plan B: Let the House re-pass the Senate version of the bill, thereby skipping the step where the Senate votes on the conference report. However, the Senate bill could not pass the House in its current form. So, the Senate needs to tweak the bill to make it acceptable to the House—either before or after the House re-passes the Senate bill. In order to make those changes without getting filibustered, the Senate Democrats will have to insert the modifications through budget reconciliation, where measures pass by a simple majority. Whew!
Of course, the Republicans trying to paint Democrats as tyrants for using reconciliation. Nevermind that 16 of the 22 reconciliation bills passed since reconciliation was invented in 1974 were passed by Republican majorities.
Whither the Public Option?
Reconciliation would appear to give the public health insurance option a new lease on life. The House bill has a public option, but the Senate bill doesn’t. The public option was traded away on the Senate side to forge the original filibuster-proof majority. As a procedural matter, the public option could easily be reinserted during reconciliation because it has such a direct impact on the federal budget, i.e., it would save the taxpayer a lot of money. The White House claims to support a public option. Yet Obama didn’t propose one in his health care plan last week.
Some observers take that as a sign that the White House doesn’t think the votes are there. (Cynics say it’s proof the White House never cared about the public option in the first place.) Even Sen. Tom Harkin (D-IA) told radio host Ed Schultz that he can’t support a public option for fear of killing the health care bill, according to Jason Hancock of the Iowa Independent. Harkin has been taking a lot of heat from progressives for refusing to join with other senators in signing a letter calling for a public option.
Abortion Storm Clouds
Speaker Nancy Pelosi had little to say about how she plans to overcome resistance within her own caucus on abortion and immigration issues within health reform, as Brian Beutler reports for TPMDC. Pelosi needs 216 votes to pass a bill. The original House bill only passed by 5 votes. Rabid anti-choice Rep. Bart Stupak (D-MI) claims to have assembled a coalition of like-minded Dems who consider the Senate’s slightly less restrictive rules for abortion funding “unacceptable.” There is no reliable public vote count on how many of these representatives, if any, would vote to kill health care over abortion. If they do, it would be purely out of spite. Abortion language can’t be tweaked in reconciliation because it doesn’t directly affect the budget.
Stupak and the myth of federal funding for abortions
In The Nation, Jessica Arons takes a closer look at Stupak’s radical and misleading anti-choice rhetoric. The federal government is already legally barred from funding elective abortions, and nothing in the Senate bill would change that. Arons explains that the Senate bill would allow plans that participate in the federally-subsidized exchanges to offer abortion coverage provided that customers buy that coverage with their own money, not with subsidized federal dollars. If the government pays 30% of the cost of the policy and the consumer pays 60%, the money for abortion coverage comes out of the consumer’s end.
There’s a long tradition of segregating government money. Both Planned Parenthood and Catholic hospitals get federal funds. By law, Planned Parenthood can’t use that money to perform abortions, but it can use it to do pap smears and offer other health care. By the same token, a Catholic hospital can take federal money to provide medical care, but not to proselytize to patients. Arons ably satirizes Stupak’s extreme position:
If everyone thought like Bart Stupak, a woman seeking an abortion:
(1) would not be able to take a public bus or commuter train to an abortion clinic, even if she paid her own fare;
(2) would not be able to drive on public roads to a clinic, even if she drove her own car and paid for her own gas;
(3) would not be able to walk on public sidewalks to the clinic, even though she paid property taxes;
(4) would not be able to put her child in childcare while she was at the clinic if she received a tax credit that offset the cost of childcare;
(5) would not be able to take medicine at the clinic that was researched or developed by the government, even if she paid for the medicine herself.
Bunning backs down
In other health care news, AlterNet reports that yesterday Sen. Jim Bunning (R-KY) ended his one-man filibuster of the extension of a bill that would have prevented a 21% cut in Medicare reimbursement rates and extended unemployment benefits while the Senate finalizes the jobs bill. Bunning caved under pressure from his own party. Even Republicans realized that there was no political percentage in stiffing doctors and the unemployed.
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