Congressional Democrats Look to Reconciliation To Pass Reform
Congressional Democrats appear to have agreed on a strategy to have the House pass the Senate health reform bill (HR 3590) and use the budget reconciliation process to make changes that are acceptable to House liberals, senior Democratic aides said Monday, the AP/San Diego Union-Tribune reports (Alonso-Zaldivar, AP/San Diego Union-Tribune, 1/25).
The maneuver will require the House to pass the Senate legislation unchanged but would give the House an opportunity to make some substantive modifications that would only need 51 Senate votes for approval (Washington Times, 1/26).
According to Democratic sources, many of the changes being considered are provisions on which House, Senate and White House negotiators agreed earlier this month that are aimed at winning the support of House liberals. The changes include:
- Increasing the Medicare payroll and unearned income tax to 2.35% for families whose annual incomes are greater than $250,000;
- Granting $50 billion more in insurance subsidies for low- to moderate-income U.S. residents;
- Cutting $150 billion from Medicare Advantage programs;
- Delaying an excise tax on high-cost health insurance plans until 2018 for state and municipal employees and those with collective bargaining agreements;
- Raising the cost of coverage at which the excise tax kicks in for families from $23,000 annually to $24,000 annually;
- Removing provisions in the Senate bill that would have the federal government pay Nebraska's entire cost of a proposed Medicaid expansion;
- Closing the Medicare prescription drug benefit's "doughnut hole"; and
- Adding a package of tax credits for certain areas -- including research and development -- that expired at the end of 2009 (Frates/Budoff Brown, Politico, 1/25).
It remains unclear whether the House -- even with the proposed changes -- has the votes to pass the Senate bill, because the budget reconciliation procedure is "subject to complex rules" that could make it difficult to include some key provisions that might be necessary for House passage, the New York Times reports (Herszenhorn/Pear, New York Times, 1/26).
Rules governing the budget reconciliation procedure limit changes to provisions that solely affect taxes and government spending, which complicates how some provisions -- such as those on how to restrict taxpayer funding for abortion services -- would be handled (AP/San Diego Union-Tribune, 1/25).
In addition, according to the Times, using the budget reconciliation procedure is risky particularly because it could incite political backlash against Democrats. According to the Times, Republicans likely would publicly portray using reconciliation as "parliamentary trickery."
Furthermore, Senate Budget Committee ranking member Judd Gregg (R-N.H.) warned that using reconciliation "would be a very hard lift" because Republicans "would make it an extraordinarily difficult exercise" (New York Times, 1/26).
No Decisions This Week
While discussions on how to possibly move health reform forward are ongoing, Democratic leaders said on Monday that they do not expect to have settled on a final strategy by President Obama's State of the Union address on Wednesday, Politico reports.
Senate Majority Whip Richard Durbin (D-Ill.) said, "Both the majority leader and the speaker need time to talk with their members."Durbin noted that while Obama's speech is expected to focus on jobs and the economy, health reform will remain a priority (Politico, 1/25). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.