As far as I can tell, the following four things are true:
The Senate already passed a comprehensive health care bill, which if the House passes as-is, can be signed by the President.
Among the reasons the House is reluctant to pass the bill as-is is that it contains some politically damaging items; chiefly, unpopular kick-backs to win over three centrist Democratic Senators.
The plan is to “fix” the bill using reconciliation. Reconciliation would allow the kick-backs to be excised, as well as other relatively minor changes to be made.
But, there is much controversy over whether the Senate will pass the fixes using reconciliation, and the House does not want to be hung out to dry by voting for the controversial provisions.
But I don’t see how all of those things hang together. Why is reconciliation needed to fix the bill? Is the GOP going to filibuster getting rid of the kickbacks to states? Are they going to filibuster adding provisions about Medicare fraud? Even if they don’t like some of other changes, couldn’t the politically problematic issues (the kick-backs) be passed separately? What am I missing?
It sure seems to me that if the House passes the bill as-is, the one thing we know for sure the Senate can then pass under normal procedures is a bill to amend the one just passed to get rid of the kick-backs. So aren’t they a non-issue?
The changes to be made don’t alter the bill too much, but they aren’t as minor as your post makes them seem. They want to lower the excise tax and push off implimenting it for a few years (which is a compromise to get Union support, and hence not popular with the GOP). They’ll also increase subsidies (which will make the bill more expensive, though it will still raise/save more money then it spends) and I think creating national exchanges is part of the compromise too, though I might be wrong.
But you make a more general point that I think has been lost on the media, which has been playing reconciliation up as some last stand for health care: if the Congress reaches the point where they seek to use reconciliation to pass the bill, Health Care will already be law. The Reconciliation vote will be a fairly anti-climactic raft of wonky changes to an already passed piece of legislation. There probably won’t even be much question at that point about whether the changes will pass, since the House is unlikely to pass their bill unless they have a firm commitment from 50 Senators that Reconciliation is a go.
I think I muddled my own question, so let me try to make it clearer. My question is this: Why aren’t the kick-backs to states a non-issue?
Some of the reconciliation fixes, as you suggest, may not be popular with the GOP for whatever reason. But surely deleting the kick-backs is popular, or at least not going to be subject to filibuster. And it is that change that the media narrative has House members concerned might not succeed, and GOP spokespeople threatening to bash them with if the Senate fails to fix them.
Isn’t it a certainty that, even if they have to be done separately, the kick-backs to certain states can be deleted by a new bill passed by normal procedures?
The Republicans want the Democrats to fail. Everything else is just a tactic. The masses are too stupid or lazy to even try and understand what is going on. I bet not one in ten people know what a filibuster or reconciliation is.
True, but irrelevant. The question is why members of Congress would be cowed by the possibility of the Senate failing to excise the state kick-backs when there is little doubt the Senate could do so without even using reconciliation.
Unless you think the GOP would filibuster a standalone bill that got rid of the kick-backs. In which case, they’d just be shooting themselves in the foot because the House members in question would just point out that the GOP filibustered the fix.
The Republicans don’t like the bill with or without the kickback provisions. If they take out those provisions, the bill goes back for a vote, and the Republicans will filibuster. They won’t be filibustering the removal of the kickbacks, but the rest of the bill, which they never liked in the first place.
No, that’s not correct. The vote in question would be a new bill that amends the already passed bill, and the only amendment would be to remove the kick-backs. The only thing they would be filibustering is the change, since the bill will have already been passed (by the House ping-ponging).
The answer to the OP is basically what Simplicio said with a good measure of “concern trolling” from the GOP.
The GOP is confident they can filibuster the “fix” bill without being tarred as supporters of the “Cornhusker Kick-back”, but are also beginning to realize that there isn’t too much they can do to stop UHC from passing short of scaring enough House Dems to vote against passing the Senate bill. Which is exactly what they are trying to do.
But in this case, “holding up their end of the bargain,” means passing a fix that doesn’t even require reconciliation to pass. Why would they be concerned that it wouldn’t pass?
But that assumes that the “fix” bill will be a one-shot deal. Why couldn’t the Senate pass the deletion of the kick-backs as a stand-alone fix, using normal procedures? Do you really think the GOP would filibuster a bill that just deletes the kickbacks?
Because it is generally expected that the reconciliation bill will do more than just remove that provision.
The 41 Republicans in the Senate have signed a letter saying that they do not support the concept of making changes to the health care bill through reconciliation. Link. Therefore, the changes (whatever they may end up being) cannot be done by normal procedures.
So then the heart of the question is: why? If the main political pill the House must swallow is the kick-backs in the Senate bill, why not promise to get rid of those kick-backs in a separate bill from the other fixes?
I’m not saying that it is the only issue being negotiated. I’m saying it is the main issue the House is being threatened with by Republicans for the purposes of 2010 elections if they pass the Senate bill and it doesn’t end up getting fixed. And I’m saying that doesn’t make any sense, because even if they can’t pass the other fixes, they can definitely pass that one.
The House Dems are worried the Senate will hem and haw and never get around to passing any fix at all. The only guarantee the Senate Dems can give is that they’ll make the changes through Reconciliation, they don’t have the votes to gurantee to break a filibuster, even on issues like the kickbacks where you wouldn’t think the GOP would filibuster.
Plus its not totally obvious the GOP wouldn’t filibuster. I wouldn’t have though they’d try and block pay-go legislation earlier either, but they did (try that is, they didn’t have 41 votes at the time so the filibuster failed).
And even if they do get, say one GOP senator to swear up and down that they won’t filibuster, they can still draw the vote out through various proceedural manuvers so that the Senate will have to choose between dropping it or resign themselves to letting Health Care draw out for another few months.
I’m sorry I’m being unclear. My question is why can’t it work like this:
House passes Senate bill.
Senate introduces bill just to get rid of kick-backs.
That bill passes OR the GOP is forced to filibuster it, neutralizing the political issue
Senate inroduces bill to deal with all the other disagreements, which requires reconciliation, and may or may not pass.
That way, the House would at least be guaranteed that they aren’t going to be slammed for the kick-backs, and the worst case scenario is that they don’t get the policy compromises they want.
You are proposing that the Congress go down a strategy in which they would need to pass two bills instead of one… why? The kickback can be taken care of in a reconciliation bill, obviously. Fixing the kickback is probably viewed by many Democrats as a good thing, or at least inevitable.
If one were to separate out this “good” thing from a package of more controversial matters, it makes the package of more controversial matters less palatable.
So far as I can see, nobody is arguing for keeping the kickbacks. Obama has proposed deleting them, Ben Nelson seems to acknowledge it is going to be deleted, and I’m not aware of anyone putting up a fight to keep them in. What political issue is there that needs to be “neutralized” if nobody is arguing against deleting the kickbacks?
ETA: The issue of kickbacks (and whatever else relatively non-controversial fixes) can always be taken up again if the reconciliation bill fails. But I don’t understand what the advantage is to passing the kickback portion first.
Republicans are saying to House members, “If you vote for the Senate bill, we will attack you for supporting kick-backs to states. They might be fixed by the Senate before the mid-terms, but they might not be. Don’t take that risk.”
This is an empty threat if the Senate is willing to pass a separate bill to delete the kick-backs, aside from any mess over other reconciliation fixes.
ETA: If the argument is that the only way to get 51 votes for the fixes is to include the deletion of kick-backs in that bill, that would explain it.
I thought that there was a lot of other stuff in the Senate version that many House Dems didn’t like. For example, the abortion provision will have many conservative Dems voting “no”, and the tax on union benefits had many liberal Dems up in arms.
So, if the Senate tries to reassure the House that they will “fix” the bill later, all it takes is for 41 Republican Senators to say “No, we won’t” and the House Dems are left with their original choice: yes or no on the Senate version.
The other point is that every House Dem being cajoled right now (except Dennis Kucinich, but I think Pelosi has given up on him) has already voted for a UHC bill. It’s not like the GOP won’t attack them over that anyway. So really, the only issues at stake are the issues that are different in the two bills. Different House members are subject to different threats over this - pro-life ones over the abortion issues, union backers over the cadillac tax, almost all of them over the kick-back issues.
The only way the GOP threat you quote (or any one like it - “I’ll tar you for voting for a pro-abortion bill” for example) works is to insinuate that the Senate Dems won’t be able to pass a fix bill. The most likely way to fix all of the problems is to pass all of the provisions at once, since some (the cadillac tax in particular, and perhaps the abortion language as well) will be somewhat difficult to get even 50 votes on individually. And to get the votes in the House you need each rep to have confidence that their issue (not just the kickbacks) will be dealt with.
In the end I still contend it’s mainly concern trolling of the “don’t throw me in that briar patch variety”. There is really very little for a house member that has already voted for the bill once to lose by voting for it again, with or without a “fix” bill (which I also think is likely to pass for reasons outlined above - not much support for not modifying the UHC plan once it’s already the law of the land).
There is a level of game-playing that would be entertaining if the bill itself weren’t so important.