Reconciliation may be Democrats last hope for health overhaul

At the close of Thursday's summit, President Barack Obama hinted at his party's next step: If Republican support does not emerge, Democrats will move forward with reconciliation, a complicated procedure that would allow them to pass health overhaul legislation even without a filibuster-proof 60-vote majority in the Senate, The Washington Post reports. Such an approach carries political risks, and may not succeed, but, Obama signaled that he would take those chances. "The question that I'm going to ask myself and I ask of all of you is, is there enough serious effort that in a month's time or a few weeks' time or six weeks' time we could actually resolve something? And if we can't, then I think we've got to go ahead and make some decisions, and then that's what elections are for," Obama said (Murray and Kornblut, 2/26).

Reconciliation, the Associated Press reports, carries myriad "pressures, emotions and uncertainty … for both sides." The tactic "would put an obscure, appointed Senate staffer — its parliamentarian — in a political crucible for one of the year's most momentous legislative and political showdowns. It would raise questions about how extensive the legislation would be, due to limitations on the process. And in the end, it may boil down to a physical endurance test as GOP senators try stopping the measure with an endless parade of votes" (Fram, 2/26).

Politico lays out how Democrats envision the reconciliation process working in this case. "Step one, House Speaker Nancy Pelosi has said Congress must first pass a reconciliation bill with major, but limited, fixes to the original Senate bill. Step two, the House would then agree to pass the Senate bill. Step three, both chambers would have to pass a third bill with policy changes that would not pass muster under reconciliation," to address issues not related to the budget, such as abortion (Budoff Brown, 2/26).

To achieve success through that process, "Obama now faces head-on the challenge of cementing Democratic support behind the healthcare blueprint he unveiled this week and rounding up the votes to push a legislative package through the House and Senate by the end of next month," the Los Angeles Times reports (Levey and Hook, 2/25).

That may not be an easy task either, The Denver Post reports. "A major sticking point is likely to be abortion. Both bills put restrictions on how insurance companies operating in an exchange can cover the procedure. The less-restrictive version adopted in the president's plan is too weak for some conservative House members and too strong for many [liberals]. Likewise, some Democrats in the House are opposed to a provision in the Senate plan that prohibits illegal immigrants from buying insurance in the exchanges, even with their own money" (Riley, 2/26).

Republicans have lambasted Democrats for discussing reconciliation, which one GOP leader called "a little-used process," CNN reports. Democrats say it's more common than the Republicans imply. A fact check concludes, "According to a report by the Congressional Research Service, 22 bills have been sent to presidents through the use of reconciliation from 1981 to 2008. Three of those bills were vetoed by President Bill Clinton." Some of those maneuvers included changes to major policy issues, like health care and tax exemptions (Lacey-Bordeaux, 2/25).

Kaiser Health News has a story explaining reconciliation.


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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