by Randolph T. Holhut
American Reporter Correspondent
November 14, 2009
IT'S TIME TO PLAY HARDBALL ON HEALTH REFORM
DUMMERSTON, Vt. -- The good news? For the first time since Medicare was enacted in 1965, one chamber of Congress has passed health care reform.
The bad news? The Affordable Health Care for America Act, otherwise known as the House's version of Health Care Reform, may have a hard time making it out of the Senate in one piece.
By a 220-215 vote late Saturday, the House did a historic step forward toward expanding health care coverage to all Americans. Flawed as it is, the House bill has some good elements.
It would extend access to 36 million people, covering 96 percent of Americans. It would include a voluntary public health insurance option to increase competition and drive down prices. It would end the insurance industry's exemption from anti-trust law to eliminate price fixing and market allocation. It would end abusive insurance company practices like denying coverage to those with pre-existing conditions and dropping coverage of those who become sick. And it would require the federal government to negotiate Medicare Part D drug prices directly with pharmaceutical companies, cutting prescription drug costs for seniors.
But there is a whole lot of ugly left in this bill, starting with Speaker of the House Nancy Pelosi's decision to placate anti-choice Democrats with a provision to prevent federal funds from being used for abortions for any woman enrolled in the public insurance option.
This bill requires all Americans to buy health insurance or face a fine. The public option in the bill is a lot less robust than the "Medicare for All" system that progressives wanted, and the for-profit insurance system is still allowed to continue with only minor infringements on the way it does business. And even if this bill somehow passes the Senate, it would not take effect until 2013.
Getting even something this flawed through the Senate will be extremely tough. Connecticut's Joe Lieberman, an independent who caucuses with the Democrats but frequently sides with the Republicans, has already pledged he will filibuster the bill. Senate Majority Leader Harry Reid, whose supposedly has a 60-vote, filibuster-proof majority to work with, has been utterly feckless in his leadership.
It goes almost without saying that Republicans are united in their opposition to health care reform and have absolutely nothing constructive to offer to the debate. That's why the Democrats have to show equal unity in the Senate to win this fight.
If Reid and the Senate leadership have any guts at all, they have to give Lieberman this ultimatum -- drop your fillibuster threat or lose your committee chairmanship and seniority. If Lieberman want to caucus with the Republicans, let him board the express train to political oblivion.
The truth is that Reid doesn't need Lieberman, or other conservative Democrats such as Kent Conrad, Max Baucus or Evan Bayh. Reid doesn't need them and doesn't need the magical 60 votes to break a filibuster if he and the Democratic leadership are willing to try something called "reconciliation," which would allow them to pass important pieces of health care reform (including the public option) with a simple majority by splitting the health care plan up into two or more bills.
Reconciliation is something the Senate has done more than 20 times in the 35-year history of the procedure. And far from being some arcane Senate rule, it's federal law. The Congressional Budget Act of 1974 states that you can pass a reconciliation bill with just 51 votes. It limits debate in the Senate on reconciliation bills to 20 hours. This means that a bill gets an up-or-down vote with no 60-vote threshold required.
So, in theory, the Democrats could produce one bill to deal with the finances to meet the reconciliation requirements, and another bill to address policy issues which comes to the floor under the normal rules.
Republicans have complained loudly, but they forget that they've used reconciliation to enact across-the-board tax cuts in 2001 and 2003 during the first term of George W. Bush's presidency. And, if conservative Democrats care to join the GOP in tying the Senate up in knots with parliamentary procedures, they do so at their own political risk. If all the Republican Party has to offer on one of most important issues facing our nation is obstructionism, reconciliation might be the only way the Democratic majority can break the logjam and get a decent health care reform bill out of the Senate.
Public pressure helped get a modest health care reform bill passed in the House. It's going to take even more constituent pressure to overcome the lobbyists pouring in millions of dollars to keep any sort of bill from reaching President Obama's desk.
The words that President Obama offered to House members before Saturday's vote apply to every American who wants to see health care reform happen: "Rise to this moment. Answer the call of history (and) finish the job."
Randolph T. Holhut has been a journalist in New England for nearly 30 years. He edited "The George Seldes Reader" (Barricade Books). He can be reached at email@example.com. For extra added thrills, read his ongoing daily blog on The Harvard Classics.