Democrats Reach Tentative Agreement on Using Reconciliation Process To Fast-Track Obama’s Health Care Proposal

Congressional Democrats have tentatively agreed to include reconciliation language in the fiscal year 2010 budget resolution (H Con Res 85, S Con Res 13) to advance health care reform legislation, the Washington Post reports. According to the Post, the use of reconciliation "would make it far easier to pass" health care reform legislation compared with attempting to reach a bipartisan agreement (Montgomery/Paley, Washington Post, 4/25).

The New York Times reports that using reconciliation to advance health care reform legislation reflects the importance President Obama places on health care reform. According to the Times, Obama's preference for reconciliation indicates he likely will be unwilling to compromise on health care legislation, "even if it means a bitter partisan fight" (Hulse, New York Times, 4/25).

According to Senate Budget Committee Chair Kent Conrad (D-N.D.), the resolution would instruct congressional committees with authority over health care to produce a reconciliation bill by Oct. 15 (Washington Post, 4/25). However, if a bipartisan bill can be reached before that date, lawmakers will work to pass that measure, according to the Times. Conrad said, "Virtually everyone who has been part of these discussions recognizes that reconciliation is not the preferred way to write this legislation," but "the administration wants to have a reconciliation instruction as an insurance policy" (New York Times, 4/25).

Senate Finance Committee Chair Max Baucus (D-Mont.) said he will push to complete a bipartisan bill before the Oct. 15 deadline (Washington Post, 4/25). Baucus on Friday said that he would prefer not to use reconciliation, adding that his goal is to produce a health care bill that could "get significantly more than 60 votes" (New York Times, 4/25). Baucus said, "When you jam something down somebody's throat, it's not sustainable," adding, "I want something that will last" (Taylor, AP/Philadelphia Inquirer, 4/26).

The compromise resolution caps spending at $10 billion less than requested by Obama. In addition, the resolution would stop for two years scheduled cuts to Medicare physicians' fees (Clarke/Conlon, CQ Today, 4/24).

Republican Reaction
Congressional Republican leaders, who have been opposed to reconciliation, say that health care is too important to be passed with only a simple majority (New York Times, 4/25). Senate Minority Leader Mitch McConnell (R-Ky.) said that the inclusion of reconciliation language in the compromise resolution "would make it absolutely clear [that Democrats] intend to carry out their plans on a purely partisan basis" (Washington Post, 4/25).

Congressional Republicans have said that if reconciliation is used to restrict a filibuster on health care, they also will use procedural tools to prevent the passage of the resolution. Senate Budget Committee ranking member Judd Gregg (R-N.H.) said, "The floor of the Senate will become a very untidy place if they start using reconciliation for major policy" (New York Times, 4/25).

Prospects
The budget resolution conference committee is scheduled to meet Monday to finalize a compromise bill. If a deal is agreed upon by the conferees, the resolution would move to both chambers for their respective approval (Washington Post, 4/25). House Democratic leaders hope to pass the compromise resolution on Tuesday, followed by Senate approval on Wednesday -- Obama's 100th day in office (AP/Philadelphia Inquirer, 4/26).

Once the compromise resolution is approved, the Senate Appropriations Committee and the House Appropriations Committee will begin work on the 12 appropriations bills that comprise the budget. Obama is scheduled to release final details of his budget proposal by the week of May 4. The House Appropriations Committee likely will begin marking up the 12 bills in late May or early June (Clarke, CQ Today, 4/24).

Comments
Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Foundation's Commission on Medicaid and the Uninsured, said that reconciliation might make it more likely that several controversial Democratic health care priorities end up in the final bill, including the creation of a public health plan option and limits on Medicare Advantage plans. However, reconciliation also substantially increases the likelihood that the White House will be successful in passing a significant health care bill, according to Rowland. She said, "It may not be the most effective way to build bipartisan consensus. It may be the most effective way to get such a large bill passed" (Levey, Los Angeles Times, 4/25).

Richard Kirsch, president of Health Care for America Now, said, "It's an incredibly important moment," adding, "It changes the whole dynamic because it allows Democratic leadership to stand fast on the fundamentals of reform that they think and we think are necessary to make change work" (Wangsness, Boston Globe, 4/25). He said, "We cannot do the kind of reform that meets the needs if it's held hostage to people who don't have a vision for broad reform" (Washington Post, 4/25).

Opinion Piece
The decision by Obama and congressional Democrats to use budget reconciliation if necessary to pass health care reform legislation "is a deeply troublesome attempt to circumvent the normal and customary workings of American democracy," Sen. John Sununu (R-N.H.) writes in a Wall Street Journal opinion piece. Sununu continues, "It's a radical departure from congressional precedent" as the procedure "was never intended to push through dramatic and expansive new programs." He writes that using reconciliation "promises bitter divisiveness under an administration that has made repeated promises to reach across the partisan divide" and "destroys any incentive for good-faith negotiations over the details between the Democrats and Republicans" (Sununu, Wall Street Journal, 4/27).