The White House is signaling that it’s full speed ahead on getting a bill to the President’s desk, but after Tuesday night that will be much easier said than done. With Scott Brown promising to be the 41st vote against ObamaCare and the threat of a filibuster in the Senate fully restored, just how do they expect to do that? Here are the options I’ve seen tossed around:
1 ) Ram it through the Senate before Brown is seated- Not going to happen, even if House and Senate Dems agreed on a compromise bill and could get it together quickly for both chambers to sign off on. Democrats Jim Webb and Claire McCaskill, as well as Barney Frank, have already thrown cold water on that idea, too, and the optics of shoving something through before Brown can cast his vote would be so poor they wouldn’t dare try.
2 ) Force the House to accept the Senate bill without changes, so that can go straight to the President’s desk- Extremely unlikely. The Senate version has no public option and includes taxes on so-called ‘Cadillac’ health plans that unions vociferously oppose, bitter pills House liberals will find hard to swallow. Pelosi herself said the Senate bill needs changes. Also, the Senate bill is less restrictive on the abortion issue, which House Blue Dog Democrats are sure to find objectionable. The first “reform” package only passed the House by a handful of votes, and they’re already assured of losing one of them. If House liberals cave, fine…but there isn’t a lot of incentive for them to go along with the Senate.
3 ) Use reconciliation- In order to bypass the filibuster in the Senate, Democrats could employ a special budgetary process where parts of ObamaCare can be passed with only a simple majority. But, this procedure is limited to only items pertaining to budgetary issues, which leaves out such things as the insurance mandate, state-level insurance exchanges, and ending the pre-existing condition limitation on issuing insurance. So, there’s not a whole lot that could get through, plus the optics would once again be pretty bad (though Republicans used it under Bush).
4 ) Break up the bill and pass the smaller pieces- It’s been said that there’s bipartisan agreement on some 80% of ObamaCare, so this avenue makes a lot of sense. Democrats would get some of what they want and force Republicans to vote against individual bills which, by themselves, would probably command popular support (ex. ending the pre-exisiting condition limitation). If they decide something is better than nothing, I think this route is a strong possibility.
5 ) Go to conference, decide on a compromise bill, and force the Senate GOP to use the filibuster- By doing so Democrats can go into the midterms saying they tried, but Republicans killed it. Since the bill as is remains unpopular that’s very risky, b/c many will applaud the GOP while the Democrats-even with hefty majorities-will be seen as weak and unable to get anything done. I believe they’d rather have something to hang their hat on, so I doubt they try this.
6 ) Go to conference, decide on a compromise bill, and buy off a few Senate GOPers- Every Senate Republican voted against the reform package, but it’s not out of the question that Collins, Snowe, or Voinovich (who’s retiring) could possibly be swayed to support the final version.
7 ) Start over by pushing a much smaller bill that includes things Republicans want- Take some of the more popular things from ObamaCare, add portability and/or competition across state lines, and maybe you get enough Republicans to push something through. Progressives will howl as it will be, from their perspective, watered-down reform (if they even called it that at all), but its something that they can all say they came together to accomplish. Hard to say if either side is open to this now.
8 ) Drop it altogether- There’s no way they spend months focusing on health care reform and not do something. Sure, they could pivot to jobs and Wall Street reform while blaming the GOP for obstructing action on health care, but I think they’ve gone too far to throw in the towel. Democrats feel that Clinton lost Congress in 1994 because his own push for health care reform failed, so again I believe they want at least something for Obama to sign.
It’ll be interesting to see the approach they take. If anyone has their own thoughts about what they should do or what they expect to happen, feel free to share.
#1 by jeff on January 20th, 2010
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The Democrats will try to blame the Republicans for health care reform not passing when the fact is they have had a year to pass it and couldn’t even do it with the Democrats in control.
#2 by Lowell Fulk on January 28th, 2010
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This is a very well done post Anon.
#3 by Lowell Fulk on January 28th, 2010
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Jeff might very well be right in comment #1. I really have no idea what WILL be done, but I personally like your possibilities #4 and #7.
Do you think that GOP leadership will want to allow their members to cooperate on anything? Sincere question, not meant as a poke.
#4 by zen on January 29th, 2010
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I wonder how many Republican votes would be gained should a malpractice reform package be added to the current legislation.
#5 by Phil Chroniger on January 29th, 2010
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I can see GOP votes being gained if Tort Reform and greater portability of health care from state to state were added, and this public option biz were dropped completely.
Freeing up imports of drugs from other countries (at least ones we trust like Canada and Japan) would be something I would support…but when that amendment was brought to the table in the Senate negotiations, there was bipartisan support for it, and bipartisan opposition…and the opposition won.
#6 by John Doe on January 31st, 2010
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With “Tort Reform” the devil is in the details. If it merely shifts the financial burden from those who caused the damages to those who suffered the damages, then it is wrong. Sure, I can see how it would decrease my costs if we didn’t force the doctors whose carelessness caused a man’s death to help pay his widow and orphans for food and shelter. But would it be the right thing to do?
#7 by Lowell Fulk on January 31st, 2010
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I agree with John.
#8 by Phil Chroniger on February 2nd, 2010
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Tort Reform can include a cap on malpractice lawsuits (which, most can agree, can get very out-of-line with reason).
There needs to be rhyme and reason to malpractice suit awards. Nobody should get millions because their belly button was off-center after a “tummy tuck” unless their job required their belly button to be centered. In the case of malpractice causing death, obviously, you’re dealing with a different animal.
Here is an interesting article on the topic… http://www.realclearmarkets.com/articles/2009/08/06/the_high_cost_of_medical_malpractice_97346.html
#9 by seth on February 2nd, 2010
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the point is that lawyers can make a killing settling questionable claims because it’s often cheaper for a provider to do that than it is to allow it to go to trial (where right now, my understanding is that a jury of your peers determines the value of your award (this is another area that must be reformed)).
i’d like to see something in the direction of the plaintiff’s attorney being obliged to pay the defendant’s legal fees in the event that their claim was deemed unreasonable by a board of medical and legal professionals.
if the subtext isn’t obvious here, please read ‘tort reform wasn’t omitted from the proposed health care legislation because democrats are so concerned about widow’s, orpahns and others who are adversely affected by the carelessness of others. it was more likely omitted because democrats are concerned about how decreased donations from legal professionals (and a de facto acknowlegement that malpractice suits have been out of hand for quite some time) would adversely affect their chances of reelection.’
#10 by Phil Chroniger on February 2nd, 2010
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The article I referenced in my previous post did point out that out of the $233 million in donations to political candidates that were made by lawyers, 76% of those donations were made to Democrats.
Just some food for thought.