Could Reconciliation Bring Single Payer Back From the Dead? GOP Obstructionists May Shoot Themselves in the Foot on Healthcare

BUZZFLASH NEWS ANALYSIS
by Meg White

There's been a great deal of speculation of late as to whether the August recess could kill healthcare reform entirely. It's starting to look like the alarmist claims about the power of the congressional vacation are a little overblown.

Political math guru Nate Silver wrote when it was becoming clear at the end of last month that there would be no finalized healthcare bill before the August recess that the timeout is just fine. He predicted approval numbers would swing blue by the time Congress returned, and that media coverage was blowing the disadvantages of the break way out of proportion.

Regardless of polling and op-eds, there may be another, more procedural reason that healthcare reform might benefit from a break in the action. The longer it takes to cobble this Frankenstein of a bill together in Congress, the closer the Senate gets to their reconciliation deadline.

Budget reconciliation is a parliamentary procedure by which legislation can be passed in the Senate on a simple majority, rather than relying on the 60 votes required for cloture, which ends a filibuster. Senate Democrats have this trick in the back pocket of their healthcare reform strategy, and have said they intend to use it if there's no bipartisan plan by Sept. 15.

The riskiest part of using reconciliation in this case lies in the procedure known as the Byrd rule, which stipulates that all legislation passed in such a manner be related to the budget deficit. Using this rule, individual lawmakers could challenge policy changes unrelated to federal spending (such as a rule requiring insurers to cover everyone regardless of preexisting conditions) and have them removed from the bill. The Byrd rule ensures unrelated committees can't step in with "fig leaf" budgetary connections to get around the requirements.

Some items could be tucked in to budgetary measures, but there is a lot in the current iterations of healthcare reform legislation that could be at risk of being stripped in the reconciliation process. Sen. Max Baucus (D-MT) warns the result could resemble "Swiss cheese."

If the reforms currently in Congress are so easily stripped, maybe the problem is with the current legislation and not necessarily the process itself.

Now, I'm no expert on parliamentary rule. But in examining the list of situations which would strike legislation under the Byrd rule, it appears that the creation of a single-payer healthcare system would meet all the requirements of a budget reconciliation measure, as long as the proposal came out of the right committee and did not increase the deficit, which -- by the estimates of single-payer advocates at least -- would be the case.

Whether or not Congress has even 50 votes to pass a single-payer plan is unknown. Obama has said that, while he supports it in theory, single-payer isn't a good option for the United States right now. Whether that's actually what he thinks, or he's just covering for the perceived lack of political will for a single-payer system is another question.

Regardless of the support or lack thereof for single-payer, there are some lawmakers who are opposed to the use of the reconciliation procedure in general. Every lawmaker who speaks on the issue seems to say the same thing: This technique is a last resort, preserved only out of the fear that Republicans will obstruct the healthcare reform process entirely.

One supporter of reconciliation is former Majority Leader Tom Daschle, who said he believes a public option could be better preserved if reconciliation is the way the cookie crumbles. Daschle also suggested Republicans' refusal to negotiate might be the downfall of their position on healthcare:

"A reconciliation vehicle would probably have a pure public option just because most likely it will only involve Democrats deciding what that reconciliation package will be," Daschle told reporters during a press briefing in late June. "The degree to which Republicans make themselves less and less relevant is the degree to which a public option is more and more likely, because we are negotiating with the Democrats rather than the Republicans who oppose it."

Now "reconciliation" is somewhat of a misleading term. Rather than reconciling one's differences, it's more like agreeing to disagree, making future collaboration even more difficult and further polarizing the Senate. Also, by using reconciliation Democrats would have sole ownership over the resulting healthcare reform plan, which is perhaps the scariest part for some lawmakers in purple states or those who see tough reelection campaigns coming up in their near future.

But let's be real: This is such a polarized process that Democrats are going to "own" healthcare reform whether Sen. Charles Grassley (R-IA) and the two Republican senators from Maine vote for it or not. Neither Republican amendments to a bill that is seen as belonging to the Democratic Party nor a handful of Rs on the final vote will make it bipartisan, no matter how many times the Obama Administration says it is so.

Besides, ownership could be a good thing, if the program works. The GOP can scream "socialism" as loud as it likes, but if the healthcare reforms that come out of this struggle actually do lower prices and expand care, the majority of Americans will likely take their appreciation to the ballot boxes. On the other hand, if bipartisan healthcare reform passes and does not do what Obama set out to do, do you really think Republicans are going to feel any pain on Election Day?

Basically it's a lose-lose situation for Democrats, unless it's actually a good bill. As Grassley said recently on restructuring healthcare (as well as on getting reelected): "My answer to anybody that's looking for a political solution is the best policy is the best politics."

BUZZFLASH NEWS ANALYSIS

Image courtesy of sskennel's photostream on Flickr.