[NYAPRS Enews] KDHR: House Approves Measure To Fast-Track Health Care Reform

[Matt Canuteson]

House Votes 227-196 To Affirm Democrats' Option To Use Budget
Reconciliation Process To Fast-Track Health Care Legislation

Kaiser Daily Health Policy Report April 23, 2009

 

The House on Wednesday voted 227-196 against a Republican proposal that
would have instructed its conferees to reject the use of the budget
reconciliation process to pass health care overhaul legislation, CQ
Today reports. The House also named its conferees, three Democrats and
two Republicans, who will meet with Senate conferees to reconcile their
budget resolutions into a final version. The Senate has yet to appoint
its conferees, and Senate Budget Committee <http://budget.senate.gov/>
Chair Kent Conrad (D-N.D.) said there is no definite timeline, adding,
"There is plenty of work, certainly, to be done" (Clarke/Krawzak, CQ
Today, 4/22).

The House included
<http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=3&DR_ID=5
7856>  instructions in its budget resolution to allow the use of the
reconciliation process to pass health reform legislation, but the
Senate, which did not include the orders in its resolution, has been
"reluctant to authorize it," the New York Times
<http://www.nytimes.com/2009/04/23/us/politics/23health.html>  reports
(Pear, New York Times, 4/23). Democratic leaders and the Obama
administration would support using the procedure if a bipartisan
compromise cannot be reached on overhaul legislation (Clarke/Krawzak, CQ
Today, 4/22). Sen. Jeff Bingaman (D-N.M.) said, "It may be a struggle to
get" the 61 votes required to bypass reconciliation. 

Obstacles  According to the Times, reconciliation would allow Democrats
to "overcome Republican objections to a big increase in federal spending
and in the role of government," but "it could fundamentally alter the
political dynamic of the health care debate, detonating an explosive
reaction among Republican senators who have been working with Democrats
on the issue." Senate Health, Education, Labor and Pensions Committee
<http://help.senate.gov/>  ranking member Mike Enzi (R-Wyo.) said that
if Democrats use reconciliation to pass health care legislation, it
would represent "a declaration of war." Neil Trautwein, a vice president
of the National Retail Federation <http://www.nrf.com/> , said, "If
Democrats push a health bill through the Senate using budget
reconciliation procedures, the bill would lack Republican support and
would lack the support of key constituencies -- certainly the business
community," adding, "Health care reform would crater for this year" (New
York Times, 4/23).

Senate Republican Conference Vice Chair John Thune (S.D.) said, "I
suspect that there is going to be an awful lot of resistance, and we
will exercise our prerogatives so that the rules of the Senate are
respected." According to Roll Call, some senior Republican aides "say it
is too early to discuss retaliation for something that might not occur;
they prefer to focus instead on trying to shape a bill that they can
embrace." However, "other key Republican senators were candid that
reconciliation, while difficult for them to stop, would prompt them to
try to trip up Democratic priorities -- large and small," Roll Call
reports (Drucker, Roll Call, 4/23).

Republicans also say that reconciliation is not intended to be used for
sweeping policy measures, such as health care overhaul (Taylor,
AP/Minneapolis Star Tribune
<http://www.startribune.com/politics/43479142.html> , 4/22). Senate
rules state that reconciliation can be used only for actions intended to
produce a change in federal spending or revenue. According to the Times,
provisions aimed at regulating the insurance industry or improving
quality of care could be challenged as "extraneous" under these rules
(New York Times, 4/23). Conrad said Republican leaders have "had many
discussions" with Senate parliamentarian Alan Frumin about how the rules
would apply.

The Hill
<http://thehill.com/leading-the-news/healthcare-reforms-fate-lies-in-the
-hands-of-parliamentarian-2009-04-22.html>  on Tuesday examined Frumin's
potential role in creating a final version of overhaul legislation if
the fast-track process is used. Frumin would decide which proposals
could be included in a reconciliation vote (Alarkon, The Hill, 4/22). 

Ways and Means Hearing In related news, the House Ways and Means
Committee <http://waysandmeans.house.gov/>  on Wednesday heard from six
witnesses discussing the implications of creating a public health plan,
according to CQ HealthBeat
<http://corporate.cq.com/wmspage.cfm?parm1=95> . Princeton University
<http://www.princeton.edu/main/>  economist Uwe Reinhardt said that it
would require "strong rationale" to deny U.S. residents the option of
buying government-sponsored health insurance after the recent drop in
public confidence related to the recession. He noted that if a public
plan was not established, strong regulations would have to be placed on
private insurers. Consumers Union <http://www.consumersunion.org/>
analyst William Vaughan said insurance policies should be simplified to
allow easier comparison by consumers.

David Boris, a small-business owner, said that private health plans have
been unable to contain costs and that "we need a public plan that will
re-energize true competition in the marketplace" and "provide a backup
if the private market doesn't work." Urban Institute
<http://www.urban.org/>  senior fellow Linda Blumberg said that a public
plan would provide a "very promising catalyst for cost containment."

Kenneth Sperling, an analyst with Hewitt Associates
<http://www.hewittassociates.com/Intl/NA/en-US/Default.aspx> , said
introducing a public plan could force private insurers to pay providers
at significantly higher rates to compensate for underpayments by the
public plan. Republicans on the panel expressed their disapproval at
what they called bias in selecting the witnesses (Reichard, CQ
HealthBeat, 4/22).

House Ways and Means Committee Chair Charles Rangel (D-N.Y.) and ranking
member Dave Camp (R-Mich.) at the meeting agreed to hold talks between
their respective staffs, according to Camp spokesperson Sage Eastman.
Camp said to Rangel during the hearing, "It is time for our staffs to
start meeting, and, more importantly, start negotiating," noting the
bipartisan meetings held by members of the Senate Finance Committee
<http://finance.senate.gov/> . Camp said, "I think there is broad
agreement on the principles of any successful health reform: lowering
costs, increasing access, ensuring portability, and prevention and
wellness, among others" (Edney, CongressDaily, 4/23).

White House Meetings House Speaker Nancy Pelosi (D-Calif.) and Senate
Majority Leader Harry Reid (D-Nev.) met with President Obama on
Wednesday to discuss strategy in advance of a Thursday meeting between
Obama, Vice President Biden and congressional leaders. The meeting
covered issues including health care reform, aides said, but neither
Pelosi nor Reid would comment on the meeting. Sen. Richard Durbin
(D-Ill.) said he expects Republican leaders at the meeting on Thursday
to seek compromise. He said, "A few of them have stepped forward, and we
really appreciate that" (Hunter, CQ Today, 4/22). 

Opinion Pieces 

*	David Broder, Washington Post
<http://www.washingtonpost.com/wp-dyn/content/article/2009/04/22/AR20090
42203090.html> : What Obama already has achieved in his presidency "is
no more than the overture to the first act of this opera," with "big
stuff ... still to come," including the "soprano [singing] her signature
aria": health care reform, Post columnist Broder writes. He continues,
"Obama had a few stumbles in assembling his Cabinet and, as a result,
lost the services of one potential major asset, Tom Daschle, his
original choice to manage his health care initiative." The "challenge"
for Obama to juggle his schedule and wide-ranging initiatives "will
become greater as Obama's initiatives move to Capitol Hill, where a
single senator can throw up a roadblock, and when the inevitable foreign
crisis explodes," Broder writes. However, "the overture has gone well,
and so far, the cast seems to know its parts," Broder concludes (Broder,
Washington Post, 4/23).
*	E.J. Dionne, Washington Post
<http://www.washingtonpost.com/wp-dyn/content/article/2009/04/22/AR20090
42203091.html> : "The biggest difference between now and the last time
around" for health care reform efforts "is the emphasis on creative
compromise in place of creative obstruction," Post columnist Dionne
writes, adding, "Because of its defeat in 1994, there will be a
temptation to treat every dispute -- notably the recent reports of
contention over the inclusion of a government-run option in a final bill
-- as the first step toward the collapse of the process." He adds,
"Public-plan advocates should stay at the table to keep things moving,"
because "[t]omorrow isn't always defined by yesterday" (Dionne,
Washington Post, 4/23).

 

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=58180

 

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