Democrats Weigh Imperfect Options For Moving Forward On Health Reform

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USA Today reports that "Democratic leaders say [Mass. Republican Scott] Brown's win hasn't killed the $1 trillion health care bill," but after a series of meetings Wednesday they still had no "clear plan for how to proceed."

Ron Pollack, executive director of Families USA, says the best option would be to have the House pass the Senate's version of the health bill, which would eliminate the need for the Senate to vote on the bill again, and Sen. Jay Rockefeller, D-W.Va., says the strategy might work, although it could be difficult. "Rep. Earl Pomeroy, D-N.D., is more blunt: 'I don't think it's a viable strategy.' Some Republicans say the White House still could get a health care bill passed if it returns to the drawing board" (Page, Fritze and Kiely, 1/21).

Two legislative strategies have moved to the forefront, Roll Call reports. "In one scenario, Democrats would push a second bill through using budget reconciliation rules that would 'fix' the Senate health care bill sitting on the House's desk." The other idea "would start over with a new bill or bills focusing on politically popular insurance reforms that have broad support on the Hill, like doing away with pre-existing conditions and eliminating antitrust protections for insurance companies" (Dennis and Drucker, 1/21).

Though the reconciliation process may be more politically appealing, the Financial Times reports, it "would be rife with complications, however, because it would force deeply reluctant members of the House to vote 'Yes' to provisions within the Senate bill that they have staunchly criticized." House lawmakers would have to approve the already-passed Senate bill before using reconciliation to amend it. Despite these and other problems, political analysts say Democrats worst option would be to start from the beginning on a smaller bill (Kirchgaessner, 1/20).

However, conservative Democrats in the Blue Dog voting bloc "shot down reconciliation, saying it amounted to legislative trickery" and cast doubt on whether the House would pass the Senate bill unchanged, The Hill reports. These Democrats believe passing the overhaul would wound their candidacies in 2010 reelection races, and favor a scaled-down or incremental approach (Allen and Young, 1/20).

Another issue with reconciliation, NPR reports, is that "Everything in it has to be closely related to the budget, so things like creating those insurance marketplaces like exchanges might not be allowed under the reconciliation process. And they would have to use a separate bill, which might or might not be able to get through the Senate." An alternative plan, to try to ram through a new version comprehensive bill before Senator-elect Scott Brown takes his seat, has already been rejected (Rovner, 1/20).

Meanwhile, House Speaker Nancy Pelosi, D-Calif., "spent the day huddled in her Capitol office with various Democratic factions," The Washington Post reports. "Senior aides said she has yet to identify the 218 votes needed to push the [already-passed] Senate bill through her chamber, nor is she convinced that the bill is politically sound" (Murray, 1/21).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

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