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Political Primer on Healthcare Reconciliation

What it is – How it Works

By Staff Reporters

Several ME-P readers have contacted us for a definition of the term “reconciliation” and what it means in the current political debates and the recent Healthcare Summit in Washington, DC.

Definition,

According to Wikipedia, Reconciliation is a legislative process intended to allow consideration of a contentious budget bill without the threat of filibuster. Introduced in 1974, reconciliation limits debate and amendment, and therefore favors the majority party. Reconciliation also exists in the House of Representatives, but because the House regularly passes rules that constrain debate and amendment, the process has had a less significant impact on that body.

Healthcare Significance  

“In 2009 the House and Senate each passed separate healthcare reform bills. The Senate bill passed only after all 60 members of the Democratic caucus voted for cloture to stop an attempted Republican filibuster. Negotiations to produce a compromise bill acceptable to majorities in both houses were thrown off track by Republican Scott Brown’s victory in the Massachusetts.

After Brown’s victory, the Democratic caucus no longer had enough votes to stop a Senate filibuster of the compromise bill. An alternative plan was for the House to pass the Senate bill verbatim, and for each house to pass another bill that would embody the compromises agreed to in the negotiations. This separate piece of legislation, which might possibly include a public option, would require use of the reconciliation procedure in the Senate.”

Of Minutia

No matter whether the House votes on reconciliation or the Senate bill first, the Speaker can ensure that the health care bill is signed into law before reconciliation. (The dirty little secret of Congress is that even if the House votes to pass the Senate health care bill tomorrow, the Speaker has unilateral power to hold that bill at her desk until January 3rd of next year before sending it to the President and starting the 10-day Constitutional veto clock).

Assessment

The Republican leader in the Senate, Mitch McConnell, said: “Using reconciliation would be an acknowledgment that there is bipartisan opposition to their bill, another in a series of backroom deals, and the clearest signal yet that they’ve decided to completely ignore the American people.” according to the New York Times, February 19, 2010.

Other opponents of Democratic legislative initiatives in the 111th Congress began to refer to reconciliation as the “nuclear option, although that term had previously been used to refer only to a majoritarian procedure to effect a formal change in Senate rules.

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Note: Cloture  is the only procedure by which the Senate can vote to place a time limit on consideration of a bill or other matter, and thereby overcome a filibuster. Under the cloture rule (Rule XXII), the Senate may limit consideration of a pending matter to 30 additional hours, but only by vote of three-fifths of the full Senate, normally 60 votes.

Conclusion

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7 Responses

  1. It’s all about HMOs

    Many thanks for this much needed essay. But, we will never have true health care reform without a complete repeal of the HMO anti-trust exemption.

    Stewart

    Like

  2. White House Okay on Healthcare Without GOP

    The White House’s top healthcare official is optimistic that Democrats will have the votes to pass a major healthcare overhaul. Presidential adviser Nancy-Ann DeParle says it makes sense to have a “simple up-or-down vote” on legislation, now that Democrats lack the 60 votes necessary to overcome a Republican filibuster. The Senate’s Democratic leaders are trying to devise a strategy for passing the legislation with a simple 51-vote majority. There are 57 Democrats in the Senate and two Democratic-leaning independents.

    DeParle notes that the House and Senate already have passed versions of healthcare overhaul. She tells NBC’s Meet the Press that she believes “we will have the votes to pass this in Congress.”

    Source: The Associated Press [2/28/10]

    Like

  3. The key point here is that reconciliation would allow passage of the healthcare bill by a simple “cramdown” majority. IOW: An “up” or “down” vote.

    Jane

    Like

  4. Obama Backs Reconciliation Maneuver

    President Barack Obama gave Congress the green light to use a budgetary process known as reconciliation to pass sweeping healthcare overhaul legislation on a simple majority vote in “the next few weeks.”

    “From now until then, I will do everything in my power to make the case for reform,” Obama said during a televised speech from the White House. “We have debated this issue thoroughly, not just for a year, but for decades.”

    The president, speaking from the White House, knocked down a number of different proposals that some members of Congress had pitched in the months that have passed after Democrats lost a critical Senate seat in January. Obama said that restarting from scratch, favored by Republicans, would not be considered, and added that a piecemeal approach, backed by some Democrats, would also fail to accomplish the broader goals set out by the White House and Congress.

    Source: Matthew DoBias, Modern Healthcare [3/3/10]

    Like

  5. Stu, Jane and Ann

    Be sure to understand that Reconciliation, while important, is no guarantee. It is far better to stop the current healthcare bill in the House.

    Austin

    Like

  6. Jane

    About the “self-executing rule” and healthcare – a related nefarious concept.

    Basically, the self-executing rule automatically makes changes to an underlying bill, like the impending healthcare reform legislation, without separate debate or votes and often sparing the party in charge a difficult vote.

    http://wokv.com/blogs/jamie_dupree/2010/03/health-care-rules.html

    Stu

    Like

  7. What’s Really in the Reconciliation Bill

    By Olga Pierce and Jeff Larson

    Thanks to some hard-working souls at ProPublica, they’ve created a side-by-side comparison of the full versions of the Senate healthcare bill versus the bill that will likely go before the House for a vote on Sunday.

    What you’ve seen elsewhere-the text put out by the House Rules Committee-is just a 150-page list of amendments to the Senate bill (“strike paragraph 4”, “insert this new sentence in paragraph B:…”).

    What they’ve created, the full proposed final bill-and highlights of the changes- allows you to easily to compare House’s Reconciliation proposal to the earlier Senate bill.

    http://www.propublica.org/article/deem-and-pass-unlikely-to-be-reversed-in-courts-experts-say

    Check out the full bills side-by-side-and see exactly what the House has added, changed, and deleted.

    And, here is a link for more on “deem and pass.”

    http://www.propublica.org/article/deem-and-pass-unlikely-to-be-reversed-in-courts-experts-say

    Hope Hetico RN, MHA
    [Managing Editor]

    Like

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