Saturday, February 27, 2010

Health Care: Blues, Cross (& Double)

I didn't watch the "Health Care Summit"--when I heard that Republican Senator Olympia Snowe, the key potential vote for a bipartisan bill, was not invited to attend by her party's leadership, then I knew that this was not a session tht would produce anything from a legislative point of view. It's clear that this was a step toward bypassing the Republicans and moving to the final stages of the process. The Democrats are singing the blues about this, as they know that the only thing worse than passing this messy, unsatisfying bill is not passing it. I think the people who are more cross about it are the President (who had to put up with moderating this nonsense for several hours), and those Democrats who want to move on to other subjects, soon; the Republicans are happy to obstruct and think they have a winning hand.

The Republicans did have one interesting idea: that is of making the government's subsidies directly to a "high-risk pool" in each state, for those with chronic health conditions whom the insurance companies would not cover. This would have some benefits--insurance premiums should be lower for the rest (though something--like a public option, or rate regulation--might well have to be done to force premium rollbacks); it would cost less government dollars (it would affect far fewer people). It would not fit with the current proposal of seeking coverage for all, though, with the result that we would still have the current problem of uninsured people seeking to enter the system only when problems arise, with the adverse consequences with which we have, by now, become familiar. It would also be yet one more boon to the insurance companies, who are starting to see that they can game this system effectively to their benefit. It may still become a last resort if the current effort fails to reach completion.

It is now clear that the way forward is for the House to pass the Senate's bill, and for both houses of Congress to pass a "reconciliation bill" that makes some necessary fixes to that bill. That "reconciliation bill" would be governed in the Senate under rules which would strictly limit debate without the need for cloture votes requiring 60 votes, so a simple majority would suffice to bring passage (as it would in the House). The challenges which would remain, and they are major ones, are gaining a majority for the Senate bill in the House, and a majority for the reconciliation bill in the Senate.

The cries of woe from the Republicans about the procedure to be utilized in the Senate are hypocritical and will not matter to voters. I disagree that it is inappropriate to use the process for this bill, and the Senate parliamentarian will watch that matters which do not bear on the budget are not included in the reconciliation.

I have supported the petition started by Sen. Michael Bennet of Colorado, which has gradually added more signatures from Democratic senators, calling for a recorded vote on a public option. The public deserves to know who is with the public interest, and who is in the insurance companies' pocket. An amendment to include it may or may not get the required number of votes (50, if VP Biden votes for it--that should be interesting!); if it passed, it could make the endgame even more complicated. I think it would make it easier to get by the House, but not in the Senate, and I don't think it would qualify as something to be included in the reconciliation bill, but rather as an amendment to the pending Senate bill. These considerations lie behind Sen. Jay Rockefeller's lack of support for the petition; a bit of a double-cross, but with the best of intentions.

The final mess is the question of the abortion language: the expected process would require the Senate's language be used, which several House members have sworn to block. Speaker Pelosi will have to get tough with them (and I think she's proved she's willing), and President Obama will need to have her back on this one.

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