The Next Move In Healthcare Reform

It’s beginning to feel like a very long (and not particularly well played) chess game.  Kim Strassel at the Wall Street Journal posted an article about Thursday’s healthcare summit.  The summit was designed to showcase President Obama’s skill at finding common ground and solving problems.  Unfortunately, someone forgot to mention that the President has not previously exhibited these skills and there was no reason to believe that he has them.

The conventional wisdom is that President Obama will make some sort of speech on Wednesday or Thursday followed by a push by Congress to pass the bill through the reconciliation process.  There are a few risks involved in this.

The Senate Parliamentarian is in charge of ruling what parts of a bill are eligible for the reconciliation process, but he can be overruled by the President of the Senate (the Vice-President, Joe Biden).  In the Senate, total debate on a reconciliation bill is limited to 20 hours; however, after that 20 hours has passed, motions and amendments can be offered and considered without debate.  This could be a procedural nightmare if the Republicans decide to block the bill by offering endless amendments. 

Another risk of using the reconciliation process is the possible backlash of public opinion.  Although many Americans believe healthcare reform is a good idea (myself included), polls indicate that most of us do not want the government taking over our healthcare system.  This is an election year–all of the House of Representatives is up for election in November and one-third of the Senate.  It is unusual historically to have major legislation passed in an election year, even if it is a mid-term election.

There is also the question of whether or not there are enough votes in the House of Representative to pass the healthcare bill if it is passed in the Senate through the reconciliation process.  The public funding of abortion issue would have to be dealt with, and some of the exceptions made in various provisions for certain states might become an issue.  If Medicare Advantage is not a good program, why are senior citizens in Florida allowed to continue their participation in the program while senior citizens in the rest of the country would not be allowed to access it?

This should be a very interesting week.