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Does the House Bill's Public Option Kill Off the Senate's?

Why the health care reform act has a very long and very difficult road ahead.
 
 
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It's encouraging that Press Secretary Robert Gibbs  threatened to use the budget reconciliation process if the health care bill stalls in the Senate. Other than a brief burst of optimism I had after Senator Paul Kirk was seated as Kennedy's replacement, I have never believed that Obama could pass a public option through the Senate. The only chance I could see for doing that was to first pass a bill through the Senate that didn't have a public option. This would allow Harry Reid to pass all the procedural hurdles up to the point that the Senate had to vote on the Conference Report. At that point, with both chambers having passed a health care reform bill, we'd be waiting for the historic vote on final passage. There would be the maximum possible amount of pressure on Democratic senators not to kill all the hard work made up to that point by denying the Majority Leader a procedural vote to bring the bill up. If a public option was going to survive, it needed to be introduced only at this final point in the process. That wouldn't guarantee passage, but it would provide us with the best chance. And, if some lonely senator like Joe Lieberman or Ben Nelson decided to take the heat and kill reform at that point, it would be relatively easy to make the case for using the budget reconciliation process rather than let one or two insurance whores in the caucus stand in the way of historic reform.

Harry Reid decided to go in another direction. He decided to make the public option part of the base bill. As soon as he did that, it killed off all the momentum for a robust public option in the House. The leadership asked the Progressives to prove that they had the votes for it, and they couldn't. It didn't seem to matter too much because the robust public option was never going to pass the Senate anyway. It was, as Pelosi stated repeatedly, a chip to use in the Conference Committee. She wanted a robust public option in hand because she always assumed that the Senate version would lack any public option at all. The idea was that each side would compromise, and the end result would be a public option that was not tied to Medicare reimbursement rates. But, when Reid put exactly that type of public option in the base bill, there was no longer any need for the House to pass the stronger version. It was easier to give nervous centrists a break and only ask them to vote for a non-robust public option that more nearly resembled the Senate version. It shouldn't make much difference in the end. The House and Senate would still wind up in the same place, they'd just start out with less of a divide.

But, of course, things didn't turn out exactly that way. Pelosi didn't gain extra votes once she dropped her push for a robust public option. Instead, the House conservadems got greedy and insisted on adding the Stupak-Pitts Amendment. Even then, Pelosi saw no spike in centrist support. She passed the bill with a mere two more votes than she needed, and one of those votes was from a Republican. It's encouraging that Obama  has announced that he finds the Stupak-Pitts language unacceptable, but it's not clear that he can strip it out without losing the support of three congresspeople.

Meanwhile, Reid's gambit appears to be failing, as he can't line up 60 votes for the base bill. Unless something changes, Reid will be forced to withdraw his bill and reintroduce one that has no public option. Failing that, he could give up and go straight to the budget reconciliation process. But, unlike the scenario I crafted, where the blame for failing to pass something with a public option would come at the very end of the process and fall on Joe Lieberman or Ben Nelson, in this scenario the failure would come prior to the Conference Committee and fall solely on Reid for miscalculating and failing to lead his caucus. Far from demonstrating overwhelming support for the public option, he would have demonstrated that it was a non-starter in the Senate. Meanwhile, the House barely passed a bill that had ridiculous abortion restrictions and a non-robust public option. How could they be expected to turn around and pass a bill in reconciliation that is much stronger?

 
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