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Democrats Ponder One-Bill Reconciliation Strategy For Health Care

First Posted: 09/24/09 06:12 AM ET Updated: 05/25/11 02:55 PM ET

Obama Democrats

Senate Democrats contemplating a controversial parliamentary maneuver that would allow them to pass key provisions of a health care bill with just 51 votes are exploring an option that would not require the bill to be split into two.

Should Democrats use the procedure known as reconciliation, the assumption has been that certain elements would have to be stripped out of the bill and passed separately, because a Senate rule known as the Byrd Rule only allows reconciliation for legislation that costs or raises substantial amounts of money. That would include the expansion of Medicare or Medicaid, revenue-raising tax provisions, and even the creation of a public health insurance option, depending on how it's written. But non-budget-related items -- most of the new insurance industry regulations, for instance -- would presumably be put in a separate bill that would go through regular order -- and would therefore need 60 votes to overcome a filibuster.

Passing two separate bills, however, is seen by some Democrats as too much of a lift for the slow-moving Senate.

But there's another alternative, according to Martin Paone. Paone, who served as a Democratic Senate floor staffer for 29 years, has been advising Democrats as they craft their legislative strategy. He proposes that Democrats try to get 60 votes to waive the Byrd Rule -- which would then allow the inclusion of those non-budget-related provision in one bill that would require only 51 votes for final passage.

What's the advantage? And why would any senator who opposes the entire bill vote for such a waiver?

The answer can be found in the specific proposals that would be in violation of the Byrd Rule. Mostly, those would include reforms to the way the insurance industry operates -- for example, a ban on using preexisting conditions to deny coverage, or a law that insurance companies can't drop a client just because they get sick.

Those are wildly popular reforms. Getting 60 votes to support those policies is much easier than getting 60 for a public health insurance option, which Republicans and some conservative Democrats oppose.

Conservative senators such as Mary Landrieu (D-La.), Ben Nelson (D-Neb.) or Olympia Snowe (R-Maine) could, in voting for a Byrd Rule waiver, put themselves on the record as being in support of popular insurance industry reforms, while still opposing final passage of the bill -- a political strategy that may be appealing to them.

Paone was involved in the effort to push a health care bill through Congress 15 years ago. Democratic leadership at the time met repeatedly with the Senate parliamentarian, he said, asking for a judgment on whether particular parts of the bill would be ruled as violations of the Byrd Rule and struck out. Piece after piece, the parliamentarian told the Democrats, would be ripped out, leaving little of the health care reform effort intact.

"This, this, and this wouldn't score," Paone recalls parliamentarian Alan Frumin saying, in a reference to whether a net dollar figure could be attached to a measure. "We couldn't do it."

Democrats made the judgment in 1994 that getting around the Byrd Rule wasn't politically possible. The biggest impediment was Bob Byrd himself. The Democrat from West Virginia is fiercely protective of Senate rules and tradition and was a much more powerful presence. Today, his poor health and advanced age have reduced his power, making him less of an obstacle to overriding the rule he created.

But the Democrats in the Senate are also a generally more progressive bunch than they were in 1994. The 102nd Senate caucus included 58 Democrats -- two fewer than today -- and many more southern and conservative members.

Reconciliation may seem like an esoteric parliamentary maneuver -- which it surely is -- but it is also increasingly on the minds of progressive voters who want to see reform passed.

And moving the entire package through at once overcomes the legislative difficulty of getting two separate pieces done. Sen. Kent Conrad (D-N.D.), long a foe of using reconciliation, suggested Sunday that passing two separate bills would be difficult. "I think it's very unlikely ... for that to work," Conrad said on CBS's "Face the Nation." "When you look at the legislative agenda, it's very hard to see how you put two packages through and coordinate them well."

Jim Manley, a spokesman for Senate Majority Leader Harry Reid (D-Nev.), said that while Democrats continue to prefer a bipartisan approach, "patience is not unlimited and we are determined to get something done this year by any legislative means necessary."

No decisions have been made, he said. "We cannot and will not be able to determine what we are doing until we determine whether we are doing it with or without Republicans. We will not know that until September 15th or so at the latest," said Manley. "While there are certainly Republicans of good faith negotiating, it's evident that House and Senate Republican leadership are determined to stop any health care reform efforts this year."

Under the one-bill strategy, the legislation would be written front to back with an eye toward getting a score from the Congressional Budget Office. That kind of legislative crafting takes time, but Democrats have it: budget reconciliation, by statute, can't be attempted until October 15th, a month after the Senate Finance Committee's (latest) deadline to come to some bipartisan agreement.

There's a policy upside, too, as far as progressives are concerned. In order for a measure such as the public option to "score" and be in line with the Byrd Rule, it would need to cost or save a substantial amount of money over five years. Advocates of a robust public option would then be able to argue that it needs to be generously funded in order to stay in the package and away from the Byrd Rule's razor.

Waiving the Byrd Rule is not without precedent. "It's happened more than once, both in 1990 and 1997," said Bob Dove, a former Senate parliamentarian, who started his career as an assistant parliamentarian in 1966 and left in 2001.

Dove, in an interview with the Huffington Post, concurred with Paone's analysis.


Ryan Grim is the author of This Is Your Country On Drugs: The Secret History of Getting High in America


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Senate Democrats contemplating a controversial parliamentary maneuver that would allow them to pass key provisions of a health care bill with just 51 votes are exploring an option that would not requi...
Senate Democrats contemplating a controversial parliamentary maneuver that would allow them to pass key provisions of a health care bill with just 51 votes are exploring an option that would not requi...
 
 
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10:25 AM on 08/26/2009
Why keep Capitalism if it doesn't work?
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HUFFPOST COMMUNITY MODERATOR
oldngrumpy
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01:11 AM on 08/27/2009
For who? It appears to work just fine for the pseudo capitalists now pillaging our economy and our children's futures. When they're done with it we can make other plans.
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11:11 PM on 08/25/2009
Cost is another one of insurance/pharma's spurious excuses to prevent REAL reform.

There will ALWAYS be excuses. It will NEVER be the right time to pass singlepaye­r.......TH­AT'S the point of what insurance/pharma want to do........NOT PASS SINGLE PAYER!! DUHHHHH!!!!

insurance took singlepayer OFF the table b/c they don't want it.
yet they have NOT taken public option off the table.......hmmmm

read matt tiabbi's piece in rollingstone ...........

"public option" = scheme thought up by insurance to make more $$$$

gov't spends TRILLION$$$ on war and bank bailout but when it comes to singlepayer a couple billion all of a sudden they are in a cash crunch? who are these clowns thinking they are fooling? perhaps someone gullible enough to believe the rest of their lies......

DO NOT be an apologist for the parasitic insurance companies.

YES to medicare for all
NO to public option

IF iranian grandmas' can stand up to malitia soldiers with guns

and yet we can not even stand up to insurance/pharma...........

GAME OVER!
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11:06 PM on 08/25/2009
here we are able to demand singlepayer and most americans are outfoxed by insurance into "fighting" for something that the insurance companies WANT (AKA PUBLIC OPTION)

single payer was taken OFF the table b/c insurance do NOT want it
public option is NOT taken off the table b/c insurance WANT it........

.............take a hint folks!!!!

NO to public option
YES to singlepayer

why let insurance manipulate the conversation?
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Henk
I like your Christ, I don't like your Christians..
11:29 PM on 08/25/2009
Single payer? That ship has sailed, but don't worry, there will be another chance, 35or forty years from now.
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HUFFPOST COMMUNITY MODERATOR
oldngrumpy
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12:45 AM on 08/27/2009
I don't think it will be that long. The public option isn't going to fix all the holes in our health care boat and it is going to continue to take on water. I see a "must do" situation ahead that will likely fall just after the 2012 elections.
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11:02 PM on 08/25/2009
NO to public option
YES to singlepayer

why enable parasitic insurance/pharma???
09:09 PM on 08/25/2009
WOW! You all want the public option with no boundaries. Well no matter what Obama calls it, single payer, public option, co-op or or insurance exhange the govenment will still be running it and they wil set their own mandates. As for Medicare, it's almost broke and they're getting ready to ration, just a matter of time. The government employee healthcare is just like the healthcare you buy from insurance companies, except they have 6 or 7 companies to choose from. Why do you think they thumb their noses to join the healthcare the average citizen will be getting under Obama's plan? They're not stupid except in bills they want to pass for us. If any of you bothered to read the healthcare bill posted on the net, you will see there's community organizers for parenting, psychiatric evaluation, end of life discussions, just like the booklet for our veterans. If they ever pass a bill, which I fervently hope they DO NOT, we will all be in "human bondage". We're up to our eyeballs in debt. Our debt for the next 10 years is 9 TRILLION DOLLARS. We're already bankrupt and monetizing our debt. China doesn't want any more of our debt and there's another dumb country who does. Every program the government runs is BANKRUPT! Can they handle a new healthcare program? If you do, I want to know what you're smoking and why you're not sharing.
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Henk
I like your Christ, I don't like your Christians..
11:27 PM on 08/25/2009
Wow, this sounds scary, it almost sounds a scary as having to deal with my insurance company, almost as scary as knowing that the premiums could double at any time, almost as scary as knowing that my insurance company is in between me and my doctor, almost as scary as knowing that if I lose my job I lose my health care, almost as scary as knowing that if I get really sick there is a very real posibility that I could lose everything I own. On second thought, what you're describing doesn't sound bad at all. Sign me up.
08:05 PM on 08/25/2009
One bill reconciliation. Good idea! Who decreed that a majority was not enough. That you had to have sixty percent in the Senate to pass anything? Congress, get off your duffs and vote!
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HUFFPOST COMMUNITY MODERATOR
oldngrumpy
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12:51 AM on 08/27/2009
It's still up to the blue dogs whether they will waive the 60 vote rule. They are sold out and have already declared their side of the fight. Look for them to stay with the Repugnants all the way to the bitter end. Ben Nelson was insurance commissioner for Nebraska and he is famous for taking corporate hand outs so he doesn't have to travel and glad hand his constituents. All of his contacts are in the insurance industry and his state is borderline conservative. Leaving Nelson in office has been more of a non decision for the voters than any conscious effort.
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02:39 PM on 08/25/2009
Disgusting the Democrats would shred the Constitution by eliminating the filibuster. This was written into the original Const. for a very good reason; so that the mob would not write the laws. Once this is done, it cannot be undone and there will be retribution when the Rs take over again. It's a bad mistake.
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06:07 PM on 08/25/2009
The filibuster is not in the Constitution. It is just a procedural rule in the Senate that has been changed many times in the past. Until 1806 a simple of majority of the Senate could end debate at any time. No one thought to block legislation by taking advantage of the 1806 rules change until 1841. In 1917 the Senate introduced cloture allowing 2/3 of those voting to end a filibuster. In 1949 this was changed to 2/3 of all members. Finally in 1975 the current 3/5 of all members rule was adopted.

The reconciliation rules were adopted in 1974. All three Bush tax cut laws were passed using the reconciliation rules.

Back when the Republicans controlled the Senate, they claimed the Democrats were violating the constitution by filibustering judicial appointments.
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01:20 PM on 08/26/2009
I have met more Right Wing Constitutional Id!ot Savants on HuffPo since Obama was elected. They don't know the Constitution from a jelly donut.
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HUFFPOST COMMUNITY MODERATOR
oldngrumpy
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12:56 AM on 08/27/2009
Aren't you embarrassed to place your ignorance on display for so many people here? Just because you wing nuts wish something doesn't make it so. You really should read the constitution through a couple of times if you're going to reference it so often.

Click your heels all you want Dorothy, your still stuck in Oz with the rest of us.
HUFFPOST SUPER USER
JoeBear55
02:32 PM on 08/25/2009
WE WANT PUBLIC OPTION
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HUFFPOST COMMUNITY MODERATOR
motoGpifupleez
watching with amusement
01:38 PM on 08/25/2009
Prepare for Democrats to pussout on this plan in 5....4.....3....2.....
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HUFFPOST SUPER USER
rcozad
Manufacturers Representative Electronics Industry
01:37 PM on 08/25/2009
Losing a popular election and taking office on a 5:4 Supreme Court decision ...that is "ramming through" winning a vote on a bill 55:45 is not 'ramming through" it is democracy in action!!
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HUFFPOST SUPER USER
maggiee
12:47 PM on 08/25/2009
This is slightly off topic but I've noticed that a lot of people on the right are asking why the Congress isn't pushing for everyone to be given the same insurance that they themselves (and every other federal employee) gets. Of course, those on the right who ask this don't realize that they are actually advocating a single payer system, but that's neither here nor there. Maybe, instead of fighting them, we should join them since they are really asking for the same thing that those of us who want a single payer system want in this instance.
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HUFFPOST COMMUNITY MODERATOR
oldngrumpy
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01:00 AM on 08/27/2009
Congress and other federal employees don't have a "single" insurance plan. They have several options that they can choose from that vary widely in benefit levels.
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HUFFPOST COMMUNITY MODERATOR
evekendall
11:37 AM on 08/25/2009
Mad As He|| Doctors
"This fall the rubber gloves meet the road"

On September 8, 2009, a group of Oregon physicians will take the message of Universal Health Care across the country on a road trip that will end in Washington, D. C. on September 30.

Join the caravan if you can!
http://www.madashelldoctors.com/
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HUFFPOST COMMUNITY MODERATOR
IzzyCA
12:47 PM on 08/25/2009
Support the public option. March on Washington for Healthcare and the public option.
Marches are being organized in all major cities.
Sign up at:
http://www.marchforhealthcare.com/
Facebook: http://www.facebook.com/group.php?gid=118144661546
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11:04 PM on 08/25/2009
NO to public option
YES to singlepayer

why enable parasitic insurance/pharma???
09:06 AM on 08/25/2009
The fact is if the Military might of the U.S. didn't have such a strangle hold on the Government the troops would be home by now and the savings of the tax dollars would be there to fund the most elaborate health plan in the Industrialized world.

It won't happen because of the way most Americans are raised to think and feel about military might but wouldn't it be real change.
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HUFFPOST COMMUNITY MODERATOR
oldngrumpy
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01:06 AM on 08/27/2009
The US spends more on it's military than all of the rest of the world combined. That's sacred and untouchable tho. Any cuts will be followed by a chorus of howls about "weak on defense". The truth is that global capitalists use our military as bodyguards so they can pillage and loot the world at their leisure. It works well for them because they can control a country without taking it's land or being responsible for the people. If anyone objects there will be an "intervention" by our military.
08:55 AM on 08/25/2009
Only in the United States Senate would fifty percent plus one be regarded as "ramming through" something. Everywhere else, it would be called "winning."
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HUFFPOST COMMUNITY MODERATOR
oldngrumpy
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01:02 AM on 08/27/2009
It was dam* sure called "winning" when Bush did it to pass three tax cut bills. Just more wing nut BS to cloud the water so we don't see that they got nothing.
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uvymopka
The voice of truth, in a sea of Loons
08:39 AM on 08/25/2009
Obama's not looking at this opposition and saying, 'Wow, I'm really out of touch with what the American people want.' No, he's looking at this and saying, 'I'm going to have a tougher time ramming this down their throats! Damn Limbaugh! Damn FOX News!"
08:52 AM on 08/25/2009
The "opposition" is 3% of the country - mostly rednecks incable of critical thought and a handful of Reaganists, still clinging to a failed, sick ideology.

The only "ramming" that needs to be done will be targeted at the corrupt Blue Dogs who, along with the corporatist Republicans, are impeding the will of most of the country.

That whole "election" thing spoils the Fox propaganda, doesn't it?
09:00 AM on 08/25/2009
No...he's probably looking at polls showing that between 55-75% of Americans want the choice of a public option.
09:35 AM on 08/25/2009
Thank you. Seconded.