If Senate HCR Bill dies, All Is Not Lost. Only 51 Votes Needed for "Good Stuff" Stripped Out of

[leveymg]

the current Senate Bill. That includes measures, killed in the existing HCR Bill, such as lifting the antitrust exemption for the health insurance industry and Sen. Dorgan's drug reimportation amendment that were erased to get 60 votes. In fact, anything that doesn't involve significant budget outlays can pass by 51 votes. There's a question about whether all we need is 50 plus the VP or it has to go through Reconciliation. In either case, all that would take is the White House leadership and pressure on the Senate leadership to allow these measures expedited treatment or to be recommitted onto the Floor as amendments to other Bills this year.

What else can be salvaged that wouldn't require appropriations? What would you add (single-payer and public option would make the top of my list, but alas under current Senate rules they require 60 to pass). . . what regulatory reforms that don't involve significant new outlays would you push for?

Let's assume for the moment that the House will not pass the Senate Bill, allowing room for passage of meaningful Health Insurance Regulation.

[DrDan]

1. reconciliation?

it was never an option prior to this election. Why do you think it will be should Coakley lose?

[CTyankee]

2. I, too, am hoping this will be a moment of "creative destruction."

If we lose the MA seat it might result in a better outcome than dragging a cumbersome, unpopular and un-reform bill across the finish line.

It can and has happened. We have a simple majority in both House and Senate. Get what we can through that. In the end, it might turn out to have been the right way after all...

[sui generis]

3. hope don't pay the rent

I'm just not quite sure how we got down to "hope", starting with a democratic majority AND a clear mandate.

[cali]

4. didn't you just post what is essentially the same op

just a little while ago? I'll repeat myself: Not gonna happen. period. the dems won't touch it with a 1000 foot pole.

[Motown_Johnny]

5. reconciliation is for budget matters only. Are you sure you can lift the antitrust exemption

and re-import drugs under reconciliation?


P.S. you only need 50 +Biden

[leveymg]

8. You are right. Straight up-down vote. 50 plus Biden.

Thanks for clarifying that. Yes, I think we have 50-plus for those, particularly if it's the only politically viable way to save some semblance of health reform, and the Democratic Party majority in one or both Houses.

[Pab Sungenis]

6. Single payer does not take 60 to pass.

An expansion to Medicare, basically Medicare Part E, can pass in reconciliation.

[leveymg]

9. Please explain that for us. Thanks in advance.

[regnaD kciN]

14. Yes, but...

...the House couldn't even find the votes to pass a public option based on Medicare rates. The odds against getting 218 House votes, and 50 Senate votes for, essentially, throwing out private insurers altogether and constructing a new government system, to cover everybody, are utterly astronomical. It won't happen, now or in any conceivable future.

[leveymg]

17. I don't disagree with you. But, if it meant the Dems will lose their majority, that is a strong

incentive to reconsider. Or, it should be, anyway.

What I'm pointing out is a potential option of taking what we can get through regulation, not a best-case outcome, which would be single-payer. Not even close.

[BzaDem]

7. Basically everything you just said is wrong.

Anything that doesn't involve the budget can NOT pass by 51 votes under Reconciliation. Lifting the antitrust exemption would never meet the criteria. The drug reimportation bill might or might not (it would have to affect the deficit). The public option might actually pass under reconciliation (though it would eventually fail without banning pre-existing condition discrimination).

Reconciliation is basically useless unless you pass the rest under normal order (i.e. the Senate bill).

[leveymg]

11. Please explain how you think the Reconciliation system does work in this context.

Are you saying one needs 60 votes to lift the anti-trust exemption and the drug re-importation bill? Or, are you saying those would be normal 50-plus one Senate votes not requiring Reconciliation? That's an important distinction with a difference.

[regnaD kciN]

12. It's a very simple rule...

If a law can affect taxation, spending, or the budget, it can be passed through reconciliation. If it affects none of these, such as lifting the anti-trust exemption or banning adverse selection by insurers, it cannot.

[leveymg]

16. Thanks. That strengthens the gist of my argument. As a straight 50 plus 1 vote, more

likely to pass than through the Senate Parliamentarian.

[regnaD kciN]

19. You are still not making any sense...

You cannot pass anything through the Senate without a cloture motion requiring 60 votes unless it is a budget item that the parliamentarian judges to be suitable for reconciliation. A non-budget item = you need 60 votes. No exceptions.

[regnaD kciN]

10. Unfortunately, you HAVE to pass the Senate bill first...

...because one of the most underlooked, but utterly vital, parts of health reform is the ban on "adverse selection" -- refusing to cover people because of pre-existing conditions, or dropping people once they get sick -- plus the cap on how much people can be charged, and making it purely age-based. And those, being regulatory rather than budget-related, cannot be passed through reconciliation. Period. And, if you don't have those, insurers will react to virtually every other reform either by selectively jacking up rates or simply dumping anyone who has a chance (based on medical records or even simple demographics) of costing them money. The end result would be that private insurance would become utterly unaffordable for anyone who ever got sick -- and, if we had a public option, it would wind up covering all those in need or expensive care, making the premium costs higher than private insurance (assuming you could even qualify for the latter).

Yes, a lot can and should be passed through reconciliation -- but, hard as it may be to understand, for them to work, you have to pass the regulatory portion of the current bill first. And, if we lose that 60th Senate vote, the only way to do it is for the House to hold their nose and pass the Senate bill as is...and then get to work on a reconciliation resolution that would fix it.

[leveymg]

13. A Bill banning "adverse selection" wouldn't require 60, just a Senate majority.

Not a budget item. Same thing with a cap on fees.

What we have now is "greenmail" scheme by the industry. Pass it with mandatory sign-on or else we'll instruct the Senators we paid for to block the regulatory part. I wish people understood that part. Otherwise, there's no reason why everything, including industry profits, couldn't be regulated as a public utility.

[regnaD kciN]

15. Sorry, but you are simply wrong...

Because it is not a budget item, it couldn't be passed by reconciliation, and could therefore be filibustered.

Contrary to some opinion I've read here, the filibuster doesn't only apply to budget items. In fact, it's exactly the opposite -- if it doesn't relate to the budget, you need 60 votes on a cloture motion -- no exceptions.

[leveymg]

18. In that case, recombine budget and non-budget items into a new Bill that can pass by Reconciliation.

Is there any way to step around the Finance Committee on such a measure? What, realistically, are the options at this point?

I assume the following Wiki is correct:

A reconciliation instruction (Budget Reconciliation) is a provision in a budget resolution directing one or more committees to submit legislation changing existing law in order to bring spending, revenues, or the debt-limit into conformity with the budget resolution. The instructions specify the committees to which they apply, indicate the appropriate dollar changes to be achieved, and usually provide a deadline by which the legislation is to be reported or submitted.<1>

A reconciliation bill is one containing changes in law recommended pursuant to reconciliation instructions in a budget resolution. If the instructions pertain to only one committee in a chamber, that committee reports the reconciliation bill. If the instructions pertain to more than one committee, the House Budget Committee reports an omnibus reconciliation bill, but it may not make substantive changes in the recommendations of the other committees.<2>

SNIP

The Byrd Rule (described below) was adopted in 1985 and amended in 1990. Its main effect is that reconciliation cannot be used for provisions that would increase the deficit beyond 10 years after the reconciliation measure.

SNIP

Any Senator may raise a procedural objection to a provision believed to be extraneous (under another part of the Byrd Rule), which will then be ruled on by the presiding Senator. A vote of 60 Senators is required to overturn the ruling.

There are two hurdles to cross under Reconciliation. 1) The contents of the instruction, and a potential objection.

Seems 1) is determined by who writes the instruction listing the committees involved, and 2) is determined by having 41 votes in the Senate. Is that correct? It seems to all boil down to a change in those persons. Any reason why we couldn't get a decent 10-year HCR Bill through Reconciliation with 51 votes if one changed the leadership or compelled their cooperation in writing a new instruction?

[regnaD kciN]

20. Uh...no...

In such cases, the parliamentarian has to review the bill and strip from it anything that is not budget-related. You can't "recombine" budget and non-budget items and have any hope of it qualifying for reconciliation. The best you could hope for would be a parliamentarian-approved bill containing only the budget-related items...and, as I've pointed out earlier, passing only the budget-related parts of HCR, minus the regulatory parts that would need 60 Senate votes, would result in an eventual disaster for taxpayers and the insured combined.

[leveymg]

21. The Parliamentarian's role is advisory. It's the Presiding Officer in the Senate who makes the

decisions as to what is extraneous. So, what's the problem here? That's Biden.

As the Presiding Officer of the Senate may not be fully aware of the parliamentary situation currently facing the Senate, staff from the Senate Parliamentarian's office sit on the Senate dais to advise the Presiding Officer on how to respond to inquiries and motions from Senators. The role of the parliamentary staff is strictly advisory; the Presiding Officer is in no way required to follow their advice, though they almost always do so. The office also refers bills to the appropriate committees on behalf of the Senate's Presiding Officer. If facing the dais, the Parliamentarian is the second from the left.

The current parliamentarian is Alan Frumin,

Seems that lots of Laws have been passed by Reconciliation that contained regulatory provisions:

Reconciliation bills have included:

* Omnibus Reconciliation Act of 1980, Pub.L. 96-499 (1980)
* Omnibus Budget Reconciliation Act of 1981, Pub.L. 97-35 (1981)
* Omnibus Budget Reconciliation Act of 1982, Pub.L. 97-253 (1982)
* Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA), Pub.L. 97-248 (1982)
* Omnibus Budget Reconciliation Act of 1983, Pub.L. 98-270 (1984)
* Deficit Reduction Act of 1984 (DEFRA), Pub.L. 98-369 (1984)
* Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), Pub.L. 99-272 (1986)
* Omnibus Budget Reconciliation Act of 1986, Pub.L. 99-509 (1986)
* Omnibus Budget Reconciliation Act of 1987, Pub.L. 100-203 (1987)
* Omnibus Budget Reconciliation Act of 1989, Pub.L. 101-239 (1989)
* Omnibus Budget Reconciliation Act of 1990, Pub.L. 101-508 (1990).
* Omnibus Budget Reconciliation Act of 1993, Pub.L. 103-66 (1990).
* Balanced Budget Act of 1995, H.R. 2491 (vetoed December 6, 1995)
* Personal Responsibility and Work Opportunity Act, Pub.L. 104-193 (1996)
* Balanced Budget Act of 1997, Pub.L. 105-33 (1997)
* Taxpayer Relief Act of 1997, Pub.L. 105-34 (1997)
* Taxpayer Refund and Relief Act of 1999, H.R. 2488 (vetoed September 23, 1999)
* Marriage Tax Relief Reconciliation Act of 2000, H.R. 4810 (vetoed August 5, 2000)
* Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA), Pub.L. 107-16 (2001)
* Jobs and Growth Tax Relief Reconciliation Act of 2003, Pub.L. 108-27 (2003)
* Deficit Reduction Act of 2005, Pub.L. 109-171 (2006)
* Tax Increase Prevention and Reconciliation Act of 2005 (TIPRA), Pub.L. 109-222 (2006)
* College Cost Reduction and Access Act of 2007, Pub.L. 110-84 (2007)