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Puzzling Out the Health-Care Vote

With my friend Yuval Levin, than whom no one seems more able to maintain a grasp on the slippery thread of this business, I’ve been trying to work through just what exactly the procedure for a successful health-care vote is. It would seem to be this (and don’t blame Yuval if I get any of this wrong).

Stage 1. The House of Representatives must now pass the Senate bill, which passed in December. In so doing, it will effectively be voiding its own bill, which was passed with a 5-vote margin in early November — because none of the  goodies and bargains House members negotiated among themselves are present in the Senate bill. Specifically, there’s no “public option” in the Senate bill, as there is in the House bill; and there’s no “Stupak amendment” forbidding the use of public funds for abortion in the Senate bill. That amendment was necessary for House Democratic leaders to secure its five-vote victory in November.

Ordinarily, the House and Senate bills would go to a conference committee, which would negotiate over the differences in them, combine them into a single bill, and send that new bill back to both chambers for a final vote. This single bill would be considered a new piece of legislation, and therefore would have to be voted on again by everybody. Once that is done, the single bill would go to the president’s desk for signature.

But because of Scott Brown’s election, there are no longer 60 votes in the Senate for a health-care bill—and 60 votes are needed in the Senate to end discussion of a bill and bring it to a vote. Without 60 votes bringing the discussion to “cloture,” a bill can remain open for debate forever in the process called “filibustering.” So there can’t be a health-care bill if the Senate has to take up a new version of it, because any new version will be fillibustered by Republicans.

So the House has to vote on the Senate bill to avoid another vote in the Senate. For then there is a single piece of legislation all tied up in a bow that doesn’t have to go to committee.

So why doesn’t that just happen?

Well, if there is to be a health-care bill, it will happen. The House will have to vote through the Senate bill without changing it. That’s just the reality. But that’s only going to happen if House members are promised that some of their concerns are taken into consideration. And so there will have to be a second bill. Immediately afterward. A second bill that fixes what’s wrong with the first bill. And this is where all this talk about “reconciliation” comes in.

Stage 2. Reconciliation. The second bill will function as a series of amendments to and fixes of the first bill. Now, ordinarily, that  should kill the whole process outright, because the same problems the first bill faced should apply to a second bill in the Senate—the need for 60 votes to close debate, etc. But that wouldn’t be the case if the second bill is treated as a “reconciliation” measure. A reconciliation measure is a the only one in the Senate that bypasses the 60-vote cloture rule and allows a simple majority vote. Keith Hennessey describes it thus:

A reconciliation bill is a special type of bill.  The full name is a “budget reconciliation” bill.  It’s purpose is to combine into one bill the work of multiple committees that are changing federal spending and tax laws.  It is an incredibly powerful tool that bypasses [unlimited debate and cloture] but only for very limited purposes.  Senators, and the Senate as a whole … allow these rules to be bypassed only for a specific purpose.

The use of “reconciliation” to pass health-care measures would be unprecedented. And there are real questions about whether the parliamentarian of the Senate will be able, even bending so far over he turns himself into a pretzel, to say that a vote on (for example) stripping abortion coverage from the bill fits the legal definition of what “reconciliation” is.

But forget that for a second. Let’s assume the Senate parliamentarian is entirely pliable. A reconciliation bill will be written. What then?

Stage 3. The House takes all the heat. Ah. Here’s the rub. It appears that, in an effort to make this as easy as possible on the Senate, the House is now under pressure from the Senate and the White House to vote for the reconciliation bill before the Senate. At which point the Senate will take it up and ramrod through the second bill with 51 votes, Obama signs it, and there’s health-care.

This strategy requires the House not only to vote for a wildly unpopular bill once, but then to vote on its sequel almost immediately afterward. In other words, House members are going to be forced to cast two wildly unpopular, highly visible votes in succession, without anybody else taking the heat. And there is going to be deal-making and back-scratching and all manner of sleazy behavior to achieve it, all of which will just increase the public sense of a corrupt process that has ensnared Democrats just as corruption seemed to ensnare Republicans in 2006. All so the Senate can sneak it through. And the House has good reason not to trust that the Senate will hold to its part of the bargain. What if there is a colossal meltdown in public support just before the reconciliation vote? What if the Senate decides to change it a little and throws it all back into chaos again? What if House members were to cast two votes and there was no health care at the end of the process?

The only thing that can make this insane business tolerable or bearable for House Democrats is geniune conviction —  conviction that this is the once-in-a-lifetime chance to put the country on the glidepath to a national health-care system. That is what can make the process seem to transcend the sleazy deals and buyoffs for those who are going to have to face voters and explain themselves and their votes.

So if, in the end, this process works as the White House wants it to work, it will do so because of core Democratic and liberal beliefs. Republicans and conservatives need to understand that; the political horror faced by every Democrat who does not have an entirely safe seat can be mitigated in part by the belief that there may be enough Democrats who can live their lives proud to have brought this measure to fruition.

Thus, the best hope of derailing health care will not derive from high motives – stopping this dreadful measure before it becomes law — but rather very low motives —sheer, panicked self-preservation on the part of Democratic pols hoping against hope to hold on in spite of the looming Republican wave.



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