Friday, March 5, 2010

Now It’s March 18

March 18 is the next deadline for health care reform, according President Barack Obama’s press secretary Robert Gibbs. At a March 4 press briefing, Mr. Gibbs noted that Mr. Obama is leaving for a trip to Indonesia on March 18, and Mr. Gibbs said, “I believe that, based on conversations that I've had in the building, that we're on schedule to get this through the House by then.”

Mr. Gibbs then clarified that March 18 was the date for “passing the Senate bill through the House,” and that a reconciliation bill (see below) would come “somewhat closely thereafter.”

In trying to gain support for reforms in the health insurance market, Mr. Obama on March 4 stopped in at a meeting between insurance executives and Health and Human Services Secretary Kathleeen Sebelius. According to Mr. Gibbs, the President ask the insurance executives to justify recent rate increases, and he read a letter from a 50-year old former cancer patient pleading for health reform because her insurance rates had increased 40% in just the last year, despite the fact that she had paid more than $6,000 in health care premiums in the previous year but had only been reimbursed for $935 in medical claims.

Mr. Gibbs added, “The President went on to discuss the need for comprehensive reform, the need for insurance companies to not block comprehensive health insurance reform."

Mr. Obama also met on March 4 with progressive and moderate Democrats from the House to push for health reform.  Those invited included the following progressives:

  • Madeleine Bordallo (Guam), Congressional Asian Pacific American Caucus chair, health care task force chairwoman

  • Donna Christensen (Va.), Congressional Black Caucus chair, health care task force co-chairwoman

  • Danny Davis (Ill.), Congressional Black Caucus Chair, health care task force co-chairman

  • Raul Grijalva (Ariz.), Congressional Progressive Caucus co-chairman

  • Mike Honda (Cal.), Congressional Asian Pacific American Caucus chairman

  • Dennis Kucinich (Ohio), Congressional Progressive Caucus, health care task force co-chairman

  • Barbara Lee (Cal.), Congressional Black Caucus chairwoman

  • Lucille Roybal-Allard (Cal.), Congressional Hispanic Caucus, health care task force co-chairwoman

  • Jan Schakowsky (Ill.), Congressional Progressive Caucus, health care task force co-chairwoman

  • Nydia Velazquez (N.Y.), Congressional Hispanic Caucus chairwoman

  • Lynn Woolsey (Cal.), Congressional Progressive Caucus co-chairwoman

Also invited were these members of the moderate New Democrat Coalition:

  • Jason Altmire (Penn.), health task force co-chairman

  • Melissa Bean (Ill.), vice-chairwoman

  • Lois Capps (Cal.), health task force co-chairwoman

  • Joseph Crowley (New York, chairman

  • Ron Kind (Wis.), vice-chairman

  • Allyson Schwartz (Penn.), vice-chair, health task force co-chairwoman

  • Adam Smith (Wash.), vice-chairman

Likely Process

Under the legislative process mentioned by Mr. Gibbs, the House would vote on the version of the bill that passed the Senate (H.R. 3590, the Patient Protection and Affordable Care Act). If the House approved that bill, it would go to President Barack Obama for his signature and it would become law.

Yet many Democrats in the House have disagreements with the Senate bill, as does Mr. Obama. Thus, it is assumed that the Senate Democratic leadership would agree to a variety of budgetary changes to the passed bill (including Mr. Obama’s suggestions), and those changes that would be considered in a separate bill introduced in the House and subsequently considered under reconciliation in the Senate. That second bill could only pertain to budget items, such as taxes and spending. That bill would require simple majorities of both chambers to pass and be sent to Mr. Obama for his signature.

Reportedly, the House and the Senate Democratic leadership are nearing an agreement on the changes that would be included in the second bill.


Under reconciliation, the Senate Finance and Health, Education, Labor, and Pensions (HELP) committees would send proposed changes within their jurisdictions to the Senate Budget Committee. The House Ways and Means, Education and Labor ,and Energy and Commerce committees would report their own changes to the House Budget Committee.

The House and Senate budget committees then would craft legislation based on those changes, which first would be introduced in the House as a budget reconciliation bill.

The legislation crafted by the budget committees would then go to the full House and Senate, with a maximum of 20 hours for debate, little or no opportunity to make amendments, and subject to a simple majority vote.

In the Senate, the bill may be challenged on the floor by any senator who asserts that a provision runs afoul of the "Byrd Rule" (named for Sen. Robert Byrd (W. Va.)) and ask the Senate parliamentarian to strip a nonbudget-related provision from the bill (or, in Senate lingo, to give it a "Byrdbath"). If that happens, then at least 60 senators must agree to add the provision back to the bill.

The Parliamentarian is the Senate's advisor on the interpretation of its rules and procedures. Staff from the Parliamentarian's office sit on the Senate dais and advise the Presiding Officer on the conduct of Senate business. The office also refers bills to the appropriate committees on behalf of the Senate's Presiding Officer. Currently, the Senate parliamentarian is Alan Frumin, a graduate of Colgate University who has been with the Senate parliamentarian office since 1977 and has headed the office since 2001.

If the House and Senate bills are approved, they generally are sent to a conference of House and Senate negotiators to agree on a single piece of legislation. That single bill then would be returned for a simple majority final vote by the two chambers under strict rules that set a timetable for action and that prohibit any amendments. The compromise measure also would be subject to Senate "Byrd Rule" objections. If the bill is passed, it would then be sent to the President for his signature or veto.

Since the early 1980s, reconciliation has been used at least 20 times, primarily to steer controversial fiscal and budgetary policies through the Senate. COBRA continuation of coverage provisions originally were included in the reconciliation bill that gave the provisions their name (Consolidated Omnibus Budget Reconciliation Act of 1985).


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