Rep. John Culberson, R-Texas, flings a copy of the health care bill out into the crowd during
a health care reform rally on Capitol hill in Washington. (AP Photo/Jose Luis Magana, File)
The debate over health care policy shifts from neutral to first gear in the U.S. Senate on Monday, November 30, 2009 and will start to pick up speed as it heads toward final Senate passage and Conference.
The Senate voted before Thanksgiving 60 to 39 for cloture which allows the merged work products of the Health, Education, Labors, and Pensions Committee (HELP) and the Finance Committee to come to the floor for debate.
One Senator, George Voinovich (R-OH), decided a political celebration party commemorating a past triumph on a Saturday night sounded like a lot more fun.
Amendments:
The next step will be the offering of various amendments from the Senate floor. Each will be voted upon individually unless grouped into a single vote. Debate goes on until another vote for cloture requiring 60 votes shuts off amendments.
It is less clear under arcane Senate rules if a third cloture vote is required to shut off debate after the amendment process ends. Repeated calls about procedure to Senate Majority Leader Reid have not been returned
Final Senate passage requires 51 votes. Following a closed door conference to agree on language for joint legislation, a simple majority of both houses must agree before presentation to President Obama for signature.
Reconcilliation:
Should successful cloture votes not appear possible at any point in the process; a second, more limited, option exists called budget reconciliation. Reconciliation dates from the early 1970’s and has been used a number of times by both parties when necessary legislation is blocked by a recalcitrant minority.
There are advantages and disadvantages to using reconciliation. A simple majority is required, but only certain kinds of fiscal matters can be dealt with. Conservative Democrats might benefit from some political cover afforded. Since more than one committee drafted the bill before the Senate, a new bill would need to be offered by the Senate Budget Committee. Matters changing the “Social Security” program are specifically excluded. Additional legislation with separate votes may be required to achieve the full scope of reform proposed.
Because of the conference, the shape of a final bill is anyone’s guess. Differences between the Senate and the House proposals are mostly related to the political deal making required to garner necessary votes for passage. The necessity of dancing on the head of a political pin is also what caused the 4000 combined pages required to address all the competing interests.
If most major hurdles can be cleared by reconciliation, then it might not be such a bad thing in the long run… especially if it simplifies things which will inevitably require repair and assure progress toward universal care at reasonable cost.
The waiting period:
A five year waiting period before reform kicks in cannot be a good thing obviously inserted to escape the next election cycles. It is an accounting trick to minimize cost over a burn in period. Second, it gives providers of all kinds time to find ways around the reforms.
For proof, one needs look no further than current schemes for medical pricing. No one is seriously expected to pay these prices except those poor uninsured souls least able to do so. Those truly unable to pay are cost shifted to the rest of America, then trotted out to show providers offer billions in charity care.
Other examples of abuse include the time lag offered to the credit card industry before new fairness regulations kick in next year. Drug companies are in the process of raising their list prices today in anticipation of health reform passage.
To be sure, there are good and bad things in the proposed reforms. Is a public option absolutely necessary? That depends on your point of view and understanding of the notions behind insurance.
Planned finish by Christmas:
Senate leadership plans to complete action on health care legislation by Christmas.
Al Portner is a former daily newspaper editor and publisher in seven states and author of the forthcoming “Mark Twain and the Tale of Grant’s Memoir.” He can be reached at alanportner@gmail.com
Next: The idea behind all insurance and a simple solution.
For More Information:
Senate votes cloture to bring HC bill to floor
Reconciliation:
The Byrd amendment
Credit card companies piling on fees before law kicks in
Big Pharma raising prices in advance of reform passage
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