In it, but not of it. TPM DC

Slaughter House Rules: The Truth About The Democrats' Plan To Pass Health Care


"I think there should be an up or down vote on that bill," Altmire said. "If you want to pass health care reform you can't do it with an end run, without people going on record. It's too big." (Altmire also said he opposes putting student loan reform in the reconciliation bill.)

Still, House Speaker Nancy Pelosi says the move is her preferred method, and the preferred method of her members. "[M]embers are more comfortable with a [self-executing rule]," Pelosi told a handful of health care reporters and bloggers yesterday morning. "It's more insider and process oriented than most people want to know, but I like it because people don't have to vote on the Senate bill."

So what is a "self-executing rule", and why are Democrats invoking it?

Taking the second question first, House Democrats are, basically, reacting to GOP threats that, on the campaign trail, they'll treat a vote for the Senate health care bill as a vote for controversial provisions like the Nebraska Medicaid deal, even though those provisions will be immediately stripped from the legislation.

So instead of holding a direct vote on the Senate bill, Democrats may adopt a rule that allows them to vote on the reconciliation fix on its own. But the rule will stipulate that if the House passes the fix, it is, in effect, also passing the Senate health care bill. It makes the latter contingent on the former.

Now, whether this will actually insulate Democrats on the campaign trail is an open question. The hope is that they'll be able to respond to charges that they voted for the Nebraska deal by saying "if it wasn't for me, the Nebraska deal would've been sustained," or "I voted to improve the Senate bill."

House members are also seeking to protect the prerogatives of their chamber. Because of Scott Brown's election, they were denied a chance to pass and amend the Senate bill through a normal legislative process--a single vote on a conference report, or an amended final bill. The "self-executing" rule allows them to proceed in as close to a normal fashion as possible--and pass the legislation that will become law with a single vote.

Republicans charge that Pelosi is trying to pass health care reform without holding a vote on it. (Earlier today, Boehner introduced a measure that would force an up or down vote in the House on the Senate health care bill.) But that's not true either. "We're going to vote on a bill...which will provide for the result that, if a majority are for it will adopt...the Senate bill," House Majority Leader Steny Hoyer told reporters today at his weekly press conference. "Does anybody in this room doubt that you have to vote on that? We will vote on it, in one form or another." And, of course, so long as everything goes as planned, anybody watching C-SPAN this weekend will be able to verify that.

About The Author


Brian Beutler is TPM's senior congressional reporter. Since 2009, he's led coverage of health care reform, Wall Street reform, taxes, the GOP budget, the government shutdown fight and the debt limit fight. He can be reached at