Not Over Yet: Senate Must Finalize Health Care

March 22, 2010 4:00 a.m.

So, what’s next?

House Democrats celebrated a major victory late last night after they passed a sweeping overhaul of the nation’s health care system while simultaneously approving a package of fixes to the measure. But it’s not the law of the land, not yet. What happens next is both simple in that there’s one major vote left. But it’s a bit complicated, since President Obama actually will sign one bill and then wait for the Senate to pass the other.

Come along and I’ll explain.The House approved the Senate bill last night, warts and all. Those warts – a tax on high-end insurance plans, several special deals made for members of the Senate on Medicaid and abortion language that pro-life Democrats in the House weren’t comfortable with – are removed through a budget reconciliation measure. That plan – which also passed the House last night – was the product of careful negotiations between the House, Senate and Obama administration and had the blessing of labor unions and many health care advocacy and interest groups. It also contained reforms to the student loan system.

Here’s where it gets tricky. Obama on Tuesday will sign the Senate-passed bill, clearing the way procedurally for Senators to begin debate on the reconciliation fix. The whole thing made House Democrats very nervous since that meant trusting the Senate would actually fix the bits they didn’t like. But Senate Majority Leader Harry Reid showed House Democrats a letter signed by members of his caucus proving they had the votes to pass the reconciliation measure on an up-or-down vote. That paved the way for Sunday night’s House victory. Still with me?

The Senate parliamentary rules are that a reconciliation measure cannot be considered unless it is actually reconciling existing law. So Obama has to sign the bill before debate can start in the upper chamber. Senators have indicated they will start debate right after Obama signs the measure, and House Democrats said Sunday night they think the matter can be wrapped up within the week.

But the Senate is the Senate, and is usually about as fast as molasses. Reconciliation rules do limit the time for debate and prevent the type of filibuster that’s become standard GOP practice over the last year, but it may be optimistic to think things will move along at a speedy pace. We’re not sure yet.

In a statement last night, Reid said the Senate was preparing to “complete its work.” Senate Democrats are planning an afternoon press conference Monday with Sen. Jeff Bingaman (D-NM) and several doctors and nurses groups to showcase what is in the health care reform legislation.

Republicans for weeks have suggested they might throw up blockades known as points of order during the reconciliation debate, but we’re not sure yet how serious that threat might be. Sen. Jim DeMint (R-SC), one of the most conservative lawmakers, said yesterday he will introduce legislation this week to repeal what he called a “health takeover.” He claims the measure is unconstitutional.

We’ll be tracking every development very closely. Keep an eye on our Countdown to Reform wire for the very latest.

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