The Health Care Map Ahead

August 31, 2009 9:07 a.m.

With the summer winding down, it’s time to take stock of where the legislative track is likely to pick up in what is likely to be the breakneck pace of September.

First, with two of the three Republican members of the so-called Gang of Six openly embracing some version of the “death panel” canard, it’s probably worth writing off the Finance committee negotiations for a bipartisan bill. But that doesn’t mean it’s all down to pushing reform through budget reconciliation, which is to say using procedures which allows you to do it with 50 rather than 60 votes.Watch for Senate Dems’ first effort be to simply get a different group of Republicans. Chuck Grassley isn’t the first Republican you’d want to make a deal with. And Mike Enzi may be close to the last. But once you’ve got the discussion out of the Finance Committee, and particularly this Gang of Six charade, there are a handful of other Republicans you might have a better shot with. The Maine senators, perhaps one of the relative moderates retiring this year. Not that it would be easy by any means. But it’s another possibility. Think of it as the Stimulus Bill model, which might be the Dems first plan B.

Next, it’s not a point that has been discussed much, but there are some extra complications or ironies involved if you go the budget reconciliation route. We’re going to be discussing this in more detail later. But there are some technical particulars about the reconciliation process (particularly tied to the so-called Byrd Rule) which come into play. Specifically, to be allowed under budget reconciliation, bills need to meet certain standards about their effect on the federal budget. And because of that, it may be that to get a health care reform bill through reconciliation it would need to have a substantially more progressive public option, because of its effect on the budget. I know that’s a lot of gobbledygook to take in. But the upshot is that the decision to go through reconciliation may not just be a matter of how tough the Dems want to get. It may force them to beef up the public option, which in turn could affect the number of Democratic votes availability.

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