Reconciliation possibilities

[liberalpragmatist]

Despite the new word that Senate Dems are going to appease Lieberman, drop the Medicare buy-in, and hopefully secure 60 votes, I still think it's less than clear that it'll actually happen. Lieberman keeps moving the goalposts and negotiating in bad faith.

That's why many people - even some insiders like John Podesta - were talking about reviving reconciliation.

The problems with reconciliation are that:

(a) Anything not relevant to budgets can get cut out - meaning no insurance regulations, no exchanges, no payment reforms, etc. If you pass something that isn't germane to the budget and thereby violates the "Byrd Rule" you have to 60 votes to override and then that provision sunsets in 5 years.

(b) You'd have to start from scratch. You'd get a much less ambitious bill - one that covered far fewer, but one that could probably include a public option or at least a Medicare buy-in.

(c) You'd also have to basically start from scratch, which would take several months and the whole process would have to be shepherded by our friend Kent Conrad (who, remember, is no progressive champion).

I'd suggest that if you are going to go to reconciliation, you basically have to restructure health care reform as two or more bills. You could either pass a public-optionless bill like the one we have now, and then revisit after the midterms to allow a Medicare buy-in or a public option. Or you could scrap what we have now, and go for a less ambitious bill with a public option, with the hope of doing the regulations, building the exchanges, etc., next time around.

It's doubtful to me that you could successfully split the bill and pass both within the same Congress. Lieberman and other centrists aren't going to be fooled and would likely block/filibuster the regular bill as well, knowing that it's passage was necessary for the proper functioning of the reconciliation bill.

Substantively, it seems like it would be better to simply pass the bill without the public option now, but revive it in the next couple of years and push it through reconciliation.

Politically, though, I think doing it the opposite way around would be better. The big flaw is you'd have to start from scratch, but it's likely that a public option or Medicare buy-in combined with a Medicaid expansion would be popular. And once it's a fait accompli, it could be easier to next year go back and resurrect a bill with all the non-budgetary aspects.

[yourout]

1. A big KnR...

Get a strong public option up and running and they would dare not kill it.

[SpartanDem]

2. i agree splitting the bills are the best option

I think the best route is to pass the bill without the public option or buy and push these through reconciliation later. With the 51 vote threshold you'd be able to get a public option with Medicare rates and/or more open buy in. I'd like to get the regulations, etc locked in now. I don't think it is likely that we lose our majority, but I don't we should dismiss that the scenario in which the GOP lets the Po/buy in provisions expire and then block attempts to add the regulations.

[tritsofme]

3. Judd Gregg claims he has 800 amendments to offer.

Even after the arduous process of crafting a bill under reconciliation, it would still face the possibility of months long debate on endless amendments from the Republicans.

Anything would be better than a bill passed using reconciliation.

[liberalpragmatist]

4. Well...

... that's why I think substantively it would be best to just pass the public option-less, no-Medicare-opt-in bill now and try to pass Medicare expansion in a couple years through reconciliation.

[ncteechur]

5. And from what I understand, you cannot amend Senate rules if not at beginning of session.

We are not at beginning of session.

[mkultra]

6. reconcilliation is for checkbooks NOT HEALTHCARE!