Republicans rage against reconciliation for healthcare reform

President Obama’s call Wednesday for an “up-or-down vote” on healthcare reform may not sound like fighting words, but for Senate Republicans, it’s a call to arms.

“If this bill is passed, in the next election every Republican candidate will be campaigning to repeal it,” said Senate Republican leader Mitch McConnell in a briefing after the president’s White House statement.

He said the bill involves $500 billion cuts to Medicare, $500 billion in new taxes, and $2.5 trillion in new spending, and most Americans oppose it. “He’s calling on us to ignore the wishes of the American people," Senator McConnell added.

At issue is not just the policies the White House wants to move through the Congress but how it plans to do it. House and Senate Democrats now say they will move healthcare reform through a controversial process called reconciliation, which requires only a majority vote instead of the 60 votes now typical in the highly polarized Senate.

The Democrats' new plan would go like this: The House would first vote to approve the Senate healthcare bill, which passed on Dec. 24 on a party-line vote, 60 to 39. But because the Senate bill is unacceptable to most House members, the House would also pass a package of “fixes.” Then, the Senate would pass the fixes under the reconciliation rules that require only a majority vote.

Angry Republicans present only one of the challenges to this plan. House Democrats wary of the Senate present another.

The key is convincing House Democrats that the Senate will pass the fixes, as promised. Asked at a press briefing whether the House is willing to take a “leap of faith” by passing the bill before the Senate passes the fixes, House majority leader Steny Hoyer said: “Well, we're working on having that faith verified."

The problems with reconciliation

In truth, Senate Democrats can only promise so much.

With Senate Republicans unanimously opposed to the bill – and furious at the prospect of reconciliation – Democrats know to expect strong procedural objections if they go forward. And even without strong opposition, the procedures for reconciliation are complex and results of the process often unpredictable.

Under the Byrd Rule, for example, opponents can try to strike “extraneous matter” from a bill. "Extraneous matter" is defined as any measure that does not contribute to the purpose of reducing the federal budget deficit. The Senate's presiding officer – typically following the guidance of the Senate parliamentarian – decides whether a challenge will stand or not. Once material has been stricken from reconciliation legislation, under the Byrd rule there is no way to add to the legislation it in another form.

In other words, even with good will, honest assurances, and every Senate Democrat fit to vote, House members can’t be sure of the outcome of votes on the fixes.

“It’s a a gamble that [House Democrats] have to take," says Julian Zelizer, a congressional historian at Princeton University in Princeton, New
Jersey.

“Because of the reconciliation process, it’s never clear what will get through. It’s easy to see some of those fixes knocked out,” he adds. “House Democrats are going to have to assume that Senate Democrats are good to their word, then hope the fixes get through.”

House Democrats: we have no choice

House leaders say there is no choice but to move to reconciliation. The Senate's inability to move legislation though normal procedures makes reconciliation the only option.

“We now have 290 bills that have passed the House that are over in the Senate – 80 bills at least of large significance and many of which passed on a bipartisan basis, and yet they are all stuck and on hold,” said Rep. Chris Van Hollen (D) of Maryland in a press briefing on Wednesday.

The reason? He said it is “a very calculated an cynical strategy to try and bring the work of the American people to a halt."

Meanwhile, interest groups on both sides of the issue are rallying their constituencies outside Washington to bring pressure to bear on the outcome. “Trying to jam this unpopular legislation through when it affects one-sixth of the American economy with a simple majority vote is ... an outrage," said R. Bruce Josten, top lobbyist for the US Chamber of Commerce in a statement.