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Healthcare Reform Update - March 11-17, 2010


Email Alert

March 17, 2010

Compiled by Brian Betner*

House Democrats Move Health Bill With Controversial, Complicated Strategy
March 16, 2010

House Democrats have started the clock to a landmark vote on sweeping changes to America's health care system.

The Washington Post reports that the House may try to pass the Senate health reform bill without voting on it by declaring it passed if the House passes an accompanying reconciliation bill that "fixes" the Senate bill. House Speaker Nancy "Pelosi (D-Calif.) would rely on a procedural sleight of hand: The House would vote on a more popular package of fixes to the Senate bill; under the House rule for that vote, passage would signify that lawmakers 'deem' the health-care bill to be passed." The tactic has been commonly used in the past, but never on something as "momentous as the $875 billion health care bill," The Post reports.

"'It's more insider and process-oriented than most people want to know,' the speaker said in a roundtable discussion with bloggers Monday. 'But I like it,' she said, 'because people don't have to vote on the Senate bill.' Republicans quickly condemned the strategy, framing it as an effort to avoid responsibility for passing the legislation" (Montgomery and Kane, 3/16).

USA Today: "Brookings Institution scholar Thomas Mann said the 'deem and pass' move being contemplated by House Democrats is not that unusual and has been employed to handle 'difficult partisan issues,' such as the ban on smoking on domestic airline flights. Mann said Congress used this procedure 36 times in 2005 and 2006, when the GOP was in charge, and 49 times in 2007 and 2008, after the Democrats had taken control" (Kiely, 3/16).

McClatchy : "However, using such a dicey procedure to enact President Barack Obama's biggest domestic initiative--the most far-reaching social policy change in decades--could inflame a public that's already annoyed at the legislation's tortured path and disgusted with Congress. . . . Legal experts also raised concerns. Michael McConnell, a professor of law at Stanford University, wrote Monday in The Wall Street Journal that such procedures are unconstitutional. He cited a 1998 Supreme Court ruling that once one house of Congress approves an 'exact text,' the other house must pass 'precisely the same text' before the president can sign it into law" (Lightman, 3/15).

Politico : "Instead of the typical wheeling and dealing to pick up much-needed support, Pelosi and her leadership team are warning members that the bill is final, and its language is set, so don't come seeking major changes or handouts for your district." The warning "indicates that House leaders plan to go to the floor with the reconciliation bill they have rather than making last-minute changes at the Rules Committee to attract more support." Thursday is the earliest that Democrats could vote on a final measure though the vote could happen Saturday or Sunday, "or later," Politico reports, "if leaders keep their pledge to give people 72 hours to review the final changes" (O'Connor and Allen, 3/15).

Roll Call: "Pelosi, meanwhile, reiterated earlier statements that the Senate bill's immigration and abortion provisions could not be changed by the reconciliation bill, in a message clearly aimed at a number of lawmakers demanding changes that she says cannot happen. 'It has to relate to the budget. It has to be about the bottom line. . . . We cannot deal with other language in a budget reconciliation bill,' she said."

"While the House ties itself in knots over how to proceed to the bill, Senate Democrats have been trying to make sure the bill is written in a way to avoid 60-vote budget points of order. Republicans have vowed to comb through the bill to find any failure to abide by strict reconciliation rules that require every provision to have a budget impact" (Dennis, 3/16).

The Hill : "Most, but not all, Democrats on the Budget Committee voted for the healthcare reconciliation package that cleared the panel 21-16 on Monday. Reps. Chet Edwards (D-Texas) and Allen Boyd (D-Fla.) opposed the package while every committee Republican rejected it. . . . The Rules panel will be responsible for actually marking up the reconciliation language and for determining how to move that bill, which contains 'fixes' to the broad Senate-passed healthcare reform bill, and the Senate bill itself" (Youngman and Young, 3/15).

CongressDaily notes that Democrats also continue to wait for an analysis on the reconciliation bill from the Congressional Budget Office. They had expected one Monday, but did not receive it. "If the House stays on schedule for a final vote this weekend, the Senate would take up the bill as early as next week, a spokesman for Senate Majority Leader (Harry) Reid said" (Edney, 3/16).

House Democratic Leader Twisting Arms of the Rank-And-File; Tracking Health Reform Vote Tally
March 17, 2010

Democrats are pressuring fellow members to accept the health care reform legislation and are playing hardball to secure votes for the health reform package.

Politico: "As health care lobbying heats up, some members are getting calls from President Barack Obama, like the three Rep. Jason Altmire
(D-Pa.) got in the past two weeks." Altmire is undecided. "Others in the House said the lobbying can be much less friendly. Aides to conservative Democratic lawmakers describe intense pressure tactics, including one who said his office has received calls from donors. Those calls are taken as a thinly veiled threat to withhold future financial support if the member doesn't vote as the donor wishes." Even Democratic National Committee Vice Chairwoman Donna Brazile used her Twitter account to encourage primary challenges to Democrats who vote against health reform (O'Connor and Allen, 3/16).

USA Today : Obama and his aides aren't taking "no" for an answer. "'When the president takes the time to personally reach out, it makes an impact,' says Altmire, 42, from western Pennsylvania, who is undecided on the bill. 'He really made an effort to understand where I was coming from.' . . . The pressure on wavering House Democrats increases by the day as Speaker Nancy Pelosi prepares to call a vote on Obama's health care bill, which would replace legislation already passed by the House and Senate late last year. . . . Pelosi's in pursuit of the 216 votes needed for passage: 'I never stop whipping. There's no beginning, there's no middle, and there's no end.'" Others, however, are criticizing the approach. Rep. Jim Costa said White House and Democratic leaders have a "level of hubris" on health reform (Wolf, 3/16).

The Boston Globe: "House leaders said they were continuing to round up votes--signaling that they did not yet have a majority--but asserting they will by the weekend. Abortion remained a potential sticking point. Representative Bart Stupak, a Michigan Democrat, told reporters that he has 12 allies in the House who would vote against the plan if abortion language contained in a Senate-approved measure is not changed" (Viser, 3/17).

The Associated Press : "White House aides said (Obama) plans at least one more public health care event this week, including remarks in Fairfax, Va., on Friday. Diverse administration resources are being employed: Even the Navy secretary is in the game. . . . The sought-after Democrats--mainly moderates, but also a few liberals--are mostly trying to stay out of sight. They include 37 who voted against the bill last year and a smaller number who are having second thoughts after supporting it the first time. Walking briskly, lawmakers duck in and out of the House chamber during votes, avoiding eye contact with reporters" (Alonso-Zaldivar, 3/16).

The Washington Post: Obama convinced a few fence-sitters--at least among the public--with his speech in Ohio earlier this week. "It is difficult to judge, amid one of the most intense political battles in recent memory, whether Obama is moving the needle toward greater acceptance of his health-care ambitions. But his reassurances about Medicare and other issues found support among skeptics in Strongsville" (Slevin, 3/17).

Reuters: "House Democratic Whip James Clyburn, the top Democratic vote-counter in the House, told Fox News that Democrats still do not have the 216 votes needed for passage but he was confident of getting there. 'I do not have 216 commitments yet, though I think we'll get there in time for the vote,' Clyburn said" (Whitesides and Smith, 3/16).

Senate Parliamentarian Wields Authority Over Democrats' Health Care Efforts
March 17, 2010

The Associated Press : "When Congress battles over thorny bills, parliamentarian Alan Frumin has been known to sleep in his office--on call 24/7 as the Senate's Solomon, divining the answers. Frumin's ability to review long-standing rules and centuries of precedent to resolve Senate questions makes the mustachioed parliamentarian something of a Washington rock star these days. As much as any elected official, Frumin, 63, holds decisive power over whether the Democrats' rewrite of the health care system survives or sinks. . . . It's fame in true Washington fashion as Frumin, an unelected Senate staffer who won't do interviews, wields outsized influence over the fate of President Barack Obama's signature domestic issue, the health care overhaul. . . . Several Republicans launched a pre-emptive effort to discredit Frumin's objectivity, a charge that Senate officials said upset him. But Frumin maintained his public silence, and the criticism was short-lived" (Kellman, 3/17).

The New York Times Prescriptions Blog : Rep. Dennis Kucinich, D-Ohio, who Obama has lobbied for his vote on the health bill, "voted against the House health care bill in November because he prefers a fully government-run, Medicare-for-all approach. He felt the Democrats' bill simply did not go far enough to eliminate the mostly private, employer-sponsored health insurance system. . . . . Mr. Kucinich has now scheduled a news conference for Wednesday morning at the Capitol to announce how he will vote on the legislation" (Herszenhorn, 3/16).

Politico: The presidential efforts at persuasion must have worked. Kucinich, "enjoying a rare moment where his vote could be critical on a landmark issue, said Wednesday morning he will vote for the Democratic health care bill, a significant boost from a liberal critic of the legislation" (Hohmann and Kady, 3/17).

The Associated Press/Seattle Times : "U.S. Health Secretary Kathleen Sebelius said Tuesday that she's confident the House will have the votes to pass President Barack Obama's health care legislation, possibly as early as Friday. . . . As the White House made a final effort to get a health care overhaul passed this week, Sebelius looked back critically at the legislation's long path. She said supporters could have done a better job correcting misinformation on 'death panels' and cuts to Medicare. She said foes of health care overhaul worked a strategy designed to scare older Americans, but supporters could have been more aggressive at telling seniors what the package included for them" (Johnson, 3/16).

McClatchy : Rep. Henry Cuellar remains an undecided vote in the health care debate. "But instead of feeling battered and blue, Texas' only Blue Dog Democrat is enjoying the process and pushing for his issues: Medicaid expansion, tort reform and no federal funding of abortion. . . . . Although Cuellar voted for the House version of the bill, he has enough problems with the Senate version, and what might come out of the House process this week, that he's biding his time. . . . Cuellar said he has spoken to [House Speaker Nancy] Pelosi--who is looking for every single vote to secure the 216 she needs to pass the health care legislation--but has not gotten any promises or anything in return. . . . As a representative for the congressional district with the third highest number of uninsured in the country, Cuellar wants to know details of coverage plans and the costs to the state. He is also concerned about protecting Texas' tort limitations, which he secured in the House version of the bill but which is not part of the Senate version" (Recio, 3/16).

ABC News : "As he headed to the West Wing for a private lunch with President Obama, DNC Chairman Tim Kaine interrupted his lobbying for health care reform and called the issue 'great politics.' . . . Kaine told ABC News in an interview he is optimistic and encouraged about a vote later this week to pass reform in the House, although he would not predict a final count. With Capitol Hill swirling with demonstrations by Tea Party activists and opponents of the Democrats' bill, Kaine actually challenged Republicans to make reform an issue in Congressional races this fall" (Compton, 3/16).

The New York Times : Long before the fight over health reform had begun, Senate Minority Leader Mitch McConnell, of Kentucky, started using his understanding of process and procedure to advance GOP strategy and objectives. "On the major issues--not just health care, but financial regulation and the economic stimulus package, among others--Mr. McConnell has held Republican defections to somewhere between minimal and nonexistent, allowing him to slow the Democratic agenda if not defeat aspects of it. He has helped energize the Republican base, expose divisions among Democrats and turn the health care fight into a test of the Democrats' ability to govern" (Hulse and Nagourney, 3/16).

Poll: More Americans Oppose Health Bill, But Democratic Faithful Want Action
March 17, 2010

A new Wall Street Journal/NBC News poll finds about half of those polled oppose the health care plan, "but core Democrats the party needs to show up and vote in November are strong backers," The Wall Street Journal reports. "The survey found that opinions have solidified around the health-care legislation, with 48% calling it a 'bad idea' and 36% viewing it as a 'good idea' when presented with a choice between those two. That gap is consistent with surveys dating to the fall. At the same time, Democratic voters strongly favor the legislation being pushed by President Barack Obama, particularly constituencies such as blacks, Latinos and self-described liberals. Those groups mobilized in 2008 to help elect Mr. Obama, but are far less enthusiastic than core Republicans about voting in this year's midterm elections."

And "complicating the calculation for all lawmakers is that a clear plurality of Americans wants the issue addressed in some form. Forty-seven percent of poll respondents said they wanted Congress to consider significant health-care legislation 'immediately' if the Obama plan fails, while another 23% wanted that done at least within the next couple of years" (Wallsten and Spencer, 3/16).

MSNBC reports on that poll, that "46 percent say it would be better to pass the president's plan and make changes to the nation's health care system, versus 45 percent who would prefer not to pass it and keep the system as it is now" (Murray, 3/16).

Meanwhile, "[p]arty leaders are assuring wavering Democrats that passage of a sweeping health-care plan will help them in the midterm elections, despite Republican warnings that supporting the bill is political suicide," The Wall Street Journal reports in a separate article. Democrats also noted that "several other recent polls have showed the margin much closer" between those who support and oppose the bill. "They also predict that the aura of victory that would surround passage of the biggest piece of social legislation in decades would boost its
popularity. . . . Republicans said Democrats were deluding themselves if they believed voters' anger toward the plan wouldn't lead to a November bloodbath" (Bendavid, 3/16).

This information was reprinted from with permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery. © Henry J. Kaiser Family Foundation. All rights reserved.

*We would like to thank Brian C. Betner, Esquire (Hall Render Killian Heath & Lyman, Indianapolis, IN), for selecting the articles for this week's update.


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