Haven’t I been saying things along these lines for over a year?
Representative Paul Ryan of Wisconsin, senior Republican on the House Budget Committee, said the budget, which the House and Senate are expected to approve this week, marked a turning point in American history – and not a good one. He said the inclusion of reconciliation in the budget was tantamount to forcing Republicans to negotiate on health care with a gun to their heads.
“This is the moment when Americans switch their kind of government, their size of government, switch their relationship between the government and the individual,” he said.
Rep. Ryan is correct that once a health care bill is passed, it will fundamentally and permanently change Americans’ relationship with their government. If anything, the change is likely to be more fundamental than what we experienced with the passage of Social Security. And that is precisely why the Republicans are desperate to kill health care, and why we need to hold a gun to their head until the thing is passed into law and signed by the president.
The key to success for the Democrats is to pass a health care bill with a public option. Centrist Democrats, including perhaps the all-important Finance Chairman Max Baucus (D-MT), might be tempted to forego a public option in order to get the needed 60 votes to cut off debate and end a filibuster. That is why the Obama administration insisted on including a provision to pass health care under budget reconciliation rules that limit debate, thus obviating the need for a cloture vote.
The Republicans should count it as a victory, albeit fleeting and probably Pyrrhic, if they can force the Democrats to use the reconciliation process. Why? Remember all that talk about letting the Bush tax cuts sunset in 2011? The reason we can do that is because those 2001 tax cuts were passed using reconciliation and they must be reauthorized after ten years. The same would be true of Obama’s health care plan if it is passed using reconciliation. Sometime in 2019, Congress would have to reauthorize the health care bill, and the Republicans could kill or revise the program at that point…if they have the power.
But the Republicans aren’t kidding themselves. They know that a health care plan with a public option will be immensely popular and that private insurers will ‘wither on the vine’ (to use a Gingrichism) over time as Americans take advantage of the lower costs of the non-profit-driven option. There’s not much chance that Americans will take anyone seriously in 2019 who wants to dismantle or weaken the national health care system. And that’s exactly the kind of fundamental change in the relationship between the people and their government that Ryan is talking about.
The Hill reports on Harry Reid’s recent actions on this front:
In a letter to Senate Minority Leader Mitch McConnell (R-Ky.), Senate Majority Leader Harry Reid (D-Nev.) on Monday reiterated that he would prefer that health reform be a bipartisan effort.
Nevertheless, Reid left no room for doubt that Democrats will leave the GOP behind if that is what it takes. “Make no mistake — we are determined to reform healthcare this year,” he wrote.
In addition, Democrats will establish the terms of any bipartisan compromise, Reid indicated.
“In order for this bipartisan process to take root, Republicans must demonstrate a sincere interest in legislating,” Reid wrote. “Rather than just saying no, you must be willing to offer concrete and constructive proposals. We cannot afford more of the obstructionist tactics that have denied or delayed Congress’s efforts to address so many of the critical challenges facing this nation.”
There is a political game being played here and the parameters are not entirely clear. What is at least implied is that the Republicans can get a bill somewhat more to their liking by getting engaged in the process of marking up the bill and providing enough votes to make reconciliation unnecessary. The Republicans feel that a national health care bill is bad enough, but a national health care bill with a public option is something that they consider to be a suicide pact. What’s not entirely clear is where the Obama administration stands on the public option. Centrist Democrats, including Max Baucus, have indicated that the public option is negotiable. But no one in the Obama administration has made any such suggestion, as far as I know. In fact, their insistence on including reconciliation as a back-up plan suggests that they won’t settle for a bill without a public option.
All things being equal, the Democrats would prefer a bill that won’t sunset in ten years. And using reconciliation can cause other problems with the breadth of the bill, as it will be subject to various points of order under the Byrd Rule. It would also be preferable, I guess, to pass something that has at least some bipartisan support. So, the Dems have incentives to compromise and it’s just not that clear where Obama stands and where Baucus and other centrists stand.
The Republicans will want to kill the public option. Short of that, they’ll want to force reconciliation so that they can chip away at the bill using the Byrd Rule and have at least a theoretical shot of killing health care a decade from now.
It should be interesting.
