Talk about hard to swallow. At last Wednesday's White House press conference, President Obama urged Congress to pass his massive health reform bill without Republicans votes. This would be possible only by using a procedural tactic known as reconciliation, which would allow the Democrats to pass their measure with a simple up or down vote. Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi support this move.
Congress never has used reconciliation for such sweeping change. The arcane procedure, first used in 1980, was designed to fast-track legislation affecting budgets and the deficit. The rules for using reconciliation require that everything in the bill must have an impact on federal spending. Debate is limited, and — perhaps most significantly — instead of requiring the usual 60 votes, the bill can pass with only 51.
In the past, Democratic and Republican lawmakers alike have resisted using reconciliation except on budget-focused bills. Democratic West Virginia Sen. Robert Byrd led a charge to restrict the use of reconciliation, creating the "Byrd rule" that allows the Senate parliamentarian to strip out any items in the bill deemed "extraneous." Byrd also was among the Democratic leaders who urged President Clinton not to use the reconciliation process to push through his health reform package back in 1994.
And yet in February, four Democrats in the Senate — Kirsten Gillibrand of New York, Michael Bennet of Colorado, Sherrod Brown of Ohio, and Jeff Merkley of Oregon — as well as 119 in the House of Representatives signed a letter to Reid urging him to use reconciliation to pass the Senate health care bill and include a public plan. The idea is snowballing with more senators and representatives signing on every week.
Why are some Democrats endorsing reconciliation now? After Massachusetts Sen. Scott Brown's surprise election, Reid doesn't have the 60 votes in his caucus to push legislation over the finish line. But forcing legislation through reconciliation would be a huge mistake.
Former Senate parliamentarian Robert Dove, who has overseen reconciliation measures, recently told reporters the process simply wasn't designed for complex policymaking and would turn any legislation into a Swiss cheese. "It would be very difficult to achieve a number of things that people want to achieve," Dr. Dove said.
While formal debate would be limited to just 20 hours under reconciliation, senators are entitled to offer as many amendments as they want, so at the very least, the American people would witness a long and exhausting vote-a-rama.
More importantly, though, congressional leaders would be thwarting the will of the people who want a smaller, bipartisan bill.
Support for health reform legislation has been tumbling steadily. According to the latest poll from CNN, 73 percent of Americans want Congress to either scrap the current bill and start over or stop working on health reform altogether. Only 25 percent of Americans believe Congress should go ahead and pass health reform.
Democrats promised that passing their overhaul bill would save the average family $2,500 a year, allow everyone to keep their current coverage, reduce the burden of health costs for American businesses, and not add a penny to the deficit. But the best nonpartisan analyses say the legislation passed by both the House and the Senate fails to meet those goals.
For example, the Congressional Budget Office (CBO) says that if the legislation is enacted, families purchasing insurance in the individual market would see an increase of $2,100 in their premiums by 2016, over and above the increases they already will be facing if Congress does nothing. A family would pay $15,200 for health insurance by 2016 if the Senate bill is enacted, and $13,100 if it isn't.
Businesses would face an avalanche of new spending and reporting requirements, penalties, and potential fines under the law — undoubtedly hurting job growth.
Total spending on health would likely increase too: The chief actuary for Medicare, Richard Foster, found that the Senate bill would bend the cost-curve up, and that new taxes on drugs, devices, and health insurance plans will increase prices and health insurance costs for consumers.
Instead of forcing Americans to swallow this bitter pill, it's time to scrap the current approach and start over, with a smaller, step-by-step approach to reform. With the current Senate bill and with reconciliation, legislators have bitten off more than they can chew.
Published in the Richmond Times-Dispatch, March 10, 2010.