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Healthcare Reconciliation & Filibuster

October 16, 2009

October 16, 2009

On HC Reconciliation, Filibuster; Pelosi & Reid Trickery

I’ll post this explanation in the hopes that it makes sense. The place to start is by remembering the basic structural difference between the House and the Senate. The House is ruled by the principle of virtually unrestrained majoritarianism. The Rules Committee, controlled by the majority leadership, determines how long a bill will be debated, when it will come to a vote, and how many amendments can be offered (if any). The minority has little power, if any, except what it can shame the majority into sharing—which is to say, hardly any. The Dem’s are conducting behind the scene closed door meetings.

The Senate, on the other hand, is a more consensual body, by both its rules and its traditions. A mere majority is often not enough to prevail; the minority has more a voice, sometimes even an individual senator. Under normal circumstances, to avoid a filibuster, you must either acquire 60 votes for a cloture vote or obtain a unanimous consent agreement laying out more-or-less the structure of the debate as a House rule would do, but approved by every senator.

Not currently in possession of 60 votes, Democrats are threatening to apply the reconciliation process—designed for deficit reduction budget measures—to health care. Then they would only need 51 votes. However, it is not clear whether enough centrist Democrats are willing to bypass normal procedures, nor is it clear how much of any health reform bill the parliamentarian will rule in order when the use of reconciliation is challenged on the floor.
Thus the opportunities and aims of House Republicans and Senate Republicans will not be identical. House Republicans can largely dispense with a long consideration of procedural tactics.

Put another way, under the normal process, senators can filibuster almost anything and the debate would only be cut off if at least 60 lawmakers vote to do so. For that reason, 60 is considered the magic number in the quest to pass health care reform out of the Senate.

But under reconciliation, or the ‘nuclear option’ typically used in the budget process, no filibusters are permitted and a bill can pass with just a simple majority. Structuring the health care bill in this way allows it to be scooped up in the reconciliation process, which could torpedo the Republicans’ trump card.

The Ways and Means Committee adjusted its health care overhaul package so that the Senate, down the road, could avoid a filibuster and pass health care reform with a smaller number of votes than normally required. But Ways and Means Chairman Charlie Rangel, D-N.Y., said the committee’s maneuver “is strictly procedural.” This of course, in its simplest form, is bullshit.

Instead, the GOP’s main goal now will be to make the argument against the approach of the House Dem’s as vigorously as possible, citing again and again the high costs, fiscal, medical, and philosophical banter. Behind the scenes, the GOP can work to pry away the 25 or so Blue Dogs who will be necessary to stop current plans. But the Dem’s won’t stop there. Pelosi & Co. will stop at nothing.

Expect the RATS to minimize or eliminate altogether any public discussion of the bill through procedural maneuvers. After all, why create the option if you don’t intend to use it? The significance of this tactic is that the Baucus bill was drafted with the provision that there would be cuts to Medicare payments to physicians. That is a primary reason that the CBO found that the bill would reduce the deficit.

But the cuts in payments are suspect. Congressmen routinely include this promise in bills to meet budget constraints and later cut that provision after the bill passes and public scrutiny and opposition dies down. Looks like the power broker tactics of Rham Emanuel who understands Congressional trickery. Its a cram down.

Even still, then there is the actual accounting tricks in the determining a budget neutral deal in the first place. Explanation: The bill imposes tax hikes and benefit cuts right away, including $121 billion of Medicare reductions between 2011 and 2015. But new spending really doesn’t start until five years out (2015) and isn’t fully operational until 2017. The bill uses 10 years worth of tax hikes and benefit cuts to fund a few years worth of benefits. Let me repeat that… the bill uses 10 years worth of tax hikes and benefit cuts to fund a few years worth of benefits. These guys are amazing.

Remember, the CBO released a report last week claiming the bill won’t add to the deficit.
But this assumes that employers who dump employee coverage under the Baucus bill will then increase worker paychecks by an amount equal to what they had spent on health care. This replaces a nontaxable event (providing health insurance) with a taxable one (increasing worker paychecks), magically producing $83 billion in revenues. Without this windfall, the Baucus bill adds billions of dollars to the federal deficit in the first decade.

Of course, why would a company drop employee coverage just so it could pay more (in fines, taxes and wages) than it did before? The CBO report also estimates that receipts from the 40% excise tax the Baucus bill would levy on “Cadillac” insurance policies “would grow by roughly 10 percent to 15 percent” a year after 2019… Let me repeat that… a year after 2019.

That’s nonsense. If you tax something heavily you’ll get less of it. If this tax is enacted, there will be fewer Cadillac plans—and hence less revenue. Under questioning at a Senate hearing Tuesday, CBO Director Douglas Elmendorf admitted that the $500 billion in tax hikes in the Baucus bill would be passed onto consumers, jacking up insurance premiums. That undercuts the argument that Democratic reforms will make health care more affordable.

At the state level, some governors are also now figuring out that the proposal in the Baucus bill to expand Medicaid will shift a big chunk of the federal HC tab to the states. States, after all, pick up an average of 47% of Medicaid’s costs—and expanding it will force states to spend more. Not good.

The Baucus bill cuts Medicare payments to physicians by 25% within two years and keeps payments at that level forever, without adjusting for inflation. If this becomes law, doctors who take Medicare patients will see their real income decline each year. The Doc’s must be very pissed.

I hate Liberals…

If they go nuclear, it may set off a political nuclear reaction leading up to the 2010 mid-term elections.

Also, what’s this that Democrats want to wait till after the New Jersey and Virginia governor elections next month for a final vote? Sounds like they want to see which way the political winds are blowing.

By hook or by crook, they have to get the public option in the final bill that goes to Obama’s desk. They will do this with a ‘trigger’ by switching bills in the darkness of night.

I hate Liberals.

It strikes me as very creepy that , if passed, the Democrats marched in lock-step in both the House and Senate. They seem like military factions under Putin or Kim Jong Il, afraid to voice any objection or any difference of opinion at all with their Dear Leader’s of Swivel-Head-in-Chief, Pelosi and Reid.

I hate Liberals.

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