Demand Majority Rule for Health Care Reform

America needs health care reform enacted this year. With millions of Americans losing their jobs and millions more losing the ability to pay for health insurance due to the recession, health care reform can’t wait. In addition, if we don’t restructure the system, health care costs are projected to skyrocket over a number of years, bankrupting both employer-sponsored private insurance and public health programs. As Senators Ted Kennedy and Max Baucus put it: “Solving the nation’s health-care crisis is a fundamental part of healing our economy.” [Wall Street Journal [1]] For ourselves and our children, for our businesses and our nation, we have to start now.

Comprehensive health care reform probably can’t be passed over a Senate filibuster. It’s not impossible, of course. But only a minimal, watered-down bill is likely to win 60 votes in the Senate. A great many health care leaders, including Speaker Nancy Pelosi, believe that the special interests can probably count on the votes of at least 41 Senators to block crucial parts of a progressive reform package [Congressional Quarterly [2]], the most important being “public plan choice.” [CAF [3]] In fact, it will take quite a battle just to get a majority of 51 votes.

The budget reconciliation process guarantees majority rule in the Senate. By placing specific “reconciliation” language in the congressional Budget Resolution, designated policies can be brought to the Senate floor in a way that avoids any filibuster and guarantees majority rule. While the obscure restrictions of the “Byrd Rule” make reconciliation an imperfect vehicle for comprehensive reform, it’s far better than no vehicle at all. [American Prospect [4]]

The reconciliation process is appropriate for health care reform. Senate Republicans are acting as if the reconciliation process—that prevents a filibuster—is somehow unprecedented or inappropriate. It is neither. Since 1980, reconciliation measures have been enacted 19 times and three other times such measures were passed but vetoed by the President. [The New Republic [5]] Republicans have employed the process repeatedly to enact their most controversial priorities, including 2005 legislation that reduced spending on Medicaid; President Bush’s 2001 and 2003 tax cuts for the rich; welfare reform in 1996; and the “Contract With America” agenda in 1995. [TalkingPointsMemo [6]] The same conservative senators who react with horror to reconciliation today employed it with enthusiasm during George Bush’s presidency. [Newsweek [7]]

The reconciliation process can help forge a sensible bipartisan plan. President Obama proposes that any vote to adopt health care reform under the reconciliation process be delayed until September to give lawmakers both an opportunity and a deadline to hammer out a bipartisan consensus. Without at least the threat of enactment by a majority vote in the Senate, opponents of health care reform will simply delay the matter again and again—as they have done for the past 15 years. [Washington Post [8]]