How are They Going to Attempt to Pass Health Reform

Editor’s note: The big fear of the House Democrats: if the Senate requires the original bill to be signed into law before it will vote on the side car, is it possible that the side car does not get passed — or it gets changed and sent to the House for another vote and it doesn’t agree, etc. and we end up with the original Senate Bill as the law of the land?

Here is an analysis by ERIC.

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THE ERISA INDUSTRY COMMITTEE 
www.eric.org
Advocating the Employee Benefit and Compensation Interests of America’s Major Employers

March 16, 2010

Healthcare reform is now in the root canal stage of the process, where pain and procedures seem to be dwarfing more substantive considerations.  At the moment, all eyes are focused on the House, where Speaker Nancy Pelosi (D-CA) must come up with 216 votes to approve the healthcare legislation passed by the Senate last December as well as a “sidecar” bill that would make enough changes to the Senate bill to assure an “aye” vote in the House for the legislative package as a whole. 

House action:  Yesterday the House Budget Committee got the ball rolling by approving a “placeholder” bill that has now been sent to the House Rules Committee.  The Rules Committee will substitute the “real” reform language for the fake language and then have a vote on a “rule” for the bill – i.e., how it will be packaged, how many amendments can be offered, how long debate can last, etc.; a vote in the Rules Committee could take place Wednesday or Thursday. 

If all goes as planned and the House Rules Committee reports out the legislation, a vote on the overall reform package in the House could occur Friday or, more likely, late Saturday afternoon.  At this point it is not entirely clear what this package will entail, i.e., if the Rules committee will keep the Senate legislation and a House sidecar bill separate or whether the two will be combined.  In the latter scenario, a vote to approve the sidecar would be “deemed” to also be a vote for the Senate bill.

One potential sticking point in all of this is that the Congressional Budget Office has still not released its final “score” on the legislative package; this score is important because a bill that bursts the $1 trillion optical ceiling for the cost of the legislation will have a harder time picking up stray votes in the House. 

Note:  the legislative language for the sidecar bill also has yet not been released.   

Senate action:  If the House summons 216 votes to approve this new healthcare reform package and avoids the numerous potholes that could cause its wheels to fall off, the last stage is consideration in the Senate.  At this point, the Senate bill will have been approved by both the House and the Senate and will have been sent to the president for his signature; although no definitive statement has been issued by the Senate parliamentarian, it appears that the president must sign the Senate bill into law before a reconciliation bill can amend it in the Senate.  What the Senate will consider and vote on is just the sidecar reconciliation bill. 

 As has been made much of lately, the Senate needs only a majority vote to approve the sidecar reconciliation bill and not the 60 votes to overcome a filibuster.  The trade-off, though, is that the reconciliation bill may not include any policy provisions that do not have a budgetary effect on the bill’s bottom line. (That is why Speaker Pelosi has been hamstrung in her ability to add a provision to the sidecar bar to appease anti-abortion House Democrats.)

 But here’s another rub:  the Senate may not necessarily want to approve the sidecar bill exactly as it was sent over by the House; the problem is that any changes to the sidecar would mean that the bill would need to go back to the House for another vote.  This would probably sound the death knell for healthcare reform legislation.