Putting Reconciliation in Context

Ezra Klein, the wiz wonk from the Washington Post/Newsweek, made an important point about the process being contemplated through reconciliation for the House and Senate healthcare bills, which he termed “micro-reconciliation.” That is, essentially reconciling both bills by making minor tweaks, as suggested by the President, contained in the 11 pages posted by the White House.

That is exactly what the reconciliation process is intended to in this instance: to reconcile the two bills passed in the House and Senate without drafting an entire new bill. The Senate bill has already passed with a 60-vote supermajority, and the House needs to pass it with 216 votes. According to Sara Rosenbaum, chair of the Department of Health Policy at George Washington University, “the way in which virtually all of health reform, with very, very limited exceptions, has happened over the past 30 years has been the reconciliation process.”

A History Of Reconciliation -- from an NPR (National Public Radio) report:

For 30 years, major changes to health care laws have passed via the budget reconciliation process. Here are a few examples:

1982 — TEFRA: The Tax Equity and Fiscal Responsibility Act first opened Medicare to HMOs

1986 — COBRA: The Consolidated Omnibus Budget Reconciliation Act allowed people who were laid off to keep their health coverage, and stopped hospitals from dumping ER patients unable to pay for their care

1987 — OBRA '87: Added nursing home protection rules to Medicare and Medicaid, created no-fault vaccine injury compensation program

1989 — OBRA '89: Overhauled doctor payment system for Medicare, created new federal agency on research and quality of care

1990 — OBRA '90: Added cancer screenings to Medicare, required providers to notify patients about advance directives and living wills, expanded Medicaid to all kids living below poverty level, required drug companies to provide discounts to Medicaid

1993 — OBRA '93: created federal vaccine funding for all children

1996 — Welfare Reform: Separated Medicaid from welfare

1997 — BBA: The Balanced Budget Act created the state-federal childrens' health program called CHIP

2005 — DRA: The Deficit Reduction Act reduced Medicaid spending, allowed parents of disabled children to buy into Medicaid

Of course, Fox viewers wouldn’t have an earthly clue about this. After all, NPR is to Fox “News” what the New York Times is to National Enquirer. Which is why Fox viewers are generally referred to in polling parlance as “low-information voters.”

So when Senator Lamar Alexander stated that reconciliation would be a “political Kamikaze mission” for the Democrats, his rapturous apocalyptic warning rings hollow indeed. Particularly, considering that Senator Lamar “the hypocrite” Alexander has himself voted for reconciliation four times on Republican agenda items. Next, the Republicans mischaracterize reconciliation (see above) as a “nuclear option” (yeah, right) to “ram/or jam through” healthcare reform that has been debated for the past 13 months and passed with a supermajority in the Senate and a sizable majority in the House.

Enough is enough. It is time for Republicans to step aside, stop obstructing the will of the majority, and allow an up-or-down vote on healthcare reform. As for Senator Alexander, he doth protest too much. If the Republicans really believe passing this bill is the equivalent of a “political Kamikaze mission” for Democrats, why are they being so nice as to counsel their opponents against it? Knowing the Republican MO, if they really really believe this “political Kamikaze” crap, they would be encouraging the Democrats.

Here’s a shovel, Lamar, and it’s not to shovel snow.