Threat of reconciliation hovers over centrist Democrats on healthcare

Talk about using budget reconciliation to pass healthcare reform in the Senate has faded from public view, but Democratic leaders continue to hang the threat over centrists in private.

Senate Majority Leader Harry Reid (D-Nev.) discussed reconciliation with wavering centrists before an important procedural vote to begin debate on healthcare reform.

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On Saturday, Nov. 21, three centrists, Sens. Ben Nelson (D-Neb.), Mary Landrieu (D-La.) and Blanche Lincoln (D-Ark.), voted to commence debate, despite heavy pressure from Republicans and conservative groups to oppose it.

Nelson wrote in an op-ed last week that he voted for the motion to avoid the prospect of Reid bringing healthcare legislation to the floor under budget reconciliation, a process with special procedural protections originally intended for legislation to reduce the deficit, such as tax increases or spending cuts.



“By following normal procedures — allowing much debate, many amendments and even an opportunity to consider a complete alternative to the new bill offered by Senate Majority Leader Harry Reid — we have avoided for now bringing up healthcare legislation by using the tactic known as budget reconciliation,” he wrote in an op-ed appearing in the Omaha World-Herald.


Under reconciliation, healthcare legislation could pass with a simple majority after a strictly limited floor debate. But lawmakers would have to carve up the bill to eliminate provisions that do not clearly raise revenue or cut spending and therefore would be subject to parliamentary objections. Reid has said that he could pass a government-run health insurance program, known as the public option, under reconciliation.

Landrieu said the subject came up during a meeting with Reid shortly before the pre-Thanksgiving vote.

“It came up in passing, but it wasn’t the focus of our meeting,” Landrieu told The Hill.

The threat of reconciliation could become more important as Reid wrangles with centrists over the public option.

Sen. Joe Lieberman, the Democrat-turned-Independent from Connecticut, has said he would vote to filibuster a healthcare bill that included a public option. Landrieu, Lincoln and Nelson have also voiced strong concerns over the public option.

Landrieu noted that Reid has said publicly that he does not plan to use reconciliation.

During a Nov. 19 news conference, Reid told reporters: “I am not using reconciliation.”

But centrists are skeptical that Reid’s public stance means the threat of reconciliation has passed.

“Some, citing comments from Sen. Reid, say reconciliation is off the table,” Nelson wrote. “But it will be right back on the table if we allow the normal Senate parliamentary procedures to break down.”

Several prominent liberal advocates say they would prefer Democratic leaders use reconciliation to pass healthcare reform with a public option than pass a more comprehensive bill with 60 votes that lacks a government-run insurance program.

“I would hope that Democratic leaders would keep reconciliation in their back pockets,” said Roger Hickey, co-director of the Campaign for America’s Future. “I think it’s better to pass a bill with the public option under normal procedures. But if it’s the only way to get a good bill, I would also support reconciliation.”

Richard Kirsch, national campaign manager of Healthcare for America Now, a coalition of liberal groups and labor unions, said: “We think a public option absolutely has to be in the bill.

“Our view is if it takes reconciliation to get the essential parts of reform, that’s better than passing a bill that falls short of reform through regular order,” he said.

Buzz over reconciliation hit its peak in August, when talks among a bipartisan group on the Senate Finance Committee were on the verge of collapse and the public option seemed to have little hope in the Senate.

Sen. Debbie Stabenow (D-Mich.), however, said there is little talk of reconciliation these days outside of Reid’s office.

“We’re not talking about reconciliation; nobody is focused on that at all,” she said.

 But Stabenow acknowledged the procedure has not been ruled out: “It’s always there. There’s a difference between not being talked about and taking it off the table completely.”

A Democratic aide said that using reconciliation would cause weeks of delay and that Democratic leaders appear committed to passing a bill under regular order.

“We’re so far along the path of doing this under regular order it would be counterproductive to switch to a reconciliation strategy,” said the aide. “There would be a lot of procedural hoops that you would have to jump through and it would eat up time.”

 Sen. Kent Conrad (D-N.D.), chairman of the Senate Budget Committee, listed some of the procedural hurdles that would make it cumbersome to pass healthcare reform under reconciliation.

“Rewriting the bill is one thing, and then you have CBO scoring the bill all over again, and you saw how long that took,” Conrad said in reference to the weeks spent waiting for the Congressional Budget Office to analyze Reid’s bill.

“I never thought reconciliation would work,” said Conrad.

A healthcare reform bill passed under reconciliation would have to reduce the federal deficit over five years by at least a billion dollars and remain deficit-neutral each and every year thereafter.

Conrad also noted that any provision in the healthcare bill that did not have a significant budgetary impact would not be eligible for reconciliation protection.

The procedural difficulties have convinced some supporters of the public option that reconciliation is not likely to be invoked anytime soon.

“No, because there would be a thousand amendments,” said Sen. Jay Rockefeller (D-W.Va.) when asked whether reconciliation is still an option to pass healthcare reform.

But a Democratic aide said circumstances could change.

“People may reserve the right to revisit that reconciliation approach — that remains preferable to accomplishing nothing,” said the aide.

The aide expressed confidence, however, that a reform bill with some form of a public option could garner 60 votes.

“People are pretty optimistic,” the aide said.