Congressional Democrats stand a good chance of passing a modified health-care reform bill even without a 60 seat majority, according to Senate Republican Minority Whip Jon Kyl (R-AZ), either by pursuing a tactic of reconciliation or by scaling back their legislative proposals.
“Reconciliation is one of the Democrats’ last, best options at this point,” Kyl said, referring to a parliamentary procedure that would require only a simple majority vote to pass certain portions of the legislative package.
‘They Will Not Quit’
Kyl thinks key elements of the health care legislation could be adopted through the reconciliation process, but he says he and his fellow Republicans would relentlessly attack the Democratic leadership if they were to take that step.
“I think politically we are prepared to pounce on that,” Kyl said. “Reconciliation would be an ultimate abuse of the process, circumventing the American people after they have spoken.”
The only other legislative options for Democrats, according to Kyl, would be to give up on health reform altogether or to negotiate a scaled-back reform bill with Republicans in the months ahead. Neither strikes him as likely.
“The Democrats and the White House have invested monumental time and effort to pass this,” Kyl said. “They will not quit on this. They’ve worked too hard on this. They deeply believe in it.”
Little Common Ground
In an appearance on ABC News’ This Week in the last week of January, White House adviser David Axelrod named a series of points President Obama deems “too important to walk away from.” These include tax breaks for small businesses to provide employer insurance, staving off Medicare’s anticipated 2017 sink into insolvency, expanding prescription drug coverage for senior citizens, capping out-of-pocket expenses, and guaranteeing patients get insurance coverage for preexisting conditions.
There are potential areas for negotiated compromises between the two parties. In June 2009, Republican Congressmen Mark Kirk (R-IL) and Charlie Dent (R-PA) drafted an alternative reform plan, the “Medical Rights and Reform Act,” which included tax breaks for small business. Dent and Kirk’s plan also calls for public grants to low-income families to purchase private plans, requiring insurance companies to allow young adults to remain on their parents’ plans until age 26, government expansions of rural access and community preventive-care programs, incentives to states to reform their insurance markets, and new measures to counter Medicare fraud.
However, according to Robert Moffit, director of the Heritage Foundation’s Center for Health Policy, the philosophical divide between Democrats and Republicans on how to reform health care would prevent any real cooperation.
“I don’t think many conservatives would favor the federal government overriding the states,” he said. “Limited government requires that Congress respect those limitations. They haven’t done that so far.”
Moffit points out the Republican alternative has several elements most Democrats are sure to oppose. It limits medical liability damages, makes no provisions for expanding senior drug benefits, and aims to cuts costs for consumers mostly by facilitating their use of private plans and encouraging health facilities to be more efficient, not by expanding public health-care options and subsidies.
Even on a popular area for reform—requiring coverage of preexisting conditions—Moffit says many Republicans would oppose allowing it for an individual who chose never to buy insurance until coming down with an illness.
“The law should make a distinction between those who were playing by the rules and paying their insurance premiums for years, and those who waited until they were sick to get insurance,” Moffit said.
Republicans Planning Alternative
Kyl suggested Republicans might agree to some specific reforms in the coming months, but he says they will prepare their own approach after the November elections, when they anticipate having a stronger negotiating position.
“The one thing I think we Republicans are going to have to figure out is how real reform can be done without adding all of these other interconnected bells and whistles,” Kyl said. “I’ll be for honest problem solving when I can get back to a fair fight to try to get my philosophy out there.”
Rick Docksai ([email protected]) writes from Washington, DC.