The White House and its allies are seeking ways to regroup and pass a new version of government-run health care proposed by President Obama, even preparing to resort to the reconciliation process since no reform package is likely to pass through traditional legislative means.
Reconciliation Avenue Unlikely
Joseph Antos, a health care policy researcher at the American Enterprise Institute in Washington, DC, thinks a comprehensive version of health care reform is unlikely to pass, even via reconciliation.
“Democratic health care reform is dead, mostly because the Democrats could not really come to an agreement on what they wanted,” Antos said.
The House and Senate budget reconciliation process requires only simple majorities in both houses of Congress, but it is limited in scope. Antos believes there is also considerable chance of public outrage if Democrats choose this method to pass health care reform.
“The problem with passing these very targeted health care overhauls through the reconciliation process is that these piecemeal bills could take months to pass through Congress. In the Senate there is no limit on amendments, so even with very small bills, it could take months. That is not a winning strategy,” Antos said.
‘Not Good Policy’
According to Kristina Rasmussen, executive vice president of the nonpartisan Illinois Policy Institute, use of the reconciliation process would send a negative message.
“It’s a sign of desperation that supporters of this package will do whatever it takes. This is not good policy,” said Rasmussen. “They’d have to strip out quite a few provisions from the legislation to get it through in reconciliation, and we will end up with a mess.”
Budget Assumes Passage, Savings
The President’s FY 2011 budget forecasts savings from reform of the nation’s health care system, even though there is significant doubt those will materialize. According to Office of Management and Budget director Peter Orszag in an interview with ABC News, “Since both the House and Senate had passed legislation, we took the average [expected savings] of the two.”
John R. Graham, director of health policy studies at the Pacific Research Institute, says there are problems with assuming these savings in the budget proposal.
“The budget assumes the bill will pass, which is not clear, and it assumes that the bill will save money, which nobody outside the White House really thinks,” Graham said. “All independent actuaries say the bill will actually increase costs.”
Medicaid Expansion Predicted
James Capretta, a fellow at the Ethics and Public Policy Center, believes the White House will eventually aim at a toned-down version of current proposals.
“If I were the Democrats, what I would aim to do is sometime in the summer come up with a health care package that just does all the popular stuff,” Capretta said. “The Democrats can expand Medicaid to roughly five million Americans, then declare victory. That is the kind of vote they are probably going to take, ultimately.”
Thomas Cheplick ([email protected]) writes from Cambridge, Massachusetts.