Final Showdown on Health Care Prepping?, The Second End of Harold Ford Junior

Reconciliation Push is Coming -- Are The Votes There?
President Obama today unveiled his "final" health care plan, basically a combination of the bill he had previously proposed (which was itself a sort of conference report on the House and Senate bills) and inserted a few GOP ideas (a $50 billion trial program to experiment with medical malpractice reform, deletion of the so-called "cornhusker kickback" which granted special immunity to increased Medicaid costs to the State of Nebraska) and has called for both houses to give the bill "an up or down vote". This is obviously a signal of a support for the reconciliation process.

So, let's review what has to happen. The steps don't necessarily, but probably will have to happen in this order:
(1) The House passes the Senate Health Care bill. The Senate 60-39 vote for passage made just before Christmas is still valid, in spite of the membership change since then. If the House passes the Senate bill unchanged, no conference report is required and the President can simply sign it into law.

But that isn't it. The House WON'T pass the Senate bill unamended, so to get the votes for #1, you also have to set in motion #2 and #3

(2) The House passes a set of budgetary changes to the bill.

(3) The Senate follows suit, using reconciliation, since the changes will pertain to budget line items. This avoids the need for a cloture vote in the Senate, since budget bills are guaranteed an up or down vote. The bill simply needs 50 votes plus Joe Biden as a tie-breaker to win approval.

So why can't they just do #2 and #3? Reconciliation is limited to budgetary items only. If you don't also do number one, you can't get in the provisions regulating insurance companies, requiring individuals to buy insurance, legally creating health care exchanges and so on.

The DEMs might try to do 2 and 3 first, but it is a very risky strategy, because if 1 fails to materialize, they will have enacted into law half a bill. They could pass the reconciliation measure through both houses first, then quickly pass the Senate bill in the House, allowing the President to sign both the same day to ensure that they are passed.

So, now that the strategy is clear, do they have the votes?

In the Senate, the Democrats are actually in good shape. Take the 59 votes that they control and eliminate all the moderates: Jim Webb, Ben Nelson, Blanche Lincoln, Mary Landrieu, Joe Lieberman. Still 54 votes. You could even let an Arlen Specter or an Evan Bayh slide and still be okay. The Senate won't be the problem, which is a strange juxtaposition, because when they were working towards 60 votes, the Senate was a mess.

The House is the challenge. The DEMs got 218 votes for their bill last time. Two of the members who voted for the bill are no longer in the House and Rep. Cao (R-CA), the lone GOP supporter, has said he won't vote for it this time. This leaves 215. Because of House vacancies, they need 217 for passage.

They might pick-up some votes from moderate Democrats who supported reform but opposed the public option. They also may lose some votes from scared Blue Dogs or from Pro-Life Democrats who are uncomfortable with the Senate's less restrictive abortion language. The vote counting is extremely hard and most of the questionable votes are not committing or commenting. The House Democratic leadership has a real job ahead of itself.

So will this all happen?

Believe it or not, I think the prospects for getting a bill to the President's desk in the next two months are greater than they have been at any time in his Presidency. Opening up to reconciliation changes the whole game. Democrats do not want to fail to do anything on an issue this big after almost 2 years of continuous work. And the House Democrats seem to be a lot better at getting their ducks in a row than in the Senate. But it certainly isn't a lock, especially in the Post-Scott Brown world. And rest assured, the GOP is going to be crying foul the whole way.

Politics is always fun.

Harold Ford Junior Flops
He carpet-bagged from Tennessee to New York to challenge a moderate Democratic Senator by running to her right. And now he is withdrawing because he fears a divisive primary? Who exactly thought any of this was going to work? And who is advising Harold Ford Junior?