Sunday is D-Day on Health Care

Sometime Sunday afternoon, it appears the House will vote on both the Senate-passed health care bill and a separate reconciliation measure to amend spending provisions of the bill, including eliminating all of the distasteful special deals for states like Nebrasaka and Florida that were included in the bill as well as deferring some of the taxes on high-benefit plans and attaching additional Medicare taxes to high income individuals. The Congressional Budget Office has estimated that with the reconciliation measure, the final bill will cost $940 billion over 10 years and bring in $1.1 trillion in new revenue and savings during the same time, yielding a net deficit reduction of $130 billion. This report seems to have satisfied a number of the previously fence-sitting Democrats, who have largely been breaking for the bill in the past 48 hours.

It is still unclear whether the House will directly vote on the bill or whether they will use the "deem and pass" mechanism, by which they would vote on a rule to debate reconciliation that would simultaneously "deem the Senate bill passed". A lot has been made in the press and by the GOP of the cowardice of not voting directly on the bill and they have somewhat of a point. House DEMs should have the courage of their convictions to vote directly on the bill. But at the end of the day, it doesn't really matter. EVERYBODY is going to know that voting for the rule is the same thing as voting for the bill and trust me, vulnerable Democrats will get hammered for this vote.

So, here's what to expect next:

(1) The House vote -- sometime after 2 PM Sunday, the House will have its two roll call votes. The vote will be very close, but expect the DEMs to prevail by a razor-thin margin. The underlying rule or bill and the reconciliation bill should pass by almost exactly the same margin. The DEMs need 216 out of the 431 occupied House seats for passage. Expect them to get 216 to 220.

(2) The President signs -- the Senate rules prohibit them from voting on the reconciliation measure until the underlying legislation being modified has become law. Therefore, the President must sign the bill, complete with its cornhusker kickbacks and Louisiana purchases. That's right, the Senate bill must become the law of the land, at least for a little while.

(3) The Senate passess the House reconciliation package -- this will likely be after the Easter break, in early April. Little attention has been paid to whether the Democrats have 51 votes in the Senate (what is required for a reconciliation measure), but I'd be shocked if there will be an issue, as they control 59 seats and even giving up moderates like Nelson, Landrieu, Lincoln, Lieberman, Bayh and Webb leaves a little margin for error.

(4) The President signs the reconciliation measure -- the final measure becomes law. Health care reform, in its present form, becomes the law of the land. On to immigration, cap and trade and the economy.

I expect this to play out this way, but the sign that I am wrong will be if the Democrats hurriedly start pushing back the vote. That will mean they haven't found 216. I can't get to 216 yet among the publicly committed House members, but all the indications coming out of the vote counters in the House are that the leadership has enough privately committed votes to put then over the top. Intrade odds have crossed 4:1 in favor of passage. Watch the debate live on C-SPAN.

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