Obama: Health Bill ‘Deserves’ Vote
Obama: Health Bill ‘Deserves' Vote
March 3, 2010
By: Alex Wayne
President Obama will have to overcome not only unified Republican opposition but also deep mistrust and division between House and Senate Democrats to get the up-or-down vote on a health care overhaul he demanded Wednesday from Congress.
Obama: Health Bill ‘Deserves' Vote
March 3, 2010
By: Alex Wayne
President Obama will have to overcome not only unified Republicanopposition but also deep mistrust and division between House and SenateDemocrats to get the up-or-down vote on a health care overhaul hedemanded Wednesday from Congress.
Congressional Democratic leaders say they are almost finished drafting a health care bill, based on an outline posted on the White House's Web site last week. They could send the bill to the Congressional Budget Office for a cost estimate as soon as this week, then share it with Democrats in both houses to test its appeal, said Senate Majority Whip Richard J. Durbin, D-Ill.
But establishing the substance of the bill is only the first and perhaps easiest step in the process. Overcoming determined Republican opposition in the Senate, which is likely to take the form of countless amendments, could prove extraordinarily difficult. Senate watchers say that Vice President Joseph R. Biden Jr., who is likely to preside over the health care vote, may have to exercise his authority as president of the Senate in ways not seen in several decades.
Dealing with political sensitivities in the House may prove even more daunting. Democratic leaders must not only find 216 votes to clear the Senate's original health care bill (HR 3590), but also convince their members to act first, before the Senate begins considering a package of changes to the legislation under a fast-track parliamentary procedure known as budget reconciliation.
"There will be procedural concerns," said Robert E. Andrews of New Jersey, a health policy leader among House Democrats. "This is not going to be easy, there's no doubt about that."
Obama Declines to Start Over
In a speech in the White House's East Room on Wednesday, Obama forcefully demanded that Congress finish comprehensive legislation. He rejected Republicans' call to start over, saying, "The insurance companies aren't starting over. They are continuing to raise premiums and deny coverage as we speak."
After a bipartisan health care summit Feb. 25 and the president's offer March 2 to include four Republican proposals in the health care bill resulted in no GOP support, Obama endorsed the use of an up-or-down vote to avert a Republican filibuster in the Senate and finish the legislation.
He did not use the phrase "budget reconciliation" in his speech, however. Republicans have made the term controversial by accusing Democrats of trying to use the procedure to "jam" the health care bill through the Senate.
Instead, Obama noted that majorities in both chambers had already passed versions of the overhaul. Senate Democrats passed their bill without GOP support thanks to their 60-vote supermajority, but the Democrats have since lost a seat with the election of Republican Scott P. Brown of Massachusetts in January.
"And now it deserves the same kind of up-or-down vote that was cast on welfare reform, the Children's Health Insurance Program, COBRA health coverage for the unemployed, and both Bush tax cuts — all of which had to pass Congress with nothing more than a simple majority," Obama said.
All of those initiatives were passed by Republican-controlled Senates using budget reconciliation.
Obama's proposal would cost about $950 billion over 10 years, according to White House aides, and would extend insurance coverage to about 31 million people. It would also require most Americans to obtain coverage, but it would provide subsidies to reduce the cost of premiums for low- or middle-income people who do not get insurance from their employers. Companies that do not provide insurance would be penalized if their workers obtain policies subsidized by taxpayers.
Division Over How to Proceed
After the Congressional Budget Office gives its official cost estimate, Democratic leaders face a difficult assessment: Can the House clear the Senate-passed health care bill into law, so that a reconciliation bill would simply supersede it?
Skittish House Democrats want the Senate to pass the reconciliation bill first, so that the House can vote on the reconciliation bill's changes to the Senate health care bill, then clear the health care bill. But Senate Democrats say that is not possible.
Durbin said Senate leaders would provide some kind of "convincing gesture" aimed at reassuring House Democrats that the Senate would act on the reconciliation bill once the House clears the Senate health care bill, but he said the House would likely have to vote first. "The first step is with Speaker Pelosi," he said, referring to Nancy Pelosi, D-Calif. "I will let her decide what it takes in the House."
House Democrats say a mere gesture from the Senate may not suffice.
"I think a lot of the new members have great consternation about the House moving forward first," said Diana DeGette of Colorado, a chief deputy whip for her party. "I think that whatever plan there is, is going to have to be explained very clearly to members, especially to new members, and they're going to have to have a level of comfort that those problems in the Senate bill are going to be solved."
Two House Democrats whose votes would likely be required to clear the Senate bill, Gerald E. Connolly of Virginia and Jason Altmire of Pennsylvania, said they were disinclined to vote for it without some kind of Senate guarantee that a reconciliation bill would follow.
"I would have great difficulty being asked to and voting for another health care bill — theirs — without close-to-ironclad assurance they will act," said Connolly, the freshman class president.
Altmire said, "Assuming I was comfortable with the reconciliation language, which is far from certain, there would have to be a guarantee that the Senate bill I was voting on would be amended. That's the problem they're going to have in rounding up the votes."
Trust between the chambers has been undermined by the fact that the Senate has ignored 290 bills the House passed last year, Connolly and other House Democrats say, including controversial proposals such as climate change legislation (HR 2454) and an overhaul of the financial regulatory system (HR 4173).
"I think the sequence [on the health care bill] is of concern to lots of people, not just new members," he said, "in part because we've sort of walked the plank on an awful lot of bills over here, only to have the plank sawed off in the other chamber."
Dissatisfaction With Abortion Language
Meanwhile, Bart Stupak of Michigan, the leader of a group of anti-abortion House Democrats, says he and as many as 10 or 11 other Democrats would vote against the Senate bill because it does not sufficiently restrict abortion coverage by insurance plans receiving federal subsidies.
Pelosi acknowledged at a March 2 news conference that the reconciliation bill cannot change the Senate bill's abortion language, because only issues directly affecting the federal budget can be addressed through reconciliation.
That means Obama and other Democratic leaders will have to convince anti-abortion party members in the House to follow the lead of Democratic Sens. Bob Casey of Pennsylvania and Ben Nelson of Nebraska, who oppose abortion and helped write the Senate bill's abortion language. They say the language is sufficiently restrictive, though some major anti-abortion groups, including the U.S. Conference of Catholic Bishops, disagree.