Delaware Liberal

What Is The Process To Get A Healthcare Reform Bill?

My understanding of the legislative process is pretty low, but here is what is happening to the best of my understanding. Health care reform is not dead! It’s moving forward, but there is still a lot to do.

There are 5 committees working on the health care bill – 3 in the House and 2 in the Senate. The 3 House committees are the House Ways & Means Committee, the House Education & Labor Committee and the House Energy & Commerce Committee. The first two committees have passed the legislation and mark-up out of their committee. The deal-making with the Blue Dogs is happening in Waxman’s Energy & Commerce Committee. They announced a deal yesterday, so presumably the bill will come out of the committee this week. Part of the deal is that the House can’t vote on the bill until after the break (I guess the Blue Dogs want insurance companies to run more ads to make them uncomfortable). Once the bill is out of the 3 committees, it can move to the floor of the House. Nancy Pelosi says they have the votes to approve the bill, so the House shouldn’t be the big issue.

The two Senate committees working on the bill are the Senate HELP Committee (Health, Education, Labor & Pensions) and the Senate Finance Committee (Baucus’s committee). The HELP committee was the first committee to bring a bill out. The hold-up is the Baucus committee, where Baucus is holding secretive talks with Republicans who want to kill health care reform.

If you seriously want to understand what is going on with the healthcare bills, you need to follow Ezra Klein at the Washington Post. Ezra explains what is going on with the SFC:

The question is whether Baucus’s final product will matter. Rockefeller and the other Democrats on the committee have felt excluded from the negotiations and will want major changes before they can sign onto the final product. Then the Finance bill will have to be reconciled with the more liberal legislation built by the HELP Committee. Then it will have to go to the floor, where it will need the support of people like Russ Feingold and Bernie Sanders and Sherrod Brown just as much as it will need Ben Nelson and Evan Bayh. And then, if it passes those tests, it will have to be reconciled with the House’s legislation.

All of which is to say that the Baucus process is attracting an immense amount of interest, but the product may not look a lot like the bill that Congress eventually considers. And the reason is simple enough: Baucus’s process doesn’t look a lot like Congress. Baucus, Enzi, Snow, Grassley, Bingaman, and Conrad all think of themselves as dealmakers, but right now, they’re not cutting a deal on behalf of anyone but themselves.

What are the options? My best understanding is that the Senate could possible bypass the SFC but the SFC controls the medicaid funding, so that would not be included in the bill if it is bypassed. Harry Reid and the Senate leadership will have to decide what to do if the SFC can’t come out with some kind of bill. Enzi is trying to kill the full bill, by trying to force Reid into signing some kind of promise that the final bill will be the SFC bill (which many Democrats have vowed not to vote for if there’s no public option). I doubt that’s going to happen. Reid needs to show some leadership here, to make sure that the bill isn’t killed in the Senate. He has 60 senators, use that. I don’t care what kind of carrots and sticks he uses (I hope it’s big sticks), he needs to get it done.

For some reason, the media seems to be caught up in the day-to-day drama of the committee work instead of explaining the process to people. It’s almost like *gasp* the media is in the tank for killing health care reform.

Again, what I’ve described is to the best of my understanding. Please correct me below if I’ve gotten something wrong.

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