The Road to Health Care Reform: Deem and Pass
Mar 15th, 2010 | 115 responses
This is slightly different from the procedure that was nixed by the Senate Parliamentarian. Like much of the Senate rule book, it’s hard to wrap your brain around because it’s just so convoluted and arcane — but as Ezra Klein explains, it’s legit:
Here’s how that will work: Rather than passing the Senate bill and then passing the fixes, the House will pass the fixes under a rule that says the House “deems” the Senate bill passed after the House passes the fixes.
The virtue of this, for Pelosi’s members, is that they don’t actually vote on the Senate bill. They only vote on the reconciliation package. But their vote on the reconciliation package functions as a vote on the Senate bill. The difference is semantic, but the bottom line is this: When the House votes on the reconciliation fixes, the Senate bill is passed, even if the Senate hasn’t voted on the reconciliation fixes, and even though the House never specifically voted on the Senate bill.
It’s a circuitous strategy born of necessity. Pelosi doesn’t have votes for the Senate bill without the reconciliation package. But the Senate parliamentarian said that the Senate bill must be signed into law before the reconciliation package can be signed into law. That removed Pelosi’s favored option of passing the reconciliation fixes before passing the Senate bill. So now the House will vote on reconciliation explicitly and the Senate bill implicitly, which is politically easier, even though the effect is not any different than if Congress were to pass the Senate bill first and pass the reconciliation fixes after.
115 Responses to “The Road to Health Care Reform: Deem and Pass”
cute analogy. try this one:
“Dad, Pam Public fell and got hurt at school. I wanted to give her a band aid and so did my friends, but that bully Johnny Boehner wouldn't let us. He just stood between us and Pam. I had to go around the side to give Pam the band aid.”
Yes, I understand that they are two separate bills that must be signed into
law separately. I think we are on the same page as far as the procedure
goes. I am saying that the statement “I voted for the Senate bill with the
House fixes” would be technically misleading (for the reasons you
specify–that it is still two separate bills being effectively voted on
simultaneously, not one combined bill as is implied by the statement).
However, what I am saying is that the answer is good enough to dodge the
question and get the interviewer/debate moderator to move on to the next
question. If you watch the sunday-morning talk shows, you know that
politicians have made dodging questions with half-truths and art-form, so I
don't underestimate their ability to do the same on this issue.
That's debatable, I know, but that's my opinion. In any case, we'll see how
things turn out.
How is Boehner standing in the way of the House passing the Senate bill with a straight up or down roll call vote?
So, obviously they don't intend to hold back the Senate bill until the final sidecar bill passes both houses (and it's unclear whether or not they even can do that…but with the timeline they say they're going to use, they either have figured out that they can't or they've decided that they won't.)
No, that's correct, they're not. As I understand it, that's because the Senate bill has to be signed by the president before the reconciliation bill can be passed and signed, and “deem and pass” is the only way they can make that happen, given that the Senate parliamentarian told them they could not pass reconciliation first in both houses, before the Senate bill was passed, which was what they wanted to do before.
(in fact if they include some of the more controversial stuff like the abortion language changes, then A) it can't be voted on via reconciliation because it's not a budget issue and B) the Senate wouldn't have the votes to pass those particular changes
They're not going to include any abortion language changes, for precisely that reason. They are the ones who told that to Bart Stupak. *They* told *him* no abortion language changes were going into the reconciliation bill. They know they can't pass it if they did that.
And yes, the reason that wavering Democrats in the House who would not otherwise vote for the Senate bill w/o the fixes will now vote for the fixes under “deem and pass” is, indeed, because they think it will give them “plausible deniability.” And no, I don't think it will actually do that, either.
And yet you ignore option C which was for the Dems to come up with a bill that had enough support among their own party that it wouldn't have mattered if the GOP refused to vote for it.
Well, the Democrats did try very hard to do that. You know — Max Baucus, the Gang of Six, lalala? Anyway, one would think that a bill that has 100 Republican wish list items in it would also be acceptable to conservative Democrats. Maybe not….
Oh, and one minor quibble: The problem wasn't that the Republicans refused to vote for the bill. The problem was that they would not let it come to the floor for a vote. They refused to allow a vote, which is different from refusing to vote for it. If that had not been the case, and the bill had been allowed to go to the floor of the Senate for a vote after the debate period, I think it likely that Democrats would have been able to scrape together 50 votes from their majority to pass the bill.
You're mistaken. The clause you mention was introduced and passed by Republicans in 1997. It was considered so onerous that both parties have halted its implementation repeatedly, so the 1997 decreases in doc payments have never been made.
You are skirting the issue. The CBO numbers assume the 21% cut WILL take effect, and the Democrats are using that to make the plan look more financially acceptable. As you point out, the cut is very unlikely to occur. Therefore the Democrats are FOR the 21% cut in formulating the budget for HCR, and AGAINST it when it actually is voted on.
Fair enough. I suspect it depends on the questioner.
My question would be. “On March 21, 2010, the President signed a health care reform bill into law, yet, in the course of the campaign, you have repeatedly denied that you voted for this bill. Given that the House Democrats passed the bill, did you vote against your party or were you not present for the vote?”
You can duck and weave but it will look like ducking and weaving. Maybe it's better for the Dems in the end. We'll never know because it will only go down one way.
“You are skirting the issue. The CBO numbers assume the 21% cut WILL take effect”
Not skirting it at all. The HCR bill does not lower payments to doctors for Medicare patients. Full stop.
If you're arguing that all CBO estimates since 1997 have included Republican cuts that were never implemented, I don't know, maybe so. (got a link to the CBO inclusion of that?) If so, everyone's CBO cost estimate is underestimated by the same amount.
But that has nothing to do with this bill. This bill does does not lower payments to doctors for Medicare patients.
“You can duck and weave but it will look like ducking and weaving. “
LOL. And they do, all of them, of both parties, duck and weave and evade questions, artfully or not. You think this wonky deep argument is a great gotcha. I don't. First, it's easy to answer your question and move on. If you re-ask it, or rephrase it, or go into some lawyerly procedural question, you lose. Steve, we'll see how this plays out, but it just sounds like more “flip-flop” charges. It's so common its power is gone.
Every pol has had media training, and knows how to dispose of your question by appearing to answer it and insert his talking point. http://www.youtube.com/watch?v=zvwEBCBEMUQ
“I voted with House Democrats to pass the fix to the Senate bill, which made it a better bill. Senate Democrats agreed. The important thing here is that 31 million Americans now have health care and everyone has protection against losing their insurance or being denied.”
Not skirting it at all. The HCR bill does not lower payments to doctors for Medicare patients. Full stop.
The HCR bill assumes a 21% cut in current Medicare provider reimbursement, I don't know how else to say it.
The House attempted to fix the problem way back last summer but the Doc Fix was taken out of their final bill. To my knowledge that was the last time CBO provided any numbers since no subsequent bills provided a fix for the problem but instead assumed the 21% cut. At that time the CBO estimated the cost for the Doc Fix at $245 billion. The CBO only provides numbers for the budgets they are given, not for the ones they're not.
You're right that this problem started way back with Newt Gingrich but right now the point is moot. The problem has been pushed back so many times it's now at a crisis point. As Kathy has pointed out in prior posts a 21% pay cut would result in an exodus of doctors leaving Medicare.
General practitioners, probably, but from what I've heard about some specialists, probably not. Like many things, it's not necessarily the general concept, it's how it's being implemented that causes the problems.
So sorry, this is a test for posting comment in PIMShell.
“The HCR bill assumes a 21% cut in current Medicare provider reimbursement, I don't know how else to say it.”
The irrational defense of Medicare (and Social Security, we see sometimes on here) has no limits currently.
“The survey shows astonishing intensity and sharp opposition to reform, far more than national polls reflect.”
It really takes barrel-scraping currently to find support for the current legislation and even more work to find people who actually support what the Dems are trying to do.
It shows the desparation that's there among a minority of the population as well as among the Dems now.
If this had been decent legislation, seeking only true reform, with the ability to pay for it clearly stated as well as determined, there would be no problem passing the legislation and no desperate measures as we see now.
The Dems are setting a number of precedents that go beyond unethical behavior — I suspect that there are at least a few Dems with the intelligence to understand that they're setting precedents that the GOP will put to misuse themselves someday. (“Is that what we want?” the few intelligent Dems are likely thinking.)
The Dems are appearing to be willing to do anything to get this legislation passed, but it's getting so desperate and measures being considered so outrageous that I suspect and I hope at least some Dems (I don't know about the people outside Washington who want this passed, no matter what) are thinking that it has to be time to think of Plan B, as a contingency in case they determine that they should defer or postpone trying to get this legislation passed. (Example: Go for good legislation for more stimulus and other economic measures, while correcting the flaws with this health care legislation before possibly trying to pass better legislation, later.) Just as right now the public option is not dead for eventual legislation, at teh same time, the Dems are now so desperate and stooping so low, still without confidence of passage, that smarter people should be starting to think about stopping the effort and doing something else instead.
“a 21% cut in current Medicare provider reimbursement”
I've posted the following on some other threads, and I bet the critics blow it again — simply concentrate on the superficial, that it is a story about Medicaid. I have posted it about Medicare because we're now going to see the same problems happen.
The New York Times hasn't neglected this problem (which is a Medicare as well as Medicaid problem).
http://www.nytimes.com/2010/03/16/health/policy…
Also see here:
http://www.prospect.org/csnc/blogs/tapped_archi…
(Do you believe the Dems have the capability to rescue these programs, or even to do something halfway sensible about the problems as part of an intelligent “stimulus” or related economic-recovery program?)
“a 21% cut in current Medicare provider reimbursement”
http://www.scribd.com/doc/28403838/Pacific-Hear…