What’s the hold up with Obamacare?

Broken Arrow Family Drug blog

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  • 22 March 2010
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    What’s the hold up with Obamacare?

    This is really the first time I’ve delved into straight politics on my blog. There are some reasons for that, but primarily it’s because it is difficult to discuss politics at length without the reader getting bleary-eyed (or worse yet, really hacked off) before they even get to the end. It’s also because politics can be a quickly moving target. You’ll note that a lot of the articles and info on here are very fresh, meaning they happened either today or yesterday.

    After having a discussion with Andi last week about the state of Obamacare (the generic name used for the current healthcare bills out there), I thought it might be worthwhile to post a primer about what is happening with the bill. To turn a favorite Obama phrase, “Let me be clear”. I will not be discussing the specifics of the Obamacare bill, for the simple reason that no one, including the members of the House and Senate, know what is in the final bill. I’ll be discussing the PROCESS of passing the Obamacare bill, and why it hasn’t been moving anywhere (and whose fault that is).

    My hope is that once you read this post, you will understand some of the words that the media throw around – like ‘filibuster’ and ‘reconciliation’. I also hope that when you see this story in the news, you have a new-found understanding of the process. I promise to keep it in simple, common sense terms. Have I let you down yet?

    Let’s start with how a bill becomes a law. If you’ve ever watched Schoolhouse Rock, you’ve got an idea how it works.

    Schoolhouse Rock oversimplified the process a bit, but to give you a big picture view –

    1. A member (or members) of the House of Representatives create a bill. In this case, we’ll call it the House Healthcare Bill.

    2. The House Healthcare Bill (after getting passed out of committee) is voted on by the entire House.

    3. The House Bill goes to the Senate, where the Senate can make modifications.

    4. If the bill is changed by the Senate, it now becomes the Senate Healthcare Bill.

    5. The members of the Senate and House come together to hammer out differences in the two bills, and jointly come up with ONE Bill that can be approved by both the House and the Senate.

    6. When both the House and Senate give approval to the exact same bill, the bill goes to the White House for the President’s signature. The bill then becomes a law.

    Simple enough, right? Especially when one party holds significant majorities in both the House and Senate.

    But it’s not that simple.

    Let’s take a trip back to January 2009. President Obama has been inaugurated, and Democrats have a strong hold on both the House and the Senate. Specifically, there are 257 Democrats and 178 Republicans in the House. There are 57 Democrats, 40 Republicans, and 2 Independents in the Senate. One seat in the Senate (from Minnesota) will be filled later by Democrat Al Franken after a contested election.

    The House passes the Affordable Health Care for America Act on November 8, after much debate (completing step 2 in the above process). The bill now goes to the Senate (step 3).

    The Senate makes some significant changes to the bill, and on Christmas Eve passes its own version 60-39 (one Republican Senator missed the vote) (this completes step 4).

    The changes made to the bill are important to understand, because it makes a significant difference later. In short, there are 3 big issues of contention between the two bills –

    1. Abortions can (and will) be paid for with federal tax dollars under the Senate bill, but not under the House’s.

    2. The House bill has a ‘public option’ insurance plan, and the Senate’s does not.

    3. The House bill exempts union members from taxation on their ‘Cadillac’ insurance plans, and the Senate bill forces union members to pay taxes on the expensive plans.

    At this point, the Senate has passed one bill, and the House a different bill. As I explained in step 5, now is the time that a compromise bill is to be created.

    Unfortunately for Democrats, before they could complete step 5, an event rocked their world.

    Scott Brown was elected Senator from Massachusetts. The balance of the Senate was changed.

    After Brown’s election, the Senate was made up of 57 Democrats, 41 Republicans, and 2 Independents. For Democrats, this was like throwing sand in the gears of their movement. Why? Because of a rule that is specific to the Senate – the filibuster.

    Lots of folks don’t understand what a filibuster is. It’s really not complicated. When a bill is introduced to the Senate, the Senators debate on the new bill. At some point in time, a vote has to be taken to end the debate and then a second vote is taken on the bill. 60 Senators must agree to end the debate (cloture) before a vote is taken. A filibuster is when the Senate can’t get 60 Senators to end the debate and finally vote for the bill. If the Senate can’t get 60 votes to stop debate, the bill is NEVER VOTED ON.

    After Scott Brown’s win, Democrats only have 59 votes in the Senate (counting the 2 Independents that always vote Democrat anyway). The situation is this – a bill has passed the House with only 1 Republican vote. A bill has passed the Senate with NO Republican votes. And now any compromise bill that the House and Senate put together will NEVER be voted on in the Senate, because the Democrats don’t have 60 votes to stop a never-ending debate on the to-be-formed bill.

    So now what do the Democrats do? There is only one true option – the House can pass the Senate bill unchanged. Since the Senate has already passed that bill, it wouldn’t have to worry about a filibuster. The House has a large majority of Democrats, and there is no filibuster rule in the House anyway.

    Unfortunately, there are those 3 stumbling blocks that I mentioned earlier – abortion, unions, and the public option. And these blocks are too big for the House to pass the Senate bill untouched.

    It is important to understand why those blocks are too big. In order to understand it, you need to consider the makeup of the Democrats in the House. House Democrats can be placed in 3 basic groups – the far left, the middle, and the ‘Blue Dogs’.

    The far left Democrats are exactly that. I would almost call them Socialists. They want the government in control of everything.

    The middle Democrats are your folks that come from pretty safe Democrat districts, and will toe the party line the vast majority of the time.

    The Blue Dogs are those Democrats who represent areas that voted for the Republican Presidential candidate. For example, Dan Boren (Representative for southeast OK) is considered a Blue Dog. They know that voting for something very liberal will get them voted out of office.

    The far left House Democrats won’t vote for the Senate bill without the public option, the Blue Dogs won’t vote for it if it pays for abortion, and the middle won’t vote for it if it penalizes the unions.

    Are you with me so far? The Senate bill must be passed unchanged by the House, and the House won’t do it because of those 3 problems. So how do they get around it? They hope the answer is reconciliation.

    I’m going to WAY oversimplify this concept. The best explanation I’ve found for the process of reconciliation are here and here. I would encourage you to visit those links in order to understand more fully.

    For the sake of simplification, think of it this way. Let’s say the House and Senate both pass a law saying that the federal budget must be cut by $1 trillion (wishful thinking). The law can be passed and signed by the President without knowing for sure where the money will come from. After the law is signed, it goes back to House and Senate committees, where they hammer out the details of where the money comes from. The final details are then voted on, and can be passed in the Senate with a simple majority vote – it cannot be filibustered.

    So why don’t they go ahead and make these changes to Obamacare to fit the budget? Well, there are a couple of issues. First, Obamacare isn’t a budget bill. It is a bill that changes a lot of things related to healthcare. Many are openly questioning whether you can take a non-budget matter and apply a budget process like reconciliation.

    I mentioned the second, but you probably didn’t catch it the first time – reconciliation can only occur WHEN A LAW HAS BEEN PASSED. And that would involve the House passing the Senate bill without changes, and President Obama signing it into law.

    So, where are we now? The House Democrats are in a very uncomfortable position right now. The Senate bill has passed, and the House can’t make changes to it. President Obama has endorsed the Senate bill. And most importantly, the House Democrats must trust that the Senate Democrats will make the House-desired changes to the bill AFTER THE PRESIDENT HAS SIGNED IT AND MADE IT INTO LAW.

    You see, once the President has signed the bill, both the President and the Senate can call it quits and not go through the process of reconciliation. They have a signed law with everything they want, and the House just voted for it. And the House can’t do a thing about it after it is signed.

    In the past 2 months, many promises have been made between President Obama, Senate Democrats and the House Democrats that the House concerns will be addressed during the process of reconciliation – after the bill is signed into law.

    House Democrats have tried to manipulate the rules in order to make sure that their concerns are met before the law is signed. They have tried to argue that it didn’t need to be signed first – but on March 11, it was determined that it MUST be signed first. They are trying a “hold-plus-reconciliation” (passing the bill, but ‘holding’ it before Obama signs it) strategy – but that probably won’t work either.

    So why hasn’t Obamacare moved? Because the House Democrats don’t trust the Senate Democrats to keep their word. The House Democrats don’t trust the President to keep his word, either. Why should Obama go back and revisit the abortion issue and the tax on union benefits after he already has a signed bill? Here’s the money quote from Bart Stupak, D-MI – “If they (the President and Senate Dems) say ‘we’ll give you a letter saying we’ll take care of this later’, that’s not acceptable because later never comes.”

    And if the Democrats can’t trust EACH OTHER at their word, why should WE trust them?

    As you read this, the House Democrats are feverishly working on two things – their wish list of what must be changed in the Senate bill (100 pages worth of things), and some sort of process to ensure that Obama and the Senate don’t stab them in the back.

    A couple of final thoughts. The American public has made it clear that if Congress passes this through reconciliation without any Republican support, the Democrats will pay dearly in the next election (I could bore you with links to polls showing this, but I won’t unless you ask). Now that the House Democrats understand that they are going to sacrifice themselves anyway, they are now trying to jam into the reconciliation agreement any other pet projects that they have.

    On March 11, the Congressional Hispanic Caucus told President Obama that they will not support the bill unless illegal immigrants are allowed to purchase health insurance through the proposed health exchanges.

    Also, some Democrats are attempting to insert language into the bill that allows the government to take over the entire college student loan program..

    They know that they are breaking the rules, that they’ll have one shot at this, and that they will lose many, MANY seats this November – so they’re grabbing all they can get.

    And if there are two things I would bet on, they are these – One, if this doesn’t pass by Easter break, it’s over. House and Senate Dems don’t want to face their constituents who oppose this bill in HUGE numbers. And two, if it doesn’t pass, they’ll try to find a way to blame it on Republicans.

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