When we look at where the health care bill is, there are a lot of arguments of what we should have done instead, or should instead be doing.
In my opinion, the most valid of these is reconciliation. And there's been a lot of discussion about the various tactical choices that we should have done or could still do. I'd like to review them below, and then attempt to show a clear conclusion of the best path forward.
Reconciliation - There are those on the right side of the aisle that try and make the case that this is some sort of nuclear option. It's not. The nuclear option is something different, and the Republicans have used reconciliation themselves.
The advantage of reconciliation, as we all know by now, is that we only need 50+1 votes, and it is filibuster-proof. But there are several disadvantages. One is that a reconciliation bill can only contain components that have to do with the budget, and decrease the deficit. There are several parts of the health care bill that do not qualify. So while a reconciliation bill might get you things like the public option and a medicare expansion, it won't get you many of the other things that are needed in the health care bill.
Two Bills - The dual bill reconciliation approach is a solution to this quandary. One of the happy accidents with this bill is that most of the non-budgetary components of the health care bill are far less controversial than things like medicare expansion and the public option. And so there is good reason to believe that those components can pass in a 60-vote bill, even though they wouldn't be allowed in a reconciliation bill. By splitting health care into two bills, and saving the more controversial (and budget-centric) components for reconciliation, it's theoretically possible to get everything.
There are some risks involved, of course. There are some people that might be gettable under the 60-vote scenario, but not through reconciliation. They disagree with using a budget process for elements of a bill that is arguably more expansive than just a budget matter. And so the math was never assured from the outset. But 20-20 hindsight is making it look pretty attractive at this point, to the point that it's argued that reconciliation should have been followed from the outset.
So, how could this have been done from the outset?
Pass the reconciliation bill, then the normal bill - This is the more satisfying approach on many levels. From the outset, we get to experience the positive momentum from the election, and push straight for a public option or medicare expansion, in an environment where it is most likely to succeed. We'd also find out if it were possible through reconciliation in terms of head count.
Assuming it passes, we then go for the normal bill. But there's a problem here. While there are congresspeople that are theoretically in favor of many of the non-budget parts of the bill, they've just been railroaded by the reconciliation process. And while technically they'd only be voting Yea on certain parts of the bill, the perception is they'd be rubber-stamping the entire bill, the government-run-healthcare part of the bill.
This also holds true if we tried passing the reconciliation bill and the normal bill at the same time. This makes it unlikely that we'd pass both sides of the bill, at least less likely than one other possibility. So, what's the other possibility?
Pass the normal bill first, and then the reconciliation bill - If we pass the normal bill first, then we have a good foundation and framework for improving regulations and cost controls in the future. You don't necessarily tell people that reconciliation will definitely come afterward, so this gives the moderates cover. And then after the normal bill is already law, we can then use reconciliation to get the more controversial "government-run" (and budgetary) components second. I would argue that this is the order that gives us the best chance of getting both halves of the bill. And this is true whether we would have followed this strategy from the outset, or whether we start over and start that strategy now.
It's important to accept that the two-bill solution was always going to be a two-step process. It's just a matter of what order we take these steps.
Now, here's the trick - The advantage of following this approach is that it allows you to cram as many reconciliation-friendly components as possible into the normal bill. Get all the chips to fall the right way, and you might not even need reconciliation. But if you do end up having to sacrifice some things, it's okay because there's always reconciliation afterward.
And it just so happens, the path we've been on so far has been consistent with this approach.
Now for those of you who believe Obama is a Jedi, I'm not arguing that this was the plan all along. I don't know if it was or not. But, I think it's logical to accept that:
- IF reconciliation is the only process to get a public option or medicare expansion (this has proven true); and
- IF a two-bill solution is better than using reconciliation by itself; and
- IF going for the normal bill first, and then reconciliation second is a better approach than the opposite...
Then it makes zero sense to scrap this bill and start over from scratch. Because we already have step one of that process almost completed.
We are this close to being finished with step one of a two-step process. Our responsibility is to accept this bill, and then after it's signed into law, scream like hell for a second stage - reconciliation for a public option or medicare expansion.
