Pieces of the Legislation We Love
At the risk of boring everyone with arcane institutional trivia (which I’m sure I did with the reconciliation post), I’m not quite sure what to make of the “two bill” idea being floated around by Senate Democrats. For those of you who haven’t been paying too much attention, here’s the basic situation: as Ezra Klein explained a few days ago, there actually is a fair amount of consensus surrounding the core provisions of health care reform. Here he is in his own words:
Here are the things that, broadly speaking, legislators agree about: insurance market reforms, including community rating, guaranteed issue, an end to rescission, an end to discrimination based on preexisting conditions, and an individual mandate. Subsidies for low-income Americans. Delivery system reforms. Health insurance exchanges. An expansion of coverage to about 95 percent of legal residents. Prevention and wellness policies. Retaining and strengthening the employer-based insurance market. Creating some kind of incentive for employers to offer, and keep offering, health benefits. Expanding Medicaid to about 133 percent of poverty.
Of course, this has all been overshadowed by the furor over the public option, and whether or not it will be included in this initial round of reform. Centrist Democrats have repeatedly spoken against including a public option in the health care package, and because they have a lamentable fair amount of legislative clout (by virtue of their position as the median senators), they also have the power to kill a health reform bill that includes the public option.
The idea then, is that instead of passing a single large bill that includes the not-controversial provisions along with a public plan or health care co-op, Democrats would split the legislation into two pieces. One piece would include the more controversial elements of the reform package and would be shepherded through the Senate via the reconciliation process. The other piece would include elements of the health care overhaul – like universal community rating and the health insurance exchange – which have a broad base of support among Democrats and Republicans. The policy benefits of going this route are pretty clear: by shepherding the entire bill through reconcilliation, you risk those provisions which are valuable, but which have very little to do with the budget/deficit reduction. If you removed those provisions from the reconciliation bill, you’d be left with a bill that still has a lot of force to it, has a measurable impact on the budget/deficit, and is far less vulnerable to the (informed) whims of the Senate Parliamentarian.
That said, I’m not sure if any of this could actually work, in large part because I’m not sure if centrist Democrats are actually interested in passing any health care reform. And, unfortunately, they are the most important players in this game. After all, a Republican filibuster can only hold if your Ben Nelsons or Blanche Lincolns decide to vote against cloture. If centrist Democrats are genuinely interested in reforming the system and do have honest opposition to a government-run insurance program, then the split bill strategy is a good one, since it holds on to their support for said insurance reforms. Likewise, the opposite is true. If our centrist friends opt follow the lead of Republicans and stand against all reform, regardless of content, then splitting the bill simply doesn’t matter.
At the risk of being too optimistic, I don’t think that’s the case. None of the usual suspects have said anything about opposing the more commonsensical insurance reforms. What’s more, there is a real political advantage to splitting the legislation; if the less controversial half makes it through the Senate, that gives President Obama a real, substantive victory after a summer of near-deafening right-wing rage. In turn, that momentum can be directed towards the reconciliation fight, which will be a madhouse, I’m sure of it.