This morning, during a panel discussion at the Academy Health National Health Policy Conference, a top Pelosi policy aide said that the reconciliation process was “the only way” for Democrats to salvage health reform in the aftermath of the Massachusetts election. “There is only one way to get it done at this stage of the game and that’s a process that the Speaker has outlined,” Wendell Primus, Pelosi’s legislative director said. Congress would have to pass the Senate health care bill alongside a package of fixes using reconciliation.
“The House would have to take up that first because it would involve revenue changes and then the Senate would pass it and then I think hopefully with the passing of that legislation, the House, only then would take up the Senate bill and pass it.”
“The trick in all of this is that the President would have to sign the Senate bill first and then the reconciliation bill would be signed second and the parts of the reconciliation bill that trump the relevant portions of the first signed bill.” “You would really have to use the fact that a later enacted bill takes precedent over a previously enacted bill to achieve the right outcome.” Primus added. He predicted that the reconciliation package of fixes would have to increase the threshold on the Cadillac tax, include more affordability credits, close the donut hole in the Medicare Part D drug benefit, and eliminate the Cornhusker Kickback.
Other Congressional aides agreed with Primus’ assessment and argued that it would be almost impossible to put together a smaller package that achieves any of the Democrats’ objectives because many provisions are interconnected. The staffers also predicted that if Congress fails to pass health care reform before the budget window closes, it’s unlikely that future administrations would take-up the effort.