Reform By Easter: The Timeline For Moving Forward On Health Care Reform

Inside Health Policy has obtained a Democratic memo that lays out a timeline for passing the Senate health care bill in the House alongside a package of fixes using reconciliation. Hoping to avoid the disastrous August recess town halls, Democrats are going to try and finish reform before members go home for the Easter break at the end of March. The hard deadline and pending vacation could pressure reluctant Democrats to vote ‘yes’ in the House and help Democrats move on to jobs and the economy as they enter the election season. Here is the rough outline:

1. March 3: President Obama lays out the path forward for health care reform and unveils a smaller package of fixes that will bridge the difference between the House and Senate health care bills.

2. March 4–19: Summary of the president’s proposal will be turned into legislative language. House and Senate leaders will begin looking for votes.

3. By March 19: The House passes the Senate’s health reform. The bill then goes to the president for signature without going through conference. Senate Democrats will make some kind of assurance to House leadership that they will pass a package of fixes through the reconciliation process.

4. By March 21: The House amends the Senate bill through a reconciliation bill.

5. By March 23: The Senate begins debate on the reconciliation bill. Debate is limited to 20 hours.

6. Votes begin March 26, the first day of Easter recess, at which point Reid announces that the Senate will stay in session through recess to consider all amendments.

7. Before March 29: Vote on final passage follows consideration of the last amendment. The reconciliation bill will have to go into conference with the House. The goal is to pass health reform before the Spring recess (March 29-April 9).

The timeline is incredibly tight and will require Democrats to move quickly in convincing reluctant members to support Obama’s package of fixes and reassuring skeptical House Democrats that the Senate has the votes to pass his package. But first, Obama will have to appease progressive Democrats while simultaneously retaining more moderate Democratic votes. The package will have to invest more money in affordability affordability standards, move up the excise tax thresholds and close the Medicare part D donut hole, all while containing the cost of the legislation and ensuring enough deficit reduction. It’s a tough haul considering that Democrats might also have to rely on Vice President Joe Biden to incorporate an abortion compromise in the reconciliation package if they hope to hold on to Stupak’s pro-lifers.


Democrats will also have to withstand the GOP’s strategy of offering hundreds, if not thousands of amendments after the initial 20 hours of debate. As Roll Call reports today, “Republicans believe these tactics could tie up the Senate floor for several weeks and force Democrats to take multiple votes that would be difficult to defend in the midterm elections.”

If Democrats decide to pursue a reconciliation strategy, as most observers and lawmakers believe they will, they should expect to come out a bit scarred on the other end. But then again, that’s their only alternative. If Democrats use reconciliation, Republicans will undoubtedly attack Democrats for ‘jamming through’ unpopular legislation. If they don’t, Republicans will attack Democrats for voting for unpopular legislation in 2009. Even worse, voters will resent Democrats for abandoning reform and succumbing to the process of Washington.

Consider that the Democrats’ Easter offensive may be the very last opportunity for passing comprehensive reform for the next 15–20 years, the battle is worth the political sacrifice. The odds of success are unknown, but if there is one thing we learned from the health care debate it’s that you never know if you have enough votes until the clerk reads the roll.


House Majority Leader Steny Hoyer (D-MD) is raising doubts “about a directive from Senate Democrats that the House needs to pass their health care bill before the Upper Chamber can approve any changes to the final package”:

“It’s difficult to do so,” Hoyer told reporters during his regularly weekly press briefing. “Members want some assurance that those items they have problems with are, in fact, modified before they vote for the Senate bill. I don’t know that it’s impossible, but it’s difficult.”