Democrats Brace for the Hardest Part of Health-Care Reform
By Karen Tumulty / Washington Monday, Oct. 05, 2009
With the passage of health-care-reform legislation out of the Senate Finance Committee expected on Tuesday, the debate moves into a new and delicate stage. It is one that will test the legislative and political skills of Senate majority leader Harry Reid and House Speaker Nancy Pelosi on a scale that no congressional leadership team has had to face in at least four decades. Whether they are up to the challenge will determine not only the fate of the legislation but also, if it passes, whether it will live up to the promises President Obama has made regarding his most ambitious domestic initiative.
The challenge for congressional leaders lies not only in the scope of the legislation, though it would be the largest undertaking by the government since at least 1965, when Medicare and Medicaid passed; it comes also from the delicacy involved in weaving together five separate pieces of legislation — two distinct Senate bills and three from the House. They must both satisfy the competing (and often conflicting) political and ideological interests within their party, and still produce a coherent bill that does not do more harm than good to a health-care system that accounts for one-sixth of the economy. (See pictures of the angry health-care debates.)
Among the still not truly resolved issues that are certain to be argued again in the broader arena of the House and Senate floors: Whether the bill should include a requirement that individuals who do not get coverage from their employers or from government programs buy it on the open market. If so, how can lawmakers ensure that people who are required to buy coverage can actually afford it? Should it include a requirement that all but the smallest firms provide a package of health benefits to their workers, and if so, how would it be enforced? How should the proposal be financed, and should it include a tax hike on the wealthy or a tax on high-end insurance plans? There will also be renewed debate over some of the side issues that have arisen, such as coverage of abortion and whether illegal immigrants might find ways of entering the system.
The test could begin as early as next week. Reid canceled a scheduled weeklong break so that the Senate could get down to work immediately after Columbus Day. He plans to begin with what one aide described as a "bed-check vote" on Oct. 13, which could be an early indication of his ability to hold his Democrats together against the threat of a filibuster; that first vote is expected to be on a routine parliamentary procedure, such as whether to proceed to the bill. The House has not announced whether it will begin deliberations at the same time or shortly thereafter. House leaders are anxious to see how things are going in the Senate before they begin their own debate.
Of the two leaders, Reid has the harder job. In part, that is because of the way the Senate is set up as an institution. The majority leader's powers are far weaker than those of the Speaker, and he has fewer parliamentary tools for controlling what happens to a bill once it hits the floor of his chamber. He must also contend with the fact that it takes 60 votes on almost anything to overcome a filibuster. Reid must also grapple with the two bills passed by his committees — the Finance Committee and the Health, Education, Labor and Pensions (HELP) Committee — which approach the health-reform issue in significantly different ways. By comparison, the measures passed by three House committees are far more similar to each other.
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http://www.time.com/time/politics/article/0,8599,1927787,00.html
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