Health Reform Push

President Obama and Democratic congressional leaders are working hard to line up enough votes and plot a path to get their version of health reform across the goal line. Though immigration hasn't been raised as much as other bubbling controversies like abortion, this issue remains alive.

Recall: The Senate health reform bill contains loopholes that could benefit many thousands, if not millions, of illegal aliens. Here is my Memorandum that highlights those loopholes. What's happened, though, is that the Senate loopholes enabling illegal alien coverage aren't as bad as the House bill's loopholes. The Senate health bill is pretty much becoming the only game in town. The House bill now sits on the sidelines.

The health reform fight has gone beyond the objections of the Congressional Hispanic Caucus, which opposes the Senate provisions requiring eligibility verification for entry into the "exchange" and for the premium subsidy payments, for instance. The White House and key congressional negotiators are lining up votes by focusing on more health care-centric issues: enriching premium subsidy levels, dealing with union health plans, expanding the so-called Cornhusker Kickback for Medicaid payments to all states, not just Nebraska, etc. And the main goal of an Obama-Democratic win on health reform is hanging the CHC out to dry. See this item, for instance.

Democrats first plan to move the Senate-passed bill through the House. That enacts the Senate version of health reform. Then the House will start moving a package that modifies the new health reform law. It's using a budget process known as budget reconciliation, which skirts normal rules of debate — in particular, the regular order in the Senate and filibusters of controversial legislation. This unusual process for pursuit of large policy changes isn't easy to steer through, and the outcome is far from certain. That means a lot of the desired changes the White House and Democrats have negotiated privately may not survive the process. And changes to immigration-related provisions of the Senate bill don't look like they'll be in the budget reconciliation package.

Thus, Latino House Dems will end up being forced to vote for the Senate immigration-related provisions by voting for the Senate health bill. They won't be able to get at those provisions in budget reconciliation. And the year-long expenditure of political capital on health care means amnesty — "comprehensive immigration reform" — not only competes for other priority items for scarce legislative calendar time, if immigration gets a turn at the wheel at all, the gas tank's getting close to Empty. Ironic indeed.