What Bill of Health?

By James R. Edwards, Jr. on March 13, 2010

The immigration issue could put health reform at risk once again, as it did last fall. Then, President Obama had to do some fancy footwork after an unceremonious challenge during his speech to a joint session of Congress. Rep. Joe Wilson was right, and the House bill held gaping loopholes that pretty much guaranteed illegal aliens would benefit under health reform. Ultimately, Speaker Nancy Pelosi added a modicum of eligibility verification to the House bill, and Majority Leader Harry Reid kept the relatively stronger verification provisions in his Senate version.

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The White House along with Senate and House Democratic leaders are desperate to score a “win” on health reform. After contriving exotic parliamentary options like the “Slaughter rule,” which the parliamentarian quashed, they have now decided to force a vote within days on their health care legislation. However, the leadership faces problems over both substance and process in lining up enough votes. Along with abortion, immigration is generating problems for Democrats trying to scare up enough House votes to pass the Senate health bill — the planned first step. Therein lies the challenge to getting legislation across the finish line.

On substance, the Senate health bill is relatively better (though far from good) where immigration is concerned. The Senate-passed legislation requires tighter verification than does the House-passed version. My Memorandum outlines those immigration-related measures and remaining shortcomings of the Senate provisions. But politically, the Congressional Hispanic Caucus negotiated House provisions that were sufficiently lax, while caucus members oppose the comparatively better Senate measures.

The head of the CHC, Rep. Luis Gutierrez, has come out against the Senate health bill the House will be considering, specifically because of its immigration-related provisions. His caucus faces a tough situation: Nancy Pelosi is twisting one arm to vote for a bill that will deprive some illegal aliens of taxpayer-funded health coverage, while the White House pays lip service to supporting amnesty (yet throwing the CHC under the bus, effectively) and open-borders activists whose main goal is amnesty are twisting the other arm. The CHC holds over 20 badly needed votes for House passage.

Also, the Senate legislation allows for taxpayer funding of abortion through taxpayer subsidies to pay health premiums. By contrast, the House-passed health bill (which is basically dead) contained the Stupak amendment, prohibiting taxpayer funds from paying for abortion services. The bipartisan amendment was roundly adopted. Rep. Bart Stupak holds the solidarity of about a dozen Democratic votes over this issue. The Stupak group has vowed to oppose the Senate version of health reform over its abortion funding – potentially depriving Democratic leadership of enough votes to pass the bill.

On process, the Democrats face trouble charting a course to get health reform enacted. The process being pursued I outlined in an earlier blog. Essentially, the House is being asked to move the already-passed Senate bill, then make changes to that legislation through the budget reconciliation process. This puts House Democrats at the mercy of the Senate and White House. Sen. Lindsey Graham put it starkly that this approach is finding the “dumbest Democrat” in D.C.

Remember Scott Brown in Massachusetts and the loss of a filibuster-proof Democrat majority in the Senate? That’s why this “nuclear option” is being pursued. Budget reconciliation spares the Democrats a conference committee and subsequent filibuster on health reform itself, because budget rules require only a simple majority vote. Thus, going the reconciliation route amounts to partisan warfare. In an already highly partisan environment in Washington, using budget reconciliation for enacting health reform is like throwing gas on a fire.

Beyond immigration in the health reform debate, forcing this partisan process is likely to poison the waters for bipartisan cooperation on other things, including “comprehensive immigration reform” – i.e., amnesty. Sen. Graham, who has collaborated with Democrats on several controversial issues including amnesty, has warned Democrats of this risk. Graham said “immigration reform could come to a halt for the year if health care reconciliation goes forward.” That’s not a bluff.

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Topics: Health Care