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Just can't legislate without you, baby

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The biggest problem for the health-care reform bill right now is not Republican intransigence, troubling poll numbers, or even procedural constraints. It's the corrosive mistrust between House and Senate Democrats. This has mostly played out as farce, with Mitch McConnell and other Republicans warning House Democrats that the Senate might abandon them, and then they'd be on record voting for the health-care reform bill. “We believe what the president is doing is asking House Democrats to hold hands, jump off a cliff and hope Harry Reid catches them,” said Sen. Lamar Alexander. The concern Republican Senate leadership has for the electoral fortunes of House Democrats is truly touching.

But it could play out as tragedy, too. Democrats are waiting for a procedural ruling from the Senate parliamentarian deciding whether they can pass the package of reconciliation fixes before the president signs the underlying Senate bill into law. Some are doubtful that it's possible. “It’s very hard to see how you draft, and hard to see how you score, a reconciliation bill to another bill that has not yet been passed and become law,” Sen. Kent Conrad said. “I just advise you go read the reconciliation instructions and see if you think it has been met if it doesn’t become law.”

This shouldn't pose much of a problem. After all, the plan has long been that the House passes the Senate bill, then both chambers pass a reconciliation rider. Whether you do those two things at the same time or in quick succession should not be much of an issue. It's the difference between meeting at home and going to the movie together or just meeting at the theater. But since the House doesn't much trust the Senate, they're worried that the Senate bill will get signed and then Republican obstruction will mix with Democratic diffidence to derail the reconciliation package. They're worried, in effect, that they'll get stood up.

People keep talking about a "guarantee" from the Senate, though I don't know what that could be. A letter is possible, but that's more of a commitment than a guarantee. What provides House Democrats with security -- or should provide them with security -- is the guarantee of consequences for the Senate if they fail to act. First, they're left with a health bill that includes, among other trouble spots, the Nelson deal. Second, they're left with a lower chamber that hates them and will mistrust and loathe them in all future negotiations, which will make any further legislative action virtually impossible.

The guarantee, in that sense, is much more abut credible threat from the House than credible commitment from the Senate. But it's really a bit nuts that we need to be having this conversation at all. The Senate and the House simply need to do their jobs here, and in this case and future cases, they need to be able to trust the other to uphold their part of the bargain.

Photo credit: Alex Wong/Getty.

By Ezra Klein  |  March 11, 2010; 7:36 AM ET
 
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Next: The cap-and-trade context

Comments

I brought this up a week ago and questioned if the President would sign the Senate bill if he wasn't 100% guaranteed that the "fixes" would be installed. I hope he does because the "fixes" only constitute watering down of some of the major cost controls (excise tax) although subsides if they are not enough will admittedly cause a major problem.

Glad to see the doc fix legislation being pushed back further got a lot of play around here yesterday. One more shining example of how this is a farce when it comes to cost containment.

Posted by: visionbrkr | March 11, 2010 8:11 AM | Report abuse

"Whether you do those two things at the same time or in quick succession should not be much of an issue. It's the difference between meeting at home and going to the movie together or just meeting at the theater."

It's the difference between putting the horse before the cart or the cart before the horse. It's the difference between using reconciliation to fix legislation that has already passed or using reconciliation to fix.....nothing. It's the difference between a credible argument that the Democrats are making appropriate use of the reconciliation process and jamming through their agenda in blatant disregard of all accepted rules and processes. It's the difference between obtaining a result that, while controversial, is legitimate, and obtaining a result that will never be accepted.

Posted by: bgmma50 | March 11, 2010 9:14 AM | Report abuse

Clarification: "The guarantee, in that sense, is much more abut credible threat from the House than credible commitment from the Senate."

"abut" should be "about"

Posted by: t_seltzer | March 11, 2010 9:23 AM | Report abuse

Why is Senator Conrad always pretending to be the majority leader in the senate? The decision to use reconciliation is the prerogative of the majority leader with advise from members of his party. The reconciliation rule is not a constitutional provision.

Senator Conrad must just cast his up and down vote on the issue and stop whining like he is the ultimate authority on reconciliation rule in the senate. He is apparently tired of being in the senate for long so please he must leave and let others interested in the job get the job done!

Posted by: ameys1msncom | March 11, 2010 9:27 AM | Report abuse

Ezra - I think you miss what House members are really SCARED about!

This bill grants the federal government new powers to set rates on insurance companies regardless of the costs they incur----in other words Obama & Pelosi can send every single Private Insurance Company into bankruptcy within the first year after passing this legislation.

http://www.nytimes.com/2010/03/09/health/policy/09rates.html

Isn't is the Democrat party's DIRTY LITTLE SECRET that Obama & Pelosi will use this legislation to run every single private insurer out of business in Day 1 after this legislation passes, and the millions of Americans today (75+%) who are mostly happy with their current healthcare insurance will suddenly be forced into paying out of pocket for everything!

How can any House member who votes for this sleep at night knowing their electoral fight in November depends on the mercy that Obama & Pelosi show for the free market insurance providers.

I've already heard Sebellius go on Meet The Press and characterize an insignificant and uncontrollable profit margin shift of 2% to 3% as a "50% increase in profits for insurance companies....


Doesn't it seem like in the same way Obama is threatening using the EPA to trigger an economic depression to appease the enviromental radicals, won't they use THIS horrendous legislation to trigger the worst sudden healthcare crisis the world has ever seen just to try and create a false case for socialized medicine?

Posted by: FastEddieO007 | March 11, 2010 9:35 AM | Report abuse

United health care's CEO alone earned over $115 million in 2005. It is probably higher now.

In the meantime, insurers are systematically rejecting sick applicants and refusing payments to existing customers.

They are raising rates, they impose high co-insurance and deductibles, and so on.

I don't have sympathy for insurance companies. They have plenty of profits and are using predatory practices.

If they didn't have high profits they would welcome reform and beg the Dems to help control costs, but instead, from the get-go, they have fought to protect the status quo, which is not something anyone can afford.

Posted by: Lomillialor | March 11, 2010 9:46 AM | Report abuse

************
Isn't is the Democrat party's DIRTY LITTLE SECRET that Obama & Pelosi will use this legislation to run every single private insurer out of business in Day 1 after this legislation passes, and the millions of Americans today (75+%) who are mostly happy with their current healthcare insurance will suddenly be forced into paying out of pocket for everything!
**************

That would be BRILLIANT, Fast Eddie!!!! I'm sure that their polling would go THROUGH THE ROOF if they cut off everyone's health insurance!!!1!

Posted by: rpy1 | March 11, 2010 9:51 AM | Report abuse

"Isn't is the Democrat party's DIRTY LITTLE SECRET that Obama & Pelosi will use this legislation to run every single private insurer out of business in Day 1 after this legislation passes"

FastEddie, You sound like a 911 Truther with all your conspiracy theories.

Also the fact you call the world's climate scientists (including US scientists from Nasa) radicals, further proves you are an ideologue.

Next you'll be calling Obama a racist, socialist from Kenya.

Posted by: Lomillialor | March 11, 2010 9:51 AM | Report abuse

It seems congressional Democrats are ruled by fear. People talk about whether the president is tough enough, but it is Congress that needs some fortitude. They are afraid of the filibuster, afraid of changing the Senate rules, afraid of the mid-term elections, afraid of their counterparts in the other chamber. Let's stand up and make some decisions.

Posted by: jduptonma | March 11, 2010 9:55 AM | Report abuse

Ezra the following is a half right.

It's the corrosive mistrust between House and Senate Democrats.

We the People have corrosive mistrust of all of those imp morons that work inside the beltway of DC.

For at that base of that corrosive mistrust is that all of them lie.

Dad a good man said "Son when a man lies one time BEWARE he will do it again"

Dwight Baker dbaker007@stx.rr.com

Posted by: dbaker00711281944 | March 11, 2010 9:57 AM | Report abuse

Lomilliator - United health care's CEO alone earned over $115 million in 2005. It is probably higher now.

So how much do suzz-bag lawyers like John Edwards make after a few lawsuits againt doctors who didn't even do anything wrong?

Posted by: FastEddieO007 | March 11, 2010 9:57 AM | Report abuse

bgmma50, passing a reconciliation bill first is not breaking the rules because we don't have a ruling from the Senate Parliamentarian.

Posted by: MosBen | March 11, 2010 9:58 AM | Report abuse

"The Senate and the House simply need to do their jobs here, and in this case and future cases, they need to be able to trust the other to uphold their part of the bargain."

Their jobs are to listen to their constituents back home, analyze the pros and cons, and vote as to what they think is best for the people they represent -- the majority of the people, or the majority of the voters.

Their job is not to fall easily to party strong-arming, to save the president or anyone else's political fortunes at the expense of the nation, the American people they represent.

Trust? Where have you been? There's no trust in DC. You want the House Dems to start trusting ... now? That's like asking the Israelis and Palestinians to negotiate in good faith, and expecting the Obama administration to play neutral enforcer of the rules.

You read the paper? That's not happening either. Trust has to be built on something, and your types (pro-healthcare "get something passed; we'll fix it ... tomorrow) are so busy building castles in the air, you haven't learned how to build the basic foundation that things like Trust are built upon.

Wise man builds his house upon the rock, not shifting sands. It doesn't take a Biblical scholar to understand how nervous House Dems should vote...

Posted by: Mary42 | March 11, 2010 10:00 AM | Report abuse

Republicans will turn the "fix" into Swiss cheese.

Senate Democrats can't make any promises in good faith, much of the compromise will be stricken through the Byrd Rule.

Posted by: JackIL08 | March 11, 2010 10:03 AM | Report abuse

"bgmma50, passing a reconciliation bill first is not breaking the rules because we don't have a ruling from the Senate Parliamentarian.
Posted by: MosBen"

If the House doesn't pass the Senate bill first, the Senate Parliamentarian will rule that reconciliation can't be used fix nonexistent legislation. I have no doubt of that, despite Ezra's attempt to gloss over the situation as being a mere timing trifle. Joe Biden will overrule the Senate Parliamentarian, and we will have health care "legislation" of questionable legitimacy. No legitimacy in my book.

Posted by: bgmma50 | March 11, 2010 10:07 AM | Report abuse

FastEd

Lawyers don't deprive me of health insurance or deny my medical claims. The money lawyers make is typically 25% of the money awarded to their clients.

Lawyers work for YOU, the people.

Health execs who earn $115 million per year work for themselves and make that money by depriving you of YOUR MONEY and YOUR access to health care.

Here's a link that reveals myths about medical malpractice:

http://prescriptions.blogs.nytimes.com/2009/08/31/would-tort-reform-lower-health-care-costs/?pagemode=print

Posted by: Lomillialor | March 11, 2010 10:14 AM | Report abuse

IdiotEddie: it's time to start apologizing for your posts again.

Posted by: rjewett | March 11, 2010 10:15 AM | Report abuse

I feel for the House. They passed their legislation and then the Senate screwed up the timeline by dilly-dallying with Republicans who were clearly acting in bad faith. And all the while, individual Democratic senators publicly slagged the hell out of the bill and made it LESS appealing to voters. Now it's up to House members, who ALL face re-election this year, to clean up the toxic mess that was largely created by the Senate.

It's got to be enraging to have to work around these insane Senate rules that NO ONE understands--all the while suffering sanctimonious BS from Senators about how their dysfunctional process makes our Democracy strong, and they are the "mature" chamber.

Seriously, I feel the pain of a House member who's got to take a hard-to-defend vote in a re-election year because Senators worry that instituting sane parliamentary rules will break up their bridge game or their barbership quartet.

I get the mistrust. The problem for the House, of course, is that failing to clean up the Senate's toxic mess will kill everyone. In fact, only the House can fix this.

But the Senate owes them something for this. They have to give up the singing groups and get real about becoming a functioning parlimentary body. We can't pretend anymore that a supermajority parliamentary approach will work in a two-party system. Jim Bunning amply demonstrated that the system as it is gives the most power to the most reckless and unreasonable elements of our legislature. That needs to end.

Posted by: theorajones1 | March 11, 2010 10:37 AM | Report abuse

Ezra, you and all the liberal bloggers are oversimplifying and underestimating the trust problem.

It's not that the House doesn't trust the Senate as an institution - it's that they don't trust specific Senators, who can have an unduly large impact on the process.

After Democrats felt backstabbed by Lieberman, who implied one thing about how he'd vote and then changed his mind at the last minute, of course there are going to be issues. The Lieberman problem illuminated how easy it is for a single Senator to hold the rest of the Senate (and thus the rest of the country) hostage to hir idiosyncratic beliefs.

If the Senate promises it will pass the changes through reconciliation, then that means that Harry Reid has to do everything in his power to make that happens. And that means that when a couple of Joe Liebermans come out, and start saying "Actually... the House voted for our version already, which I think is better - why should I vote for the reconciliation fixes that I don't believe in? Unless we also pass... " And then Harry Reid, who promised very sincerely to pass the reconciliation fix, has to listen to their idiosyncratic and likely stupid demands. Or else the fixes don't get passed. Which would also be terrible.

So yes, I think the House is right to be worried! Who really does trust the Senate nowadays, comprised of all its individually frustrating Senators?

Posted by: madjoy | March 11, 2010 10:40 AM | Report abuse

bgmma50, maybe that will happen the way you say it will, maybe not. Maybe the Parliamentarian will say it's fine to pass the sidecar first. Maybe he'll say it's not ok and the House will then pass the Senate bill first.

My point is that you don't know, and the process isn't even argualy illegitimate at this time. Everything is proceeding according to the rules, and it's a bit dishonest to assume several outcomes which haven't happened yet.

Posted by: MosBen | March 11, 2010 11:08 AM | Report abuse

So if Paul Ryan can send a bunch of hypotheticals in the form of an 80 year budget to the CBO for them to score, why can't Democrats send a hypothetical, post-reconciliation health care bill for the same? I don't get it.

Posted by: flounder2 | March 11, 2010 11:10 AM | Report abuse

flounder

It's because the corporate media has a dbl standard. They would rip the Dems on a fake CBO score, but clearly not the GOP.

Posted by: Lomillialor | March 11, 2010 11:14 AM | Report abuse

I can put House Democrats minds at ease with a simple proposal: first pass and get signed a bill that requires complete honesty, openness, and transparency in the legislative process.

Then, the severe penalties attached to my proposed law will assure House Democrats that they can pass the Senate bill in full faith that the Senate will follow through.

For example, when the first abortion is funded by tax dollars as a result of this bill, require Pelosi to commit seppuku in the House chamber.

If she refuses, hang her by the neck from the ceiling of this same chamber and leave her corpse hanging in perpetuity as a reminder of the price of duplicity by legislators promoting legislation.

Then, follow suit with every other legislator who lied and misrepresented facts to get this or any bill of consequence passed.

Posted by: RUKidding0 | March 11, 2010 11:32 AM | Report abuse

Ooooh! Good idea RUKidding0! And who gets to decide if facts were "misrepresented" or what happens if someone abuses the system in a way that wasn't intended? I think you probably should since killing legislators is your great idea!

Posted by: MosBen | March 11, 2010 11:38 AM | Report abuse

Lawyers don't deprive me of health insurance or deny my medical claims. The money lawyers make is typically 25% of the money awarded to their clients.

Actually Lawyers play a more prominent role in denying healthcare to people than Insurance Execs do.

Take the entire salaries of every CEO and feed it back to the insurance companies denials and at best it would have an impact of less than 0.1 %

But the defensive medicine and high lianity insurance costs end up costing people their lives!

Posted by: FastEddieO007 | March 11, 2010 11:40 AM | Report abuse

Before Insurance CEOs created a business model around selling market-driven risk sharing pools to consumers, most middle class families suffered from potentional bankruptcies from health problems.

These market-driven risk sharing pools have served the middle class in the USA very well. It is only NOW due to the dysfunction of our system that arrives out of:
1. Unhealthy coupling of insurance to employment

2. Third-party payer phenomena of "comprehensive" care programs,

3. Imbalance of Medicare payouts for services rendered as compared to what everyone else pays.

This dysfunction has killed healthcare costs so badly, that these market-driven risk-sharing pools----as valuable as they've been---are hitting their limits of value to middle class families.

Nonetheless even today more than 75% of people are happy with their policies!!!

Posted by: FastEddieO007 | March 11, 2010 11:47 AM | Report abuse

@ Mary42 "Their job is not to fall easily to party strong-arming, to save the president or anyone else's political fortunes at the expense of the nation, the American people they represent."

This is a good one. Dumbocrat leadership strongarming its caucus?????? Right. That's how the Stupak amendment got in the house bill. Dumbocrat leadership forcing compliance on its membership. That's how the Public Option was eviscerated in the house, because the dumbocrats rule with an iron fist. You really should be a comedian.

Their jobs is to make the hard votes that are good for their constituents, whether or not they are politically popular at the moment. Lots of people from both parties lost their seats by voting for civil rights, when their districts opposed it. Do you think they should have voted with the mob or voted to give equal protection under the law to all citizens?

Posted by: srw3 | March 11, 2010 11:52 AM | Report abuse

@FE007: most middle class families suffered from potentional bankruptcies from health problems.

How exactly is this different from today's situation where the majority of medical bankruptcies happen to people with insurance?

"more than 75% of people are happy with their policies!"

I bet they are haven't had a major illness or treatment denied multiple times by insurers. I bet this statistic would be radically different if you limited the respondents to people who have made significant claims on their policies. I suspect the 25% unhappy are people who actually have to use their insurance.

Posted by: srw3 | March 11, 2010 12:20 PM | Report abuse

"My point is that you don't know, and the process isn't even argualy illegitimate at this time. Everything is proceeding according to the rules, and it's a bit dishonest to assume several outcomes which haven't happened yet."

What outcomes have I dishonestly assumed, MosBen? I have discussed several possible outcomes and given my opinion as to what would be controversial but legitimate and what would be illegitimate in my book. There's nothing the least bit dishonest about that.

Posted by: bgmma50 | March 11, 2010 12:23 PM | Report abuse

now here's a dilemna for Lomillalor. What about insurance company lawyers? Are they good or bad???

hmmm.

Its really sad when you've got someone that's so pathetic that only sees one side as good and one side as bad no matter what the actual TRUTH is. Sad and pathetic.

Posted by: visionbrkr | March 11, 2010 2:02 PM | Report abuse

Trust?!!! Who rational human being can trust Obama and his comrades?!

How can anyone trust Obama and his comrades when, with every passing day, the stench of the Obamacare scam becomes more and more nauseating.

The stench of the lies, manipulation, intimidation, coercion, bribery, corruption, and backroom deals to force us to swallow the Obamacare SCAM -- which would destroy our health care, our economy, our freedoms and our country -- has forever tainted the Democratic Party and demonstrate the degree of corruption, bribery and fraud we can expect from Obama and his comrades as they continue to enslave us through their Marxist schemes.

More and more Americans understand there's no longer a Democratic Party. The Democratic Party has been replaced by the Progressive (Marxist) party, controlled by U.S. enemies like George Soros and bent on destroying America using the tactics of their Marxist mentor Saul Alinsky.

More and more Americans are ready to do whatever it may take to defend their future -- and the future of their children and grandchildren -- from Obama and his Marxist scams, including Obamacare and cap and trade.

Posted by: AntonioSosa | March 11, 2010 3:02 PM | Report abuse

What is the difference between what our congress and president are doing and what Hugo Chavez and the Venezuelan congress did. What we have in office right now is the nearest thing to a dictatorship this country has ever had. A revolution is brewing. Americans will not stand to being dictated to or oppressed. Forcing someone to buy a product of any kind is unconstitutional and is dictatorial. Obama, Reid, and Pelosi need to be impeached then arrested for corruption. I support the TEA Party movement and hope it can help win seats for enough American patriots that we can undo the damage Obama, Pelosi, and Reid have done to this country. I am especially ashamed of the condoning of this illegal act by both my senators, Senator Rockefeller, who rubber stamps anything Reid supports, and Senator Byrd who claims he is a great parlimentarian and who authored the "Byrd Rule". He is a low life who is once again voted for legislation the majority of West Virginian are strongly against. He did the same thing when he helped give away the Panama Canal with 87% of West Virginians against it. Senator Rockefeller and Senator Byrd both supported Obama when the people of my state had voted against Obama by a large majority. Neither represent West Virginian interests with the exception of the coal companies and miners. They are both carpet baggers and both are dishonest. They shame West Virginia.

Posted by: good_angel | March 11, 2010 5:00 PM | Report abuse

Everyone seems to be bad mouthing insurance companies. They are in business to make a profit, not be a charity. If they break a contract (cancel a policy without good cause) then prosecute them as you would any criminal. If they turn some one down for an existing condition that is just good business on their part. Can you wreck your car and then go buy insurance to cover the damage? I do not care what executives in the insurance business make as far a salary. That is between them and their stock holders or board. Why do people think a free company should be forced to pay welfare?

Posted by: good_angel | March 11, 2010 5:10 PM | Report abuse

Dear Ezra and #p2 tweeps,
Ezra's phrase above, 'jumping off a cliff,' begs a revisit of this Oliphant cartoon:
http://bit.ly/OliphantGOPLemmings

And IMHO, the lobbyists-fueled GOP disinformation spew is legerdemain, Newspeak and breathtaking. Literally. Their misrepresentation of the facts and the numbers reveals their perfidy. They lipflap their lies to selfish, xenophobic, homophobic, misogynistic, uninformed acolytes and seem only do the math related to their own pockets. Go to OpenSecrets and find out just how much.

With brilliant clarity, New York Times columnist and Nobel Prize winner Paul Krugman gets it right, and lays it out here:
http://www.nytimes.com/2010/03/12/opinion/12krugman.html

Offended? Too bad. As a voting citizen, one needs to read the bill, get the real facts from your representative and understand, above all, that each of us is already paying for the millions of uninsured and under-insured who have no recourse but to seek care in already overburdened emergency rooms. That a six-month-old child with medical challenges can be denied insurance coverage reveals the cold -- if even present? -- heart of health care reforms' avaricious opponents.

For those who scream about abortion measures, I do absolutely respect devout expressions of faith, but ask this: insurance companies have deemed pregnancy as a pre-existing condition and as a result, care is denied to these women which, if reversed, could save the life of that child AND its mother.

Lastly, if you are not registered to vote and/or have not voted recently, your outrage on either side of this issue is simply hot air.

- A / (at)bleuz00m

Posted by: ALR2 | March 12, 2010 11:47 AM | Report abuse

"Why is Senator Conrad always pretending to be the majority leader in the senate?
Posted by: ameys1msncom"

Maybe he's campaigning for a position that will be vacant after Reid loses his seat in November?

Posted by: cprferry | March 12, 2010 9:56 PM | Report abuse

"United health care's CEO alone earned over $115 million in 2005. It is probably higher now."

If you're so interested in the profits of health insurers, why not address the Senate's abortion language that sets a mandated price floor on an abortion coverage surcharge over and above the cost insurers would otherwise charge. The result would be that insurers would add elective abortions to their coverage not because they or their subscribers want it or demand it, but because government regulation made it profitable?

Posted by: cprferry | March 12, 2010 10:03 PM | Report abuse

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