Congressional leaders and the Administration are trying to figure out the exact content of a final health care reform package and the legislative strategy to get it through the House and Senate. Discussions have mainly centered on a two-step process by which the House would pass the Senate bill, H.R. 3590, and then both chambers would pass a companion bill with agreed-upon changes to H.R. 3590. But questions regarding this approach still remain.
The House is concerned about voting on the Senate bill, which did not go as far as the House-passed bill, without an assurance that the Senate is able to pass the follow-up bill with the corrections the House seeks. Therefore, leaders are exploring various strategies. House Rules Chairwoman Louise Slaughter (D-NY) is considering a rule that would assume the Senate bill passed once the House passes the “corrections bill.” This would avoid having Representatives directly vote on the Senate bill, which many do not particularly like. Another approach would be for the House to simultaneously clear the Senate bill and the corrections bill.  At the same time, Congressional leaders are waiting for the Congressional Budget Office (CBO) to produce a score of the budgetary impact of their proposed changes to the Senate bill. Democratic leaders could continue tweaking the provisions in the bill offering corrections based on the CBO score. The substance of this bill has still not been disclosed but most assume that its provisions are similar to those the President laid out recently: affordability improvements, changes to the individual and employer mandates; as well as modifications to the tax provisions.  (For more details of the President’s proposal see the March 1, 2010 Human Needs Report).

Meanwhile in the Senate, leaders are consulting with the parliamentarian about ways to protect the corrections bill from parliamentary challenges from Republicans. Such challenges could delay and hamper passage of the bill. In order to keep certain provisions from being stricken from the bill Democrats may need 60 votes to defeat points of order challenges from Republicans. Thus far, no Republican seems willing to join the 59 Democrats to overcome the 60-vote hurdle.  Opponents of the legislation could also delay passage by offering a marathon of amendments.  Although the bill providing corrections would be subject to limited debate and no filibuster, Senate rules do not set limits on the number of amendments that can be offered after debate ends.

As Congressional leaders work to develop an endgame strategy to pass a final health care package, advocates continue to stress the urgent need for reform. Over 5,000 advocates from across the country gathered in DC on March 9 and held a rally outside of a hotel where insurance company leaders were attending a policy conference. The protesters delivered a mock warrant of arrest to the insurance companies and urged Congress to stop listening to the insurance industry and complete health care reform. A new report by Families USA, Lives on the Line: the Deadly Consequences of Delaying Health Reform, presents stark statistics on the human cost of doing nothing. The report states that in the 15-year period since Congress last took up health reform (1995-2009), more than 294,000 American adults (25-64 years old) died prematurely due to a lack of health coverage. It estimates that a similar number will die in the next 10 years if Congress fails to pass health reform this year.

Timing

The White House would like to see a final health care package passed through Congress by March 18, which is when the President is scheduled to leave on an international trip. However, Members have pushed back on this timeline and are instead aiming to have a vote before their two-week spring recess begins on March 26.

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