Health-Care Reform Isn’t Over, by the Way

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Photo: Saul Loeb/AFP/Getty Images

Don't get the wrong idea from all the momentous headlines. Though the House passed the Senate's health-care reform bill last night, and the legislation is on the way to being signed by President Obama, you still have to hear about health care for a little longer, because the Senate still has to pass its reconciliation bill — the fixes to the legislation, including the repeal of the "Cornhusker Kickback" — that the House also passed last night. And the Republicans, as one would expect, hope to make this as difficult as possible.

For one, they plan on offering hundreds of amendments to the bill, which could last a couple of days and potentially alter the legislation.Then you have the Byrd Rule, which requires that items being passed via reconciliation must be directly germane to the budget. The Republicans will ask the Senate parliamentarian — this guy — to rule on whether certain provisions of the bill meet that requirement. There's also a rule that reconciliation items can't impact Social Security, and the Republicans claim that the tax on expensive "Cadillac insurance plans" would do that. Democrats are reportedly meeting with the Senate parliamentarian today to ask him if he agrees.

So can the Republicans succeed? Only partially. Health-care reform will soon become law, and there's nothing they can do about it. In the rosiest of scenarios, though, they can stop passage of the fixes. If the Democrats are forced to strike any provisions from the legislation, or if any Republican amendments pass, the House will have to vote once again so that both reconciliation bills are identical. This probably won't be a problem for the House, but, again, hypothetically, in a best-case scenario for the GOP, if just four Democratic congressmen decide they don't like this altered reconciliation bill, and refuse to support it, the bill wouldn't pass. That would leave Democrats, come election time, to defend the bill they did pass — one that includes the notorious Cornhusker Kickback, as well as a higher price tag and less robust subsidies for purchasing health insurance.

The least promising scenario for the GOP is that the Senate Democrats get their reconciliation bill through without changes, the House doesn't need to vote again, the legislation is signed by Obama, and Congress quickly moves on to other business. What could also happen is something in between: Republicans force changes to the bill, but the House passes it anyway. The political ramifications wouldn't be that significant, except that Democrats really, really want to not be doing health-care reform anymore, and Americans, however they feel about the legislation, have to agree.

Senate has some work left on health-care bill [WP]
Health Care Bill Passed the House, But Battles Ahead in Senate, Court [CBS News]
The Last House Vote Is Just the Beginning of Reconciliation [Gaggle/Newsweek]