The House of Representatives has posted its health care reconciliation bill, which can be found here. First, I have to say the bill is nothing like what I expected. I was expecting it to include only changes to the Senate bill, not a 2,300 page bill. Second, while it takes some time to digest and understand the statutory text, on a first reading it appears to me that the House bill establishes a national insurance exchange (something I strongly prefer over the Senate state exchange plan), and, after a transition period of 3 years, employees of large employers are eligible to participate in the exchange as well, subject to approval from the Commissioner. States would still be eligible to create their own exchanges too after complying with some requirements presumably designed to ensure they provide the same level of competition as the national exchange would provide. Assuming I am reading the bill correctly, both of those provisions would be significant improvements over the Senate bill. They are also surprising changes. Even Obama’s reconciliation outline presented at the health care summit maintained the Senate exchanges.
The CBO is expected to release its scoring of the bill tomorrow and, assuming all goes as planned with the scoring, the House should take action this week.
UPDATE: David Waldman (who knows this stuff better than anyone) thinks that the just-posted bill may not be the actual reconciliation bill but the October House bill reported out of the Budget Committee (which isn’t the version finally passed by the House). He suggests the House rules may require the House to start with that bill as a vehicle for adopting a reconciliation bill now, and that the October bill may be deleted in its entirety and replaced with new (and quite different) language. That suggests I am premature in my excitement about a national exchange (he notes the bill also has a public option in it, which I haven’t yet seen, but which would be totally unexpected- indicating he is correct).
I have seen several reports indicating that Rep. [fill in the blank] is/is not going to support passage of health care reform over the past several days, but I haven’t seen anyone actually aggregate them all in one place. I tried to do just that.
Results below (all are Democrats unless otherwise indicated; click on the “XX” in the vote column for the hyperlink to the story describing the Representative’s vote):
| Representative Name | Original Vote | Now Leaning Yes | Now Leaning No | Now Undecided | Now Definitely Yes | Now Definitely No |
| John Adler (NJ) | No | XX | ||||
| Jason Altmire (PA) | No | XX | ||||
| Brian Baird (WA) | No | XX | ||||
| John Boccieri (OH) | XX | |||||
| Rick Boucher (VA) | No | XX | ||||
| Bart Gordon (TN) | No | XX | ||||
| Stephanie Herseth-Sandlin (SD) | No | XX | ||||
| Larry Kissell (NC) | No | XX | ||||
| Suzanne Kosmas (FL) | No | XX | ||||
| Frank Kratovil (MD) | No | XX | ||||
| Dennis Kusinich (OH) | No | XX | ||||
| Michael McMahon (NY) | No | XX | ||||
| Walt Minnick (ID) | No | XX | ||||
| Scott Murphy (NY) | No | XX | ||||
| Glenn Nye (VA) | No | XX | ||||
| John Tanner (TN) | No | XX | ||||
| Michael Arcuri (NY) | Yes | XX | ||||
| Dan Maffei (NY) | Yes | XX | ||||
| Bill Owens (NY) | Yes | XX | ||||
| Dan Lipinski (IL) | Yes | XX | ||||
| Kurt Schraeder (OR) | Yes | XX | ||||
| Shelley Berkley (NV) | Yes | XX | ||||
| Bart Stupak (MI) | Yes | XX | ||||
| Jerry Costello (IL) | Yes | XX | ||||
| Kathy Dahlkemper (PA) | Yes | XX | ||||
| Joe Donnelly (IN) | Yes | XX | ||||
| Steve Driehaus (OH) | Yes | XX | ||||
| Brad Ellsworth (IN) | Yes | XX | ||||
| Marcy Kaptur (OH) | Yes | XX | ||||
| Paul Kanjorski (PA) | Yes | XX | ||||
| Dale Kildee (MI) | Yes | XX | ||||
| Jim Oberstar (MN) | Yes | XX | ||||
| Charlie Wilson (OH) | Yes | XX | ||||
| Solomon Ortiz (TX) | Yes | XX | ||||
| Raul Grijalva (AZ) | Yes | XX | ||||
| Joseph Cao (R-LA) | Yes | XX | ||||
| Steve Kagan (WI) | Yes | XX | ||||
| John Spratt (SC) | Yes | XX | ||||
| Dan Boren (OK) | No | XX | ||||
| Bobby Bright (AL) | No | XX | ||||
| Arthur Davis (AL) | No | XX | ||||
| Collin Peterson (MN) | No | XX | ||||
| Mike Ross (AR) | No | XX | ||||
| Ike Skelton (MO) | No | XX | ||||
| Gene Taylor (MS) | No | XX | ||||
| Jerry McNerney (CA) | Yes | XX | ||||
| Mike McIntyre (NC) | No | XX | ||||
| Chet Edwards (TX) | No | XX | ||||
| Jim Marshall (GA) | No | XX | ||||
| Jim Matheson (UT) | No | XX |
The vote count is obviously very fluid, and some of the individuals listed above have sent mixed signals on their possible vote. Where more than one position has been indicated, I have taken the most recent public position for inclusion in the table above.
Some of the votes above are also speculative. The identity of the “Stupak 12,” for example, has not been officially confirmed, but it is believed to include the individuals listed in the table in bold font (there are actually 14 names for the Stupak 12 listed, due to conflicting reports on the identity of the 12).
In summary, we have the following:
Former “No” Votes Now Voting:
Leaning Yes: 6
Leaning No: 1
Undecided: 5
Definitely Yes: 0
Definitely No: 15
Former “Yes” Votes Now Voting:
Leaning Yes: 0
Leaning No: 9
Undecided: 13
Definitely Yes: 1
Definitely No: 0
216 votes are now required to pass health care reform (Rep. Abercrombie, Rep. Wexler, and Rep. Murtha are not in the House anymore and were all former “yes” votes; Rep. Massa was a former “no” vote who is no longer in the House).
If the vote were held today, based on the table above, the vote would be (assuming all leaning votes are cast in the direction in which they are leaning and all others vote as they voted for the original House bill):
Yes: 201
No: 214
Undecided: 16
Counting all those who are “leaning yes” or “leaning no” as “undecided,” the tally as of now is as follows:
Yes: 196
No: 204
Undecided: 31
Speaker Pelosi has her work cut out for her. Assuming all “leaning” votes are cast in the direction they are leaning, she will need to find 15 more votes to swing this in her favor (if leaning are counted as “undecided,” she will need to find 20 more votes). That said, this is certainly doable. She has 13 “undecided” votes to work with (or 31, depending on how you count it), plus 11 who have not expressed an opinion who previously voted “no” (see note below for the full list). Furthermore, any compromise on abortion could sway several of the “Stupak 12,” and it is even possible they may become convinced the current abortion language is sufficiently strong (see here for a good summary of why). Of the “Stupak 12,” the only Representatives thus far to have stated they will not vote for the bill without an abortion “fix” are Berry, Driehaus, Lipinski and Stupak.
This fight is far from over. Please call your representative today and push them to vote “yes” for health care reform.
NOTE: Several original “no” votes have not expressed an indication on how they will vote this time. Those Representatives are: Barrow (GA), Boyd (FL), Chandler (KY), Childers (MS), Davis (TN), Griffith (AL), Holden (PA), Markley (CO), Melancon (LA), Shuler (NC), and Teague (NM) (11 total).
UPDATE: Dennis Kusinich added to the “no” column., Spratt added to the “undecided” column, and Kagan added to the “leaning no” column.
UPDATE II: Due to a helpful update on www.thehill.com, we have significantly updated the table from the earlier version. Earlier, I had placed all suspected members of the “Stupak 12″ into the “leaning no” category. The Hill has clarified that many of them should instead be listed as “undecided” instead, other than the four listed above who will not support the bill without changes to abortion language.
UPDATE III: Matheson moves to “undecided,” and Marshall moves to “no.”
Senator Reid announced late Friday that Democrats will proceed with the so-called “sidecar” option to pass health care reform. According to the Majority Leader, the White House and Democratic leaders in the House and Senate have signed off on the plan, which involves passing through reconciliation an amendment to the already passed Senate health reform bill. The House would then pass the reconciliation bill and the Senate bill. Reid suggested the full text of the reconciliation bill is being finalized and will be posted to the web on Monday. The content of Reid’s statement is very good news for those hoping to see real health care reform pass. The timing, however, seems poor.
The White House health care summit is Thursday and President Obama has already been struggling to convince Americans that the summit is a real attempt at bipartisanship. Republicans have criticized the summit as nothing more than political theater and at times have suggested they may not attend as a result. They seem locked in to participating now, but Reid and other Democrats need to be wary of giving Republicans an excuse to back out.
The summit, at minimum, appears designed to demonstrate in a very public forum that Republicans aren’t serious about cooperating to pass health care reform and that they have no substantive ideas to contribute to the process which are superior to those already adopted by the Democrats. If Obama can make that case, he would have political cover to promote reconciliation without appearing overtly partisan. That strategy can only succeed to the extent Americans believe the summit is a real invitation to Republicans to offer ideas and contribute to molding a reform bill. Reid’s statement undermines the strategy. Alternatively, one could argue the summit really is designed to elicit Republican ideas and incorporate them, but if that is the case, why decide on reconciliation before the summit begins? I suspect Reid was projecting his opinion on the low probability that Republicans attend in good faith (and cooperate at all to pass any reform), but he must know his statement plays poorly politically.
The White House has said all along it will publish a proposed bill at least 72 hours prior to the summit so the public and Republicans can come prepared to discuss the bill and ways it can be improved. In fact, Republican House leaders have also demanded the White House publish its proposed bill before the summit. Consequently, it isn’t really an issue that Reid said the bill will be drafted and published on Monday. It is an issue that he implicitly suggests no Republican ideas will be incorporated into the bill (either because Republicans likely won’t cooperate or because Democrats don’t really want Republican input).
In any event, Reid just made Robert Gibbs’ Monday a mess. The White House is now in the uncomfortable position of denying reconciliation has already been agreed to (which will anger Democrats everywhere) or admit it has been (which will anger Republicans everywhere and diminish the odds the summit is a springboard for passing the bill). Gibbs’ ability to answer somewhere in the middle of those two positions will be critical. Reid’s announcement would have been much better if it came one week later.
Sen. Tom Harkin (D-Iowa) told reporters today that the House, Senate and White House had reached a compromise on the differences between the House and Senate bills on January 15, and that the compromise language had been sent to the CBO for scoring. Just days later, however, before the CBO report could be finalized, Massachusetts elected Scott Brown in a special election for the Senate seat vacated by Senator Kennedy’s passing. Brown’s election killed all momentum the bill had behind it and many have since suggested health care reform is now dead.
Speaker Pelosi has been particularly vigilant in keeping the health care debate alive, with surprisingly little cooperation from the White House or her Senate counterparts- much to the chagrin of Democrats everywhere. Greg Sargent reports today, however, that the White House has now privately told Senate Democrats that Obama favors the “sidecar” option. That option would involve passing a reconciliation bill in the House and Senate which amends the Senate health care bill, and then enacting the reconciliation bill and the Senate bill into law. If true, this is the first real sign President Obama was serious when he told a townhall gathering that he “will not walk away from health care reform.” The next step, which must happen quickly, is for Obama himself to tell Senate Democrats to move forward with the sidecar option. Until that happens, progress in the Senate is unlikely.
Using reconciliation to amend the Senate health care bill certainly involves some parliamentary and political hurdles. As CongressMatters has noted, the parliamentary hurdles can be overcome. If Obama continues to advocate for real health care reform (and endorses the sidecar option), the political hurdles can be as well.
State of Health Care Reform
President Obama is receiving a significant amount of criticism for being too “hands off” in governance. His leadership style with respect to health care in his first year largely involved speaking in generalities on the topic and leaving the details and messy process to Congress for resolution. When the process would start to collapse, he would once again deliver a powerful, albeit unspecific, speech on health care, and urge Congress to get back to work. Time and again they did. In the end, health care reform hasn’t yet passed, but whatever you may think of Obama’s leadership in the first year, he came closer to shepherding comprehensive health care reform to passage than any president who has ever tried.
Now granted, “close” isn’t much consolation in politics, especially to the tens of thousands of people who will die because they do not have health insurance in the United States. So why does “close” matter? Because if we were close to finalizing health care reform two weeks ago, there is no good reason we can’t still be close today- and finished tomorrow. To understand what Obama can do to finalize the bill, we need to first understand who the obstacles are.
The House of Representatives has been particularly responsive to Obama’s calls to action- and not just on health care either. Of course, the House doesn’t have to deal with the filibuster or the nonsensical Senate tradition of the “hold” which permits one single Senator to block debate or passage of a bill indefinitely (or at least until the Majority Leader grows weary of the hold). At every step of the health care reform process last year, the House was ahead of the Senate. The House Energy and Commerce Committee passed a draft bill in August while Sen. Baucus’ committee toiled on. The House then passed its full bill in November while the Senate remained stuck in negotiations. The nation’s attention turned to the Senate and, rather than rise to the occasion, the Senate had to deal publicly with the ego of Joe Lieberman, the special interest demands of Senator Nelson and Landrieu, and procedural votes taking place in the late hours of night or in the early morning on Christmas Eve. The public reacted to the messy Senate process about as one would expect- negatively.
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