The Health Care Gauntlet

Sunday, December 20, 2009

If the news from the Senate is to be believed, Democrats stand on the verge of passing land mark health reform. However, several hurdles still remain before Democrats have reason to celebrate a major accomplishment.

First, Democrats have to overcome 3 separate cloture votes. This does not appear to be a major obstacle as Nelson's signing on to the bill gives Democrats a (dare I say) solid 60 votes to break the certain GOP filibuster attempts. Assuming these filibuster attempts are broken, which is likely, a vote on final passage could come as early as Wednesday

After final passage in the Senate, a new concern materializes. The Democrats have two options to (hopefully) put the bill on the President's desk:

(1) House Democrats can introduce the Senate approved bill in the House and have a simple up or down vote. IF that were to happen, and no changes were made to the bill, the bill would land on Obama's desk with no conference committee required. Or...

(2) The conference committee hammers out a revised health care bill agreed to by the leadership of both houses. The conference committee's bill would then by subject to a vote in both houses before the bill could be signed into law.

If the Democrats opt to take the Senate bill straight to the House, one has to believe Nancy Pelosi has the votes. However, if this bill goes to conference, the possibilities for failure start to rise again. The Senate requires 60 votes, and any change to the Senate bill in committee could flip a leaning Senator to vote against cloture, effectively forcing the process to start over in the Senate. The House only passed their health care reform bill by a vote of 220-215, and liberals in the House are not happy with the Senate bill as it stands now. We can assume Pelosi can pull in a few more votes if she were required to do so, but that comes with its own strings attached for each member.

Bottom line, I don't see Democrats going to conference if Pelosi has the votes. Pelosi and Reid could have some other (and possibly very good) reason to go to conference, but it's hard to imagine.

UPDATE: as if on cue, the Huffington Post reported the following this morning:

The chairman of the Senate Budget Committee says the House must stick close to the Senate's version of health care reform or risk losing the 60 votes needed to pass it in the Senate.

Looks like the bill is going to conference after all.