On Health Care Who Goes First: House or Senate?

There has been much musing around town (and on Swampland) about the tricky logistics of pushing a comprehensive health care reform bill through Congress at this point. The process will require at least three big votes: The House has to pass the Senate bill. The Senate has to pass amendments to its own plan through reconciliation. And the House has to pass the same amendments. But no one wants to go first. As Chris Matthews had it last night, “Much as in a kidnapping, the money and the baby have to be turned over as much as possible at the precise same time.”

Mike Allen channels the ether this morning and says that the House might begin working on its reconciliation vote before passing the Senate bill, a trick that involves the under-used verb “deem.” Here is one way this process might work:

The Senate does not want to go first because Republicans will be able to bottle up the reconciliation process, delaying the vote and making for another ugly sausage making spectacle that Americans hate to watch. If reconciliation takes too long, the thinking goes, then the House will never act, and the whole health care deal will die. But if the House goes first by passing the Senate bill, and the president signs it, then the incentive for Republicans to bottle up reconciliation would be diminished. Health care reform would, at that point, already be law. The horse would be out of the barn. Republicans would then be obstructing fixes to the law that would make the bill, arguably, better by getting rid of stuff like the “cornhusker kickback,” a much tougher proposition.

Here is where it gets tricky: The House is not going to vote on the Senate bill (even with a separate package of amendments to match the Senate’s reconciliation) until it is dead certain that the Senate will act. So how could those assurances be arranged? With the help of C-Span cameras, of course, or perhaps a letter from 51 Democrats vowing to pass reconciliation come hell or high water. Once the letter is read on the nightly news, the House can act, and suddenly the pressure would be on the Senate Republicans. With health care already law, the GOP will have to decide whether or not to spend weeks gumming up the Senate to delay some amendments to that bill.

Without a doubt, the whole thing is a long shot. It’s not clear that Pelosi has the votes she needs, but if she can get to 217, then it is unlikely to be all that difficult to get the Senate to 51, despite Republican carping over process. There is a path. It’s tiny. But it’s there.

Related Topics: Health Care, reconciliation, Uncategorized
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  • afguy

    Can someone come up with good name for this legislative dance we’re seeing?
    .
    Some sort of waltz? DIsco, perhaps?
    .
    How about the “Chickensh!t Polka”?

  • Ivy_B

    “of pushing a comprehensive health care reform bill”

    Did you choose to use that instead of jamming? Both seem equally used by the Repub folks these days.

    A more neutral way might be to say “logistics of passing…”

  • http://twitter.com/michaelscherer Michael Scherer

    make no mistake, Ivy_B. There is going to be a lot of pushing involved if this thing happens.

  • spob

    Doesn’t Pelosi only have to get to 217? And are Rangel’s issues irrelevant?

  • afguy

    Ivy,
    .
    We jumped on Michael last evening about using unnecessarily “loaded” terms in his pieces – he claimed it was an innocent mistake.
    .
    Guess he’s just made another one… he’s just being consistently “innocent”…

  • http://theblindspotsofgod.wordpress.com lawyermommy

    I could not agree more. The only thing I will add is that it is a dance for nothing. Nothing will be gained from the arm flapping and moon walking.
    It is a pile of crock which will go no where.

    A waste of Obama’s time.

    LM

    http://theblindspotsofgod.wordpress.com/2010/02/15/stalking-criminality-the-law-and-women/

  • http://twitter.com/michaelscherer Michael Scherer

    Yep, you are right. 217 given current vacancies. Fixed.

  • spob

    now if you can answer the rangel question–how much, if any, will his issues hinder hcr?

  • http://forgottenlord.livejournal.com forgottenlord

    Does Reid need 51 with Biden as the tiebreaker?

  • destor23

    This is so lame. It sounds complicated but it isn’t. House pass Senate Bill. Senate bill pass ammendments by majority. House pass ammendments by majority. President signs. That’s the order it needs to go in. If Pelosi wants Reid to produce a signed letter by 51 Dem Senators swearing they’ll do their part, then just do it and get it over with.

    Chris Matthews is wrong though. It’s not like a hostage swap. There’s a very clear order that makes sense that they just need to follow.

  • spob

    and the smart mouse said, “who proposes to hang the bell on the cat?”

  • http://forgottenlord.livejournal.com forgottenlord

    Well, Pelosi might need an internal whip count that she can show the Senate that says she has 217 before some of the 51 Senators would be willing to publicly say “I support reconciliation”. The bill will be a lot less popular if it fails than if it passes so they might not want to risk it before having to go home.

  • destor23

    @forgotten: Good point. But the whipping and letter signing can be done at the same time, now. The legislative process, order of actual voting, is clear. I feel like this is exactly what they shouldn’t be letting become some sort of public issue.

  • kristiia

    Reid only needs 50. Biden would be the 51/tiebreaker.

  • afguy

    About as much as any other Congressman with ethical issues that do not impact the project at hand.
    .
    But, spob, obviously YOU want them to matter a great deal…

  • http://forgottenlord.livejournal.com forgottenlord

    Well, this goes back to my theory that the Health Summit was actually to give more time for Pelosi and Reid to work the back rooms and prevent more poll slippage.

  • markstev

    Mr. Scherer and TIME’s editors still need to address an issue or three from the post by Mr. Scherer and a Sophia Yan regarding a “new poll” by Public Opinion Strategies and the Center for Health Transformation that allegedly found that “52% of voters oppose the current proposal and 59% of voters prefer to simply start over.”

    Some things to consider:

    So it’s Public Opinion Strategies and the Center for Health Transformation. Sounds interesting. Let’s see who and what these organizations really are all about.

    Public Opinion Strategies

    http://www.pos.org/inthenews/20041103.cfm

    Nov. 3, 2004 Public Opinion Strategies Press Release

    First sentence: “The Republican polling firm of Public Opinion Strategies (POS) polled for four Republican takeovers in the U.S. Senate, one new Governor, and six new members of Congress.”

    Hmm, so Public Opinion Strategies is a self-described Republican polling firm. Funny, but you kids never mentioned this affiliation. Wonder why?

  • markstev

    11

    Then there’s Bill McInturff of Public Opinion Strategies. Never heard of the boy. Let’s find out a bit more.

    http://www.pos.org/about/mcinturff.asp

    “Bill McInturff is a partner and co-founder of Public Opinion Strategies, a national political and public affairs survey research firm. Since its founding in 1991, the firm has completed more than 5 million interviews with voters and consumers in all fifty states and over a dozen foreign countries, and conducted more than 3,500 focus groups. Called by The New York Times, “the leading Republican polling company,” Public Opinion Strategies currently represents nineteen U.S. Senators, seven governors, and over 40 Members of Congress.”

    Well, golly gee whiz, Ole’ Bill McInturff’s not just some grunt from Public Opinion Strategies. Looks like McInturff, as per his firm’s own website, is partner and co-founder of the operation.

    In addition, seems those nasty types at The New York Times have called Public Opinion Strategies “the leading Republican polling company.” McInturff proudly admits as much right there on his firm’s own website and in his own company profile.

    Wonder why you silly kids never mentioned these, ummm, facts?

  • markstev

    Let’s see if someone with a computer, google, and a little hunger (you remember hunger, kids, it came right before the nannies) can find out about ole’ Bill McInturff.

    http://marcambinder.theatlantic.com/archives/2008/10/mcinturff_responds_to_stan_gre.php

    “Undecided Wars: Bill McInturff Responds To Stan Greenberg
    30 Oct 2008 09:10 pm
    “John McCain’s chief pollster, Bill McInturff, responds via e-mail to Stan Greenberg:
    “I went on Real Clear Politics tonight to find these two headlines back-to-back.
    “CBS/NYT: Obama up comfortably
    “FOX: Race tightens significantly
    “No wonder people can be confused about the status of this campaign.
    “I am weighting African Americans to census +1%. I am weighting young voters to be at least 16% of the turn-out. With those weights, I have seen the race tighten since last week.
    “If we were betting on the spread of a football game, I will let Stan take the CBS/NYT’s poll’s margins.
    “I believe we live in a world much closer to the Fox results.”

    Well tie me to an anthill and smear my face with jam! According to Marc Ambinder at The Atlantic, seems ole’ Bill McInturff worked as “John McCain’s chief pollster” during the 2008 presidential election. You silly kids remember Mr. McCain. He was the Conservative candidate for president. Lost, too.

    Even more interesting, ole’ Bill McInturff believed then (and believes now?) that “we live in a world much closer to the Fox results.” Turns out he was wrong in 2008. Wonder, though, if Mr. McInturff retained those Fox-Ailes tenets of his when Public Opinion Strategies developed this poll?

    And I wonder why you silly kids neglected to mention ole’ Bill McInturff’s work for Conservative presidential candidate John McCain? Or his Fox-centric view of the world?

  • markstev

    Then, of course, there’s the Center for Health Transformation. Let’s see if we can find out anything about this operation.

    http://www.healthtransformation.net/cs/newt_gingrich

    Newt Gingrich
    Founder
    “Since retiring from Congress, Newt Gingrich has worked extensively on the issues of health and healthcare, devoting the majority of his time to advocating a transformation of the entire system. In 2003, he founded the Center for Health Transformation, a collaboration of public and private sector leaders dedicated to the creation of a 21st Century Intelligent Health System that saves lives and saves money.”

    Well, I’ll be darned. Newt Gingrich isn’t just the former House speaker like you kids mentioned above. Mr. Gingrich is the founder of the Center for Health Transformation. Mr. Gingrich has been running the place for about seven years, if my math is correct.

    Wonder why you silly kids never mentioned Mr. Gingrich’s direct ties to the Center for Health Transformation in your fine, thorough, in-depth piece of reporting.

    Really, though, one looks forward to your next effort: A probing conversation on the need to include financing for lip injections in the next defense bill with Miss Beverly Hills (sic), Lauren Ashley.

  • afguy

    Mikey,
    .
    Those “innocent mistakes” are starting to add up.
    .
    Your repeated “slips” are showing…

  • spob

    getting to 217 is going to be tough–it gives people leverage . . . . a major house guy, with issues, could cause problems, and yeah, i want it to

  • http://patricksartor.wordpress.com patricksartor

    Even though i like the house version somewhat better, I think the house should pass the Senate version, forget the drama and, over the next year or so work out the details by amending the bill to include things like the public option.
    Here is what I do not understand:
    1) All other developed countries have discovered that, like public parks, libraries, a postal service and fire departments, health care is a public good far better managed either by the government or through flexible but clear government regulation.
    2) Without a national system of some kind, a wealthy anti-government Republican walks into his favorite coffee shop and the uninsured employee breathes bacteria all over him making him ill, too, since the uninsured coffee shop worker, twenty five years younger, did not go to a doctor because he could not afford to. Do Republicans like being contaminated by people too poor to go to doctors?
    3)A huge majority of the uninsured wait until they are extremely ill and then get free care for a far more serious and expensive illness through hospitals raising the cost to that same wealthy Republican who is insured when he goes in for the illness he caught from buying coffee. Do Republicans like these overloaded emergency rooms taking care of illnesses which could have been cured much earlier? Isn’t this against the Republican concept of efficiency?
    4) With an advertising budget of $0, no multi-million dollar salaries for CEOs, the Medicaid, like other national health care systems, cost less across the board. Do Republicans believe that this system we have now of enriching people every time we need medical care is efficient or good?
    5) Often, but not always, associated with religion, how could a Republican proclaiming faith in charity demand that the working poor go without health care?

    We are dealing with Republican fear mongering and corporate greed at it’s worst. I say that the public option can be added in later but if we can bypass Republican obstruction by passing the Senate version, let’s hurry up and get there. Pass the Senate version now and bypass the Republicans now.

  • shepherdwong

    “There is going to be a lot of pushing involved if this thing happens.”
    .
    Please elaborate on that statement. Pushing by whom (and how) if what happens?

  • newfreedomblog

    I’ve just updated my site and posted “Health Care Reform: What comes next after the Summit” read it at http:www.newfreedomblog.com
    .

    Our Media is nothing more than a supermarket tabloid, proclaiming the next victim of some sexual diviance. Reputable magazines such as TIME or Newsweek have fallen to the low levels of the National Enquirer. They now simply report on all the atroscities that spew out of Washington like liquid cow manure into those holding pits we see on nearby farms.

    .

    Their ideas for America are big government programs, filled with many constraining regulations with taxes to burden the working people of this country to prop up their evil intentions. Without our dollars they steal as taxes from those of us who are working hard to even get by, they are powerless. But, with trillions of dollars at their disposal, they can buy whatever policy or program seems to fit their whim of the day. They have already raided Social Security and Medicare, making both of these programs insolvent. Now they want to set up another entitlement program to take even more of our hard earned dollars away from us.

    .
    Read the truth….it shall set you free!

  • stuartzechman

    Sh*t Sandwich.

  • Paul-no not that one

    Rusty-you brought NewFreedom back from timeout!

  • stuartzechman

    I’m sorry, I should have put that in better context:

    [reading a review of the album "Shark Sandwich"]
    .
    Marty DiBergi: The review for “Shark Sandwich” was merely a two word review which simply read “Sh*t Sandwich”.

  • afguy

    patrick,
    .
    What a LOT of us are worried about is that, given all of the horse-trading and high drama present in the process to this point, NO ONE is going to have the stomach to come back any time soon and fix this.
    .
    For example, a program passed that mandates coverage but does NOTHING to keep costs down for the insured, will be the worst of all possible worlds, just a giveaway to the insurance companies.
    .
    Given the absolute gutlessness shown to this point in the Senate, plus the fact that they eliminated consideration of a public option from the get-go, it’s not an empty concern.

  • Ivy_B

    Thanks for all that work on our behalf on the Google! I thought I recognized McInturff, but had taks to do and snow to shovel before I could check.
    .
    He is frequently used on NPR as well – with no identification, of course. I don’t have a problem if TIME or NPR want to do stories based on Republican polls, I would just like them to make the identification.

  • diecash1

    NewBlogwhoreRusty – No one cares about your pathetic blog where you wax idiotic about the “issues.” You said you were leaving remember? Whatever happened to integrity? Now piss off………

  • http://patricksartor.wordpress.com patricksartor

    A little harsh, I would say.
    After the laser noises and special effects finding out what famous person cheated on who, some TV news does give you some facts about real news.
    Skim past the gossip articles and much of the print media can be very useful.
    No, BTW, I am not a journalist and don’t personally know any at the moment, either.
    No, I don’t have a TV around, either.

  • afguy

    patrick,
    .
    Put even more plainly…
    .
    We question if they have the COURAGE to come back to this and do what is needed NEXT YEAR.

  • http://patricksartor.wordpress.com patricksartor

    A vast majority of legislation are amendments. Once the Republicans loose the fight to prevent the poor from getting health care, they will, probably be too tired to oppose very much as I see it.
    Our number one priority to me is:
    Let’s get something done for our national health.

  • freeinpa

    On Health Care Who Goes First: House or Senate

    ==
    You first, no you, no you ……

    The Demos can’t agree themselves and Obama despite his lectures is finding out that its easier being a Community Organizer– you just antagonoze you never have to do anything.
    ==
    His approval rating fall and the American people are tired of the spending. The only outcry for either outrageous bill is with the MSM and extreme left. The Demos in Congress should be busy figuring out post-Washington plans

  • shepherdwong

    “I’ve just updated my site and posted “Health Care Reform:…”

    Well, it’s an outlet I suppose. Though it appears…inadequate:

    …all the atroscities that spew out of Washington like liquid cow manure into those holding pits we see on nearby farms…they steal as taxes from those of us who are working hard to even get by…to take even more of our hard earned dollars away from us.

    http://psychcentral.com/disorders/sx37.htm

  • newfreedomblog

    I’ve just updated my site See what’s changed at: http:www.newfreedomblog.com New video: Nancy Pelosi, she says she does not have the votes.
    .

    ,

  • markstev

    ivy,

    You’re quite welcome.

    I just wish that Mr. Scherer and the mysterious Ms. Yan had done the original work for the benefit of all TIME readers.

  • 53_3

    “…the truth shall set you free…”
    .
    Isn’t that what death does, newfreedomblog?
    .
    After all, as I’ve pointed out before, you, in “real America” get more tax dollars back in the form of subsidies for everything from roads to rural technology than I ever could, or will at any point in the future.
    .
    Without those taxes, and the income redistribution that goes along with it, you would be farming dirt – and starving.
    .
    Of course, when you become malnourished, there wouldn’t be any doctors to go to anyway as the Rural Health initiative programs would be gone too!
    .
    So be careful what you wish for, newfreedom. You might just get it.
    .
    I think that the “new freedom” being constantly referred to is the freedom to be an arsal oraface…

  • 53_3

    Urine.

  • markstev

    afguy,

    We shouldn’t be too hard on Mr. Scherer and the mysterious Ms. Yan.

    After all, it took me a whole 20 minutes to research and write about Public Opinion Strategies, the firm’s personal billing as a “Republican polling firm,” Bill McInturff and his post as the co-founder of Public Opinion Strategies, Mr. McInturff’s job as Conservative John McCain’s chief presidential campaign pollster, and Newt Gingrich’s role as the founder of the Center for Health Transformation.

    A whole 20 minutes.

    Surely, Mr. Scherer, the mysterious Ms. Yan, and the editors at TIME cannot be expected to devote 20 minutes to the writing and research of a major story on adverse poll data regarding the national health care debate.

    They just don’t have the time at TIME. After all, there’s so much else to do – such as pore over Belinda Luscombe’s Pulitzer Prize front-runner on male apologies and her equally vital story on the TigerText to track wayward spouses.

  • http://patricksartor.wordpress.com patricksartor

    We are trying to go from an extremely limited health care system with Medicare and Medicaid to a nearly perfect system. That would be like going from the Model T to a flex fuel, plug in hybrid.
    First, we make sure that we have something pretty good which the Senate version is.
    Next, we, far more quietly, fix it up.
    Just like anything else in an increasingly complex world, other countries with a national health care system is always amending and debating it. It will never completely stop, but, just become un-sensational like debates over highway bills.
    When things get relatively boring, Republicans along with Democrats can work on making relatively minor fixes instead of Republicans scoring points with scare tactics like “death panels” and other complete fiction and BS.

  • tedford47

    The House has to go first. Do a comprehensive fix later. Intrade, the prediction market, now has healthcare passage at 49.9% likely by June 30.

  • tngus

    Ownership of Legislation: make our congressmen own the health care bills
    I have been following the debate on the health care overhaul and I am confident that there would be a good strategy to pass all legislations and to make the government more effective.
    Why have many congressmen resisted to the health care overhaul bill?
    Majority of them do not own the bill. The president and few people drafted it and forced others to accept it. On Thursday, the president also resisted to other people ideas. I think human by nature as they like to have some kind of ownership.
    Lack of performance evaluation is also a big problem for making the government cost-effective. It does not matter much if elective officials do or do not work effectively as they rely on their money and party to win election.
    What does it mean ownership?
    Make people own what they work for and ownership has been an effective management tool in many business organizations. For example, if all senators and house representatives to own the health care bill, they will take their responsibility to pass it for American people. Otherwise, those who voted for her or him would vote them out in the next election. Why do we do politics in that fashion?
    How can they own the bill and pass it?
    Let our congress men and women draft their own terms based on the ideas of the people whom they represent and then they seek support from their colleagues. If any single legislature gets 60 votes of approval from the senate and 217 from the house, put it to the bill. By doing so, the president as the CEO empowers his team and builds a stronger teamwork environment.
    Moreover, making ownership will erase the party line as they have to compete for good ideas to prove to the people whom voted for them that they are working for them. Ownership is also a barometer to evaluate individual performance. In the current system, people cannot just who is or is not working effectively.
    Finally, ownership which is the norm in many other organizations will eliminate government bureaucracy and give American people the power to evaluate their elected officials not the money.

  • allthingsinaname

    I don’t care; pass the thing or lose the election.

  • linnk1

    The kidnapping analogy doesn’t sound quite right.

    It sounds more like they’ve agreed to all jump off a cliff but nobody wants to go first for fear that the rest won’t follow through.

  • tngus

    Following the health care debate and your comments, I have a plan for my self. I would buy a lethal injection and keep under my pillow. If I feel sick, inject it and die.

    Obama is not an effective CEO to sail his boat passing the turbulence of water.

    American people do not have power to select effective officials, because there has not been an evaluation system to judge elected government people.

    If the government cannot work effectively, this nation will go to hell soon.

    There is a need for a sweeping change in the way people choose and evaluate their elected officials.

  • http://patricksartor.wordpress.com patricksartor

    In theory your concept is wonderful and, for groups of five, ten, or even twenty five people this may make sense in something like a Japanese concept of consensus. However, with so many people involved…

    No.

  • tngus

    I would name this Bill as HELL Care.

  • http://patricksartor.wordpress.com patricksartor

    tngus,
    That’s a little dramatic.
    My view is democracy is a big, sloppy mess of horse trading, feuding, personal insults and, finally, when you least expect it, good things happen.
    Read your history books. FDR had many of these same problems Obama is (often EXACTLY the same problems since Republicans have not yet adapted to the victory of the New Deal) and, amongst Republicans, the things Lincoln went through during his presidency.
    We’ll know most about the Obama administration when our grandchildren will sit on our laps and tell us about what they read in history class about him (good, ineffective or just plain forgettable).
    He hasn’t attacked the wrong country as Bush did and nobody is accusing him of having sex with anybody. That, alone, has got to be at least two stars.

  • freeinpa

    It is more like pass the bill AND lose the election

  • sevenoaks07

    Can’t help feeling nostalgic for ” Who’s on First?”

  • CP in FL

    I say we do away with the elected officials in congress altogether and we create a real democracy. Every issue gets voted on by the people either through the internet or mail.

    If not, can we at least get rid of the Senate and have term limits for the house?

  • http://patricksartor.wordpress.com patricksartor

    In Ireland the country can not ratify at treaty nor go to war without a referendum. I know of no direct democracy for any country larger than Iceland in the middle ages.In today’s world, even if one could secure voting online in the near future, would be a chore. We’d be voting several times a week. To vote knowledgeably we would have little time for anything else in life. Maybe for some big issues like health care, war, the stimulus package and so on a detailed referendum would be an excellent idea. But this is a little far fetched for this debate. We just need to catch up with the rest of the industrialized world and let our sick see doctors for now.

  • http://theblindspotsofgod.wordpress.com lawyermommy

    I am an Obama supporter but this was a complete waste of time.
    The Old boy Republican network of old school Washington “Nothing must ever change” crew will do any and everything to make sure Obama does not suceed. Meeting with them is some sort of wasted chicken waltz.

    LM
    http://theblindspotsofgod.wordpress.com/2010/02/15/stalking-criminality-the-law-and-women/

  • http://firstfarmandweatherreport.blogspot.com/ maxwelldog

    I KNOW exactly where to start.
    Getting that shark, give her a big stick, and by god set her loose on some dragfeet!
    New York Congresswoman Louise Slaughter!

  • http://firstfarmandweatherreport.blogspot.com/ maxwelldog

    well, the problem is, as I see it, though I have been known to have a contrary bone…
    Like we are Farmer and Mrs. Brown, and the senate/congress are weasels.
    Well, Mrs. Brown wanted Farmer to put up a fence around the chicken quarters.
    Farmer Brown goes out and starts building a fence when the weasels come by and ask him what’s going on.
    “Building a fence,” says the farmer.
    “Well, we took a vote on it and found where you don’t need a fence because everything has a way of working out” say the weasels.
    So Farmer Brown goes home and the weasels raid the chicken house.
    “Dang!” says the farmer when he sees the mess the next morning. “What the heck is this all about!?”
    And the weasels came out and told the farmer, “well, we had some problems with that, last night, but, we’re on it now!”
    …and farmer Brown wanders off, thinking he is safe from the ravishes of the weasels again.
    .
    Some are good, honorable men, both sides of the aisle, no matter what the extremist right wingers say.
    Sadly, there are some bad eggs on both sides of the aisle, too.
    .
    I’m just always curious how many times Farmer Brown lets the weasels win. I also don’t know why the French get bad mouthed so much, either…
    Perhaps because they have a guillotine and know how to use it?

  • laro1292

    I think they need to sit down again because the american people aren’t getting anything out of it. If there is a winner, it is the Rep and the Dems.

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