Health Care Reform Advisory: Health Care Endgame
3/15/2010
By Kevin Kappel, Tom Koutsoumpas, and Jeremy Rabinovitz
In the past couple of days, momentum has increased significantly in Washington, D.C. in the effort to reform the nation’s health care system. While discussions on the final details of the President’s requested modifications continue behind closed doors, House and Senate leaders released a final timeline late last week for the health care endgame, setting the stage for a politically charged atmosphere this week in health care. According to Democratic leaders, there are two main paths being considered for health care, both of which would occur this week. In the most widely expected approach, the House Budget and Rules Committees will pave the way for a vote as early as this Thursday on two separate bills: (1) the underlying Senate-passed bill, and (2) a “fix-it” bill to be passed under reconciliation. The House Budget Committee will meet today at 3 p.m. to mark-up and report out a reconciliation bill. The Rules Committee will then meet this Wednesday to set the final rules for the debate on the bills, as well as to insert the “fix-it” or corrections language to incorporate the changes sought by the President and other Democratic leaders. In this case, the House could begin voting on the bills this Thursday, but Democratic leaders have warned that the vote may slip until this weekend as House Democrats are still trying to find the 216 votes needed to pass the legislation.
Since the House will have approved the identical bill that the Senate passed last year on Christmas Eve, the President would then have to sign that bill into law before the Senate could take up the reconciliation bill that is expected to include changes sought by the President and Democratic leaders. The President was originally scheduled to take a diplomatic trip to Asia on March 18th, but he has extended his departure date until March 21st in anticipation of the House passing the Senate bill. According to the Senate parliamentarian, the independent expert authority on the procedural rules of the Senate, in this case the President would need to sign that legislation before Senators can begin consideration of the reconciliation package. If the process comes to this point, Republicans in the Senate are expected to issue procedural and substantive challenges to the reconciliation package in an effort to delay or kill the legislation.
However, since many House Democrats are highly skeptical of voting on the Senate bill, which contained many unpopular provisions such as the special deals for certain states, Democratic leaders are considering another maneuver for health care that would be intended to shield vulnerable Democrats from future criticism. According to an obscure procedural rule, House Democrats believe that they may be able to approve the Senate bill without ever voting on it by using what is known as a “self-executing rule.” According to some political insiders, House Democrats could attempt to maneuver the legislation to pass the “fix-it” bill only, which would in turn consider the underlying Senate legislation as passed. In this case, the Senate could then proceed directly to its reconciliation process on that same “fix-it” bill. The President would then only need to sign the reconciliation package, and not the Senate-passed bill as well. The Senate parliamentarian hinted this past week that this maneuver is possible, but it remains unclear whether Democrats will be able to pull it off. Republicans have slammed this move as a gimmick and have pledged to oppose it.
While both paths to pass a comprehensive health care bill are fraught with procedural questions and political challenges, Democratic leaders have struck an increasingly confident tone these past couple of days. House Speaker Nancy Pelosi (D-CA) held a press conference Friday morning where she laid out the strategy for this week. The press conference followed a meeting with the Democratic Caucus where she reportedly received approval to move forward. During that caucus meeting, the House Speaker informed Democratic Members that they should prepare for a vote as early as late this week, but also clear their schedules for next weekend as she promised to stay in session until the vote is complete. The White House is also approaching the situation with a lot of confidence. Yesterday, White House Press Secretary Robert Gibbs made the rounds on the Sunday talk shows and declared that health care reform will be the “law of the land” by next Sunday. Meanwhile, Republican leaders are continuing to mount an opposition campaign and are targeting a handful of moderate Democrats in the hopes that they will vote “no” on the legislation. Although this timeline is fluid and subject to change, we will be closely monitoring every development and detail over the next couple of weeks.
* * *
For up-to-date information regarding health care reform‚ please visit our Health Care Reform: Analysis & Perspectives page.
Please click here to learn more about our health care reform practice.
For further information regarding this or any issue related to Health Care Reform, please contact one of the attorneys listed below or the Mintz Levin attorney who ordinarily handles your legal affairs.
Alden J. Bianchi
Chair‚ Employee Benefits and Executive Compensation
(617) 348-3057
AJBianchi@mintz.com
Tom Koutsoumpas
Senior Vice President of ML Strategies/U.S.
(202) 434-7477
TKoutsoumpas@mintz.com
Karen S. Lovitch
Manager, Health Law Practice
(202) 434-7324
KSLovitch@mintz.com
Jeremy Rabinovitz
Senior Executive Vice President of Government Relations‚ ML Strategies
(202) 434-7443
JRabinovitz@mlstrategies.com
Stephen M. Weiner
Chair, Health Law Practice
(617) 348-1757
SWeiner@mintz.com
