Irreconcilable Differences on Health Bill

Republican Sen. Tom Coburn of Oklahoma and Democratic Sen. Kent Conrad of North Dakota on "Face the Nation," Sunday, Feb. 28, 2010.
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With Democrats pledging to move ahead on their health care plans following Thursday's bipartisan health care summit, much of the talk has focused on whether they will use a procedural method known as "reconciliation" to pass a final measure through he Senate.

Reconciliation would allow Democrats to pass the bill with a simple majority of 51 votes, rather than face a potential Republican filibuster requiring 60 votes to move the legislation forward.

Since Republicans now hold 41 votes in the 100-seat chamber following Scott Brown's victory in Massachusetts last month, reconciliation appears to be on the radar for many Democrats. But the prospect has drawn fierce debate among Democrats and Republicans, as was evident during Sunday's "Face the Nation."

Democratic Sen. Kent Conrad (N.D.), chairman of the Senate Budget Committee, defended the possible use of reconciliation by saying that the procedure would only be used for "minor" issues with the bill.

"Reconciliation cannot be used to pass comprehensive health care reform," he told host Bob Schieffer. "It won't work because it was never designed for that kind of significant legislation; it was designed for deficit reduction."

Conrad said the role played by reconciliation in health care reform "would be very limited. It would be on sidecar issues designed to improve what passed the Senate and what would have to pass the House for health care reform to move forward."

Conrad said that owing to the Byrd rule, which states that non-budgetary sections of a bill must be removed before consideration, major portions of the legislation would need to be jettisoned. "That would eliminate all the delivery system reform, all the insurance market reform, all of those things the experts tell us are really the most important parts of this bill. ... The only possible role that I can see for reconciliation would be to make modest changes in the major package to improve affordability, to deal with what share of Medicaid expansion the federal government pays, those kinds of issues, which is the traditional role for reconciliation in health care,"

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Conrad is apparently referring to a plan pushed by some Democrats by which the House would pass the bill passed by the Senate (thus sending that bill to President Obama's desk), and then changes to that bill would be taken up via reconciliation.

But Republicans are not happy about that prospect.

"It shouldn't be done at all," Rep. Marsha Blackburn (R-Tenn.) said.

"That's not a reasonable position to take, Congresswoman," Conrad responded. "On relatively minor issues, it's totally reasonable."

"But this is not a minor issue," Blackburn said.

"Well, health care reform at large . . . the major package would not be done through reconciliation. That would be unreasonable. But that's not going to happen here," Conrad said. He cited COBRA and the Children's Health Insurance Program (CHIP) as health-related issues that in the past have gone forward through reconcliation.

"I think that, on the reconciliation issue, if they had the votes, we wouldn't have had the summit. And if they try to go through reconciliation, it will be a change in semantics," Blackburn said.

"Instead of the American people saying 'stop the bill' or 'kill the bill,' it's all going to be about repealing the bill. That's not the kind of discussion that they want."

"The danger of what's happening right now in terms of using reconciliation is, the purpose of the Senate is going to be defeated," added Sen. Tom Coburn (R-Okla.), also appearing on the show. "And that is to bring consensus to big issues in this country so that we have a reasoned and thoughtful approach and that the American public buys into it."

Many Democrats have pointed out that Republicans have also used reconciliation to pass big bills like welfare reform and the Bush tax cuts, but Coburn said the difference between those cases and the current health care debate is that those bills had some bipartisan support.

"Welfare reform happened with reconciliation; half the Democrats voted for it. The Bush tax cuts happened with reconciliation; twelve Democratic Senators voted for it," he said. "You didn't have a real partisan issue on those times that it was used."

Democratic House Majority Leader Steny Hoyer (Md.) also defended the use of reconciliation on the show.

"It's a parliamentary term, but it's simply a process that the Senate adopted to allow it to deal with, in an expeditious way, issues that relate to the budget," he said.

But Coburn had another warning for Democrats who want to move ahead with reconciliation.

"If you use reconciliation on this health care bill as we see today, what you're going to have is a thumbing of the nose at the American people," Coburn added. "They don't agree with it."

More from Face the Nation:

Steny Hoyer: Health Care Will Move Forward
ems, GOP Divided on Health Care Costs
Bob Schieffer: The Strange Obsession With Curling
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