Reconciliation: The Tipping Point On Health Care Reform

What is probably the decisive battle in the war to reform our health insurance system is currently being fought behind closed doors. It is not a battle over regulation, the public plan, or funding. It is the fight to include in the budget a provision to pass health care reform using reconciliation if a bipartisan bill fails. Reconciliation would allow health care reform to pass with a simple filibuster-proof majority.

Currently (without reconciliation) the Senate Republicans have an enormous influence over health care reform. If they can keep all 41 GOP senators together, they can filibuster any health care bill. Barack Obama has made health care reform his first of several major initiatives he wants to tackle. If health care reform fails, it would mean Obama is a weak and ineffective president. It would destroy his political capital and cripple all his other reform plans.

Obama needs to pass health care, and the Republicans know it. They know walking away from a bipartisan bill could hurt Obama more than themselves. Without reconciliation they could force any health care bill dramatically to the right despite their small numbers.

Including a health care reconciliation provision completely alters the political dynamics. With reconciliation the Democrats don't need any Republican support to pass health care reform. Without reconciliation, if the Republican senators walked away from a bill it would kill it. Now if Republicans refuse to compromise on health reform, it will end up being written by the left wing of the Democratic Party.

Reconciliation is the key to passing progressive health care reform. It is the massive stick which forces Republicans to make large compromises or live with a bill written entirely by Democrats. By including reconciliation and maintaining enough unity, the Democrats will be able to pass any health care reform they want.

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