The Great Big Myth That Reconciliation Would Not Work For Health Care Reform

One the the greatest myths you will hear from senators is that reconciliation will not work for health care reform. This myth is pure nonsense, just like the myth that they need 60 votes (something that could be changed any time by 50 senators and the vice president, but that is another story).

The argument against using reconciliation to pass health care reform is that provisions not related to the budget could be removed by the Byrd rule. There are two big problems with this argument.

First, the argument ignores that reconciliation would still protect the guts of reform. For example, half of the people who will gain insurance (roughly 15 million) will get insurance because of the expansion of Medicaid. Expanding Medicaid is completely doable with reconciliation.

Expanding Medicaid, Medicare buy-in, the public option, closing the Medicare doughnut hole, taxes, affordability tax credits, cost control reforms for Medicare and Medicaid, and more can all be done with reconciliation. These are all the most difficult parts of reform.

Secondly, the argument that reconciliation could strip out the important insurance regulations is very weak. Technically, provisions not related to the budget can be removed by the Byrd rule, and that includes the important new insurance regulations (ban on pre-existing conditions, community rating, lifetime limits, etc.), but there is a very important caveat: these provisions will only be removed if they fail to get 60 votes to wave the Byrd rule for those provisions.

I dare all 40 Republicans plus one conservative Democrat to vote for a stand-alone provisions that would let insurance companies continue to exclude people for having pre-existing conditions. If they are foolish enough to vote against extremely popular insurance regulation as stand-alone provisions they will face the mother of all attacked ads in 2010.

I suspect that there will only be a very narrow set of provisions that don't violate the Byrd rule, and would not get 60 votes to wave the Byrd rule. It is possible the Republicans will vote "no" on everything related to reconciliation as a protest against reform. Even if the Republicans do unite to commit political suicide by voting against a wavier of the Byrd rule for the extremely popular insurance regulations, that is only a temporary set back. The insurance regulations can be added as a whole or piecemeal to some big omnibus defense bill.

This is not a new strategy. Earlier this year, an expansion of hate crime legislation was passed by adding it to a massive defense authorization bill. I simply can't imagine anyone taking down a huge defense authorization bill because it contained a very popular regulation stopping recession or lifetime caps on coverage.

The greatest myth being told in Washington right now is that reconciliation could not produce a good health care bill. That is pure nonsense. Even if the Byrd rule strips some important provisions from this bill, there are plenty of ways to get those provisions passed into law using other hardball tactics. Don't buy Democrats' lame excuses for not doing everything they can to get the best bill possible. Just because they don't want to pass a good health care reform bill using reconciliation doesn't mean they couldn't.