According to Politico, the potential reconciliation measure contains six major components:
- An increase in the Medicare payroll tax for the rich
- More cuts to Medicare Advantage
- The special excise tax deal for unions
- Small increases in affordability tax credits
- A fix for the Nebraska Medicaid deal
- Closing the Medicare Part D donut hole by 2019
There will also be some other small, technical fixes and, ideally, a national exchange instead of state-based exchanges. The national exchange could easily run afoul of the Byrd rule, and might not be possible.
Before Democrats try this, I want them to think long and hard. Their “fix” to a very unpopular health care bill is an additional bill that Republicans will easily attack as being more tax increases, more cuts to Medicare, and more backroom deals to give special tax breaks for unions. Even if I agree with these general policy changes, they are not a "fix," they are political death wish.
If Democrats plan to use the reconciliation sidecar strategy, they should use it only for very popular ideas. For example, they can add popular cost control ideas like a public option, Medicare buy-in, or drug re-importation to pay for fixing or eliminating the excise tax. Tax increase are unpopular; this is American politics 101.
When I first proposed the sidecar strategy, I joked that the Democrats would completely mess it up by using the reconciliation sidecar to raise taxes so that they could give a special tax deal to unions, making the Senate health care bill even more unpopular than it already is. It appears my joke was dead on.
I must ask the Democratic leadership if they are actively trying to lose control of the House in 2010? Do they want House Speaker Eric Cantor? It really seems like they are actually trying to do everything they can think of to make sure that they destroy their brand before the midterms. Raising taxes, Medicare cuts, and special union deals--Democrats might just as well have added death panels to the bill because I bet those might poll slightly better than this combo. Have fun explaining to the American people why you thought it was a better idea to raise taxes instead of controlling costs by giving people the choice of a public option.
Democrats really should rethink the politics of this move before it advances any further. The same unpopular bill with only some small unpopular, easily attacked tweaks around the edges is an awful political path forward for health care reform.