Democrats Better Have a Health Care Reform Reconciliation-Only "Plan B"

I'm still skeptical that Democrats will ever be able to find the votes to pass their current health care reform strategy. Their plan is to have the House pass the comprehensive Senate bill as it is, then pass "fixes" using reconciliation. With even the Democratic leadership basically admitting that there is no way out of the standoff over abortion language, I fail to see how they could get the votes. This is why Democrats better have a health care reform "plan B," which should be a new reconciliation-only bill.

I've repeatedly laid out several possible reconciliation-only health care bills that would still be very good reform packages (here, here, and here).

Importantly, if you passed only the parts of the House and Senate bills that could be acted upon using reconciliation, it would still be a significant health care reform package. The House Democrats already voted for a bill expanding Medicaid to everyone below 150% the federal poverty line (FPL) and allocating billions for community health centers. In the Senate, all Democrats voted to expand Medicaid to 133% FPL, provide billions for community health centers, and to fund states that copy Washington's Basic Health program for everyone between 133%-200% FPL. These provision should cover between 13-20 million of the uninsured, and could be passed in a reconciliation-only bill.

Providing states money to expand coverage to everyone under 150-200% FPL through Medicaid, SCHIP, or a form of the Basic Health program could pass through reconciliation, and since they are covered by the Hyde amendment, the Stupak gang should not jump ship. Putting just these provisions in a reconciliation-only bill would allow Democrats to get a health care “win,” help millions of American get insurance, and allow the Democrats to say they have listen to the American people and are going to do health care reform piece-by-piece, with this being the first big piece.

If Democrats were smart, they would add many of the most popular consumer protections to the reconciliation bill, knowing that they would violate the Byrd rule. It would force Republicans to take stand-alone votes during the reconciliation process to strip these popular regulations from the bill.

I don't know if the Democrats will ever find the votes in the House for the Senate health care bill. What I do know is that it would be an act of political malpractice to not have a backup plan ready to deploy quickly now that Democrats have made it clear they are willing to use reconciliation.

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