Anthony Weiner is saying that if Martha Coakley loses today, health care is dead.  But Eugene Robinson says the White House is going to fix the bill by getting tough with corporations.

While Howard Fineman is reporting that Congressional “groupthink” just wants health care to go away, as Weiner says, the reality should be closer to Robinson’s predictions.  The Democrats can’t just walk away from the signature issue they’ve devoted so much energy to, nor can they pass a giant giveaway to the insurance companies and PhRMA without huge electoral consequences.  

So what option do they have to fix the health care bill that doesn’t require 60 votes in the Senate?

Well, Chris Van Hollen is now using the “R” word — reconciliation.  It’s interesting that the head of the DCCC, whose job it is to get Democrats elected in 2010, is the one who recognizes the need to rescue the health care bill from the Senate corporatists like Joe Lieberman who would take the entire party down to give Aetna a big payday.  Win-win for him, really.

What would “Sidecar” Reconciliation look like?

Jon Walker sketched it out:

Passing the Senate bill first, and then fixing it with reconciliation, could also create strong political and policy pressure for reviving the public option or Medicare buy-in. Probably the only way they could jam the Senate bill “as is” through the House would be to get labor on board. To get labor, you need to promise to fix the excise tax, and probably the only way to do that is by using reconciliation. The unions agreed to a “fix” of the excise tax that would cost $60 billion. That money needs to be recouped through other tax increases or cost-cutting measures. Even a weak, “level playing field” public option would save $25 billion, and increasing Medicaid from 133% to 150% FPL should save another several billion.

The steps to get through “sidecar” reconciliation:

  1. House passes the Senate bill
  2. House and Senate pass a “fix” to the excise tax that they’ve negotiated
  3. Find a way to pay for the “fix,” which costs $60 billion.  The best way to pay for it without raising taxes means putting in a public option, expanding Medicare, passing Dorgan’s drug reimportation amendment, or some combination of the above.
  4. House and Senate then pass the “fix” through reconciliation, which requires a simple majority. 51 Senators have said they’d vote for Schumer’s “level playing field” public option, while 51 voted for Dorgan’s drug reimportation amendment.

The alternative to paying for the excise tax “fix” with any of these is to raise taxes.   Let’s see them try and sell that.

Why would anyone trust that Congress would make this fix after passing the Senate bill?

The adminisration has made such a big deal about how their “fix” of the excise tax helps the middle class, they’d suffer even MORE damage if they reneged.  And the unions would — quite rightly — go apeshit (or face a rebellion within their own ranks) if they didn’t.

Even Republicans like John Shadegg have been running around saying the public option is a superior outcome to the current bill, which simply forces people to buy insurance from the companies who created this problem in the first place.  As we’ve seen in polling in both Vic Snyder and Steve Driehaus’s districts, that’s a wildly unpopular concept.

How long would “sidecar” reconciliation take?

Theoretically, it could  happen quickly in the Senate, since the underlying bill has already passed.  The Finance and HELP committees would probably have to approve, and then it could go to the floor for a vote.

None of this, by the way, is a function of what happens to day in Massachusetts. It can — and should –  happen regardless of what happens with the Coakley/Brown election in Massachusetts today.  The Democrats have a huge perception problem that the health care bill is just the bank bailout extended to the insurance companies, and they need to fix it if they want to turn the ship around before the 2010 elections.