Finally, everyone is starting to admit that real health care reform was always possible using reconciliation. After months of telling the “dirty hippies” they simply don’t understand the complex nature of the Senate, the loss of one Democratic Senate seat seems to have changed everyone’s tune. The Center on Budget and Policy Priorities has a new paper showing that the use of reconciliation for major health care reform is not outside the tradition of the Senate–or the realm of possibility. After all, the SCHIP program was a major expansion of health insurance coverage passed in a reconciliation measure:
Congress also has used reconciliation in the past to establish entirely new health coverage programs or to substantially expand existing ones.
- Children’s Health Insurance Program. Reconciliation legislation enacted in 1997 created the Children’s Health Insurance Program, which now provides subsidized coverage to 7 million children.
- Medicare Advantage. The 1997 reconciliation law also established the Medicare+Choice program, now termed Medicare Advantage. The Medicare Advantage program currently serves 10.4 million Medicare beneficiaries.
- Continuation of Employer-Sponsored Coverage. The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 established new rules under which workers leaving employment with a firm that offers health insurance can remain enrolled in the employer’s health plan for a specified period of time if the worker pays the premiums. COBRA also makes continuation of coverage available to spouses and children of workers upon the death of the worker, loss of dependent status, or other specified circumstances.
This public acknowledgment from left-leaning think tanks that using reconciliation to pass health care reform is more than possible would have been helpful back in September, when it became clear that their would be no real bipartisan legislation. It would have also been helpful during the months of negotiations when progressives were told that they must keep giving into Joe Lieberman’s insane demands because we must “get 60 votes for anything.” At the very least, strong validation that reconciliation was a good option would have empowered progressives in the negotiations.
Months ago, now, we could have passed a health care bill that was more progressive, more cost effective, and likely much more popular. We could have done something like SCHIP for everyone or a major expansion of Medicaid and Medicare. Instead, those months were wasted to maintain the stupid 60th-vote myth, losing the Democrats a seat in the Senate, and further destabilizing that institution–and, I’d argue, our country.