Democrats seem to have an unsolvable legislative problem on their hands. It does not seem that their current strategy of passing the Senate bill as is and then arranging some fixes through reconciliation will work. Bart Stupak (D-MI) and his anti-abortion gang want changes to the abortion language before voting on the bill, and Senate Republicans have promised to make sure that can’t happen. It would appear like the Gordian Knot this is a mess the Democratic leadership simply can’t untie. But if they follow the historic example of Alexander the Great they can pull out their sword and cut straight through the knot instead.
Below are just four hardball strategies Democrats could employ to pass health care reform, if they were truly willing to do everything possible to pass a bill:
1) A New Reconciliation-Only Solution: Create a brand new reconciliation-only Byrd-proof bill that would rely on expanding current public health insurance programs and offering a buy-in to the Federal Employee Health Benefit Program. Despite complaining by Kent Conrad (D-ND), it is completely doable. Reconciliation can be used to provide coverage to 31 million Americans, just not with the exact same weird step-up in the current Senate bill. This solves the Stupak problem because current public programs and the FEHB program are already covered by the Hyde Amendment. It might also appeal to other reluctant House members because it would be a “new” bill without deals like the “Cornhusker kickback.”
2) Nullify Byrd Rule for Just Abortion: Pass the reconciliation measure first with a self-executing rule. The abortion changes can be added to this reconciliation measure. To protect abortion changes from the Byrd rule, Vice President Joe Biden as President of the Senate can use his power to ignore the parliamentarian and declare that abortion changes don’t violate the Byrd rule. This would solve the Stupak problem. On the other hand this might not be workable because it could easily cause a revolt among pro-choice House and Senate Democrats. Most importantly if Joe Biden was willing to take the bold step of nullifying the Byrd rule for one provision, why not do it completely to make life much easier for Democrats.
3) Nullify Byrd Rule For the Whole Bill: Instead of nullifying the Byrd rule and other rules of reconciliation for just one provision, Biden could do it for the whole bill. Senate Democrats could take up the House health care bill under reconciliation, have Biden rule against any Byrd rule point of order and pass the bill as is. It would go straight to the President’s desk and become law.
Similarly Democrats could write a “new” bill which would just be a traditional merge bill between the House and Senate bill. They could put this new bill through reconciliation with Biden ruling against any Byrd rule point of order raised by Republicans. This would allow Democrats to pass a whole health care bill through reconciliation with only a simple majority vote.
4) The Actual “Nuclear Option”: It is funny Republicans have attacked the traditional use of reconciliation as the nuclear option. The whole reason Democrats are tying themselves in knots is because Senate Democrats refuse to actually think about using the real “nuclear option.” If Democrats really wanted to, fifty senators plus Biden could use the “nuclear option,” like Republicans threatened to in 2005, to kill the filibuster. This would allow them to pass the current House bill, a new merged bill, or an abortion sidebar bill with only a simple majority in the Senate.
The difference between what Senate Democrats say they can do and what they actually could do.
Democrats have tied themselves into knots, gotten themselves into a seemingly inescapable legislative standoff, and will possibly fail on a top goal because of their weird allegiance to Senate rules. Rules the Republicans have exploited to maximum efficiency to ruin Democratic legislation, cripple the Senate, deny help to millions of Americans in need, and hurt the re-election bid of Democrats.
Democrats might allow themselves to fail at health care reform simply to protect Senate rules that now every top member of Democrat Senate leadership says need to be changed. Senate Democrats plus Joe Biden do technically have many tools at their disposal to pass health care reform, if only they have the will needed to play hardball. This is something Democrats should keep in mind because constituents will ask “what have you passed to help us?” not “how well have you protected the stupid broken traditions of Congress that we hate and don’t even understand?”
Remember, if health care reform fails, it is not solely the fault of House Democrats. Senate Democrats could pass health care reform without members of the House taking another action.




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Thank you for that exercise in thinking outside of the box. Unfortunately, the Dems don’t seem to be thinking at all and have boxed themselves into a no-win situation. They seem intent on pursuing the absolute wrong course of action all the way through to the bitter end, and believe me it will be a bitter end if they are “successful” in this. Apparently no one in the caucus has a creative imagination comparable to yours Jon, for shame!
I think I find this the scariest path of all as given the track records of both the House and Senate, I’m quite sure we would wind up with a bill that encompassed all of the worst elements of both bills rather than one encompassing the best of both bills.
I’m not advocating for any option just getting people right when they try to blame House members for the sins of the Senate.
“…maximum efficiency to ruin Democratic legislation, cripple the Senate, deny help to millions of Americans in need, and hurt the re-election bid of Democrats.”
If you were to reverse this list I believe that you would have the correct ordering of perceived priorities in the Dems political calculus. They want to pass what they’ve got right now because…
1. They think it will help them all get re-elected, but they are wrong about that, very wrong! Most of us do want true HCR, but this is not it and we will not be convinced that it is because of political expediency.
2. They don’t give a rat’s ass about providing millions of uninsured citizens with affordable health care, otherwise they would pass a PO without and individual mandate and focus on fixing this broken system for the long haul. However, the current legislation is what they obviously consider the best way to pretend that they care about this, so off they go over the cliff…
3. They don’t want to alter existing Senate rules, heaven forbid, even if they are archaic and totally antithetical to the current real needs of the country. The rules as they stand are simply unethical in the present political and social contract context!
4. They don’t want to mess up what they’ve already worked so hard to mess up. It took a long time and a lot of hard work to screw HCR up this bad and the so-called pragmatists get really bent out of shape when they come face to face with the truth of the matter, that the legislation in it’s current form totally sucks in so many different ways. The political calculation is that it’s better to pass something, anything at all, even if it’s a bad bill that takes the country in a direction diametrically opposite of the path to real HCR, because not passing it would be worse politically. The obvious logical fallacies inherent in this thought process, and it’s being generous to call it that, will be revealed in all of it’s infamy in November!
Aw, didn’t think you were advocating any one position. Just pointing out that if they did go this route, the probable outcome would be whatever is worst.
Of course not! That would remove their excuses for doing absolutely nothing to help the American people.
Or pass Grayson’s Medicare buy-in bill in lieu of the Senate bill, tacking on on the House bill’s tax hikes and cost savings to subsidize premiums and send THAT over as the HCR reconciliation bill.
Since Medicare already doesn’t pay for elective abortions, Stupak and his gang would vote for it and there’d be no Byrd Rule issue in the Senate. Obama can start whipping the Senate Dems to get his 50 votes if he wants HCR this year.
Well you know who actually DID cut the Gordian Knot? Alexander the Great.
In other words it took a real leader to take bold action.
What’s interesting is that the Greek Fourth Army Corps motto is Τώ ξιφεί τόν δεσμό λελύσθαι Solve the Knot With The Sword.
None of the article’s suggestions appear to me at all to be cutting the Gordian Knot. They all seem like complicated instructions on how to untie it.
Here’s the Alexandrian solution. Elect more progressives to office, over turn the Hyde Amendment, kick out the filibuster, and pass Single Payer Universal Health Care.
Got the official offer letter today with a starting salary a little higher than the maximum range that was advertised and a tentative start date of March 29. I have to pass a pre employment drug screen, which is not a problem as I knew I would most likely have to take one and a background check. That can be problematic, depending on what they care about. I haven’t had a felony conviction and only one misdemeanor in 1978. I haven’t even been arrested since then or had any tickets in the last ten years or so. If they are worried about old, unresolved debt, that might be a problem.
Well, if you had a *magical* sword in your scabard all this time, why the Hell haven’t you been out there smiting and taking names?
There are a couple giant leaps in your sequence that could bear some explanation.
Yes. We’ve known since last year that Democrats could enact meaningful reform that would help every American if they only wanted to.
The Republicans, oddly enough, are right (in the wrong way, of course). Scrap this monstrosity and use reconciliation to enact a Medicare buy-in for everybody who wants it, with subsidies for those who need help.
What’s stopping it? It’s too simple for the sausage makers and too honest for the tools of the insurance industry.
Indeed what you are talking about is basically Pete Starks Americare and probably could be down completely through reconciliation
This post is a good example of “blind persistence” … so to speak whilst quoting.
The first option of a reconciliation only approach seems most sensible and feasible to me. Much as manywould like to see a Senate that was less sclerotic, I don’t think the Senate and Biden would go for the nuclear option. Obama is still propounding bi-partisanship like a political masochist.
Why they haven’t had a reconciliation only bill in their hip pocket the entire time just amazes me. It seems clear Hereford that they intended to use 60 threshold to strip from the bill anything tilting to the left of Lieberman.
Reconciliation only may be rough but that’s what needs to happen.
“Democrats have tied themselves into knots, gotten themselves into a seemingly inescapable legislative standoff, and will possibly fail on a top goal because of their weird allegiance to Senate rules. Rules the Republicans have exploited to maximum efficiency to ruin Democratic legislation, cripple the Senate, deny help to millions of Americans in need, and hurt the re-election bid of Democrats.”
Actually Democrats have done that on their own so that they could pass corporatist legislation while using Republicans as cover. Look no further than the PO with the claim that 60 votes were needed for it but there were only 51 so that the PO had to be killed off. Then when 60 votes fell away other excuses were then generated. The elected Democrats don’t want democracy because democracy would remove their cover and force them to expose themselves as corporatists instead of just citing the rules and blaming the Republicans. Senate rules is what lets the corporatists stage kabuki theater while lying about where they stand on their positions – people can get their bread and circuses from the House since the politicos know the Senate will head things off at the pass and none of the politicians have to take responsibility since they can just cite the rules. If these guys were serious about democracy and weren’t corporatists, they’d go nuclear and at a minimum pass a strong PO as the only thing that is stopping them from doing that is themselves.
So simple and uses established systems as well, so it could go into effect sooner. Why couldn’t that have been the Obama plan? Oh, maybe it was but he just didn’t tell anyone.
It is truly amazing. Everyone in the House voted for Medicaid to 150% FPL and the Senate to 133% FPL. That is 15 million of the uninsured right there with that one provision
I have started getting headaches whenever I start mulling over health ins. reform at the end of the day. Now I think I know why. We are strategizing an endless series of methods to accomplish what we think would be a progressive solution. But we don’t actually know what our presumed allies in Congress actually want to do. And they aren’t listening to us (reading our blogs). And the White House is ignoring us in the progressive grass-roots.
We are wandering in the desert looking for a way out. Nobody in Congress cares that we are out here. No wonder I’m getting headaches.
Washington and Wall Street are both cesspools that if not drained will destroy the nation.
Completely agree.
And agree with Sparkatus @15:
Latest print edition of New Yorker confirms both of these points about Obama. Intense reporting by George Packer, who gives a summary in a blog post but says the full piece is not online yet.
The more I think about it, Gordian Knot is not as good as “Augean Stables.”
We need a Hercules!
I thought that’s who we elected President. But he is squeamish about the stink, apparently.
Caddell & Schoen in the WaPo column were accusing Dems in Congress of blind persistence, not progressives in the grass roots who are trying to steer the Dems away from disaster. Anyway, I lost interest when they cited Rasmussen.
Hell, yeah, we need to re-route the Potomac through the Capitol.
Good idea.
@ PJEvans: Smartypants! You stole my next set up line! Good for you!
superb, concise, thank you.
I would only differ with the reason for the impasse. Imco, the rules, just like the whole bipartisanship schtick are a convenient cover. They are beholden to the lobbyists, the lot of them and so we get treated to Kabuki.
little pleasures, nice.
I’m wondering if there’s something lurking in the shadows. Specifically with Rahm negotiating with Graham about Gitmo/KSM/etc, I can’t see how Graham would cut any sort of deals when he’s already agreed to put up all roadblocks if reconciliation is used and we all know how Rahm thinks HCR should be done. Perhaps Obama will ignore Rahm and then see that Rahm is Svengali and fire him and start acting like Candidate Obama now that he’s no longer under Rahm’s spell, just I think Rahm is a symptom rather than a cause of what’s going on and that Rahm isn’t Svengali. I’m trying to figure out what everyone’s game is as we’ve certainly seen there’s a game with PhRMA and the PO and it seems like the only solutions Obama and others are open to are the ones that deliver to the corporate lobbyists.
It may have started out as an Augean Stables, but our beloved leaders have succeeded in turnng it into the Labor of Sisyphus.
Years earlier in fact. The Americare billl Jon mentioned would provide 100% coverage via the Medicare system (with zero premiums, deductibles or copayments for current recipients of Medicaid and SCHIP, children, pregnant women and every adult under 200% FPL) starting Jan. 1 2011, three years sooner than Obama’s plan starts offering much less generous subsidies for private insurance only.
The reason for the long wait, of course, is Obama’s foolish promise to keep the 10 year cost around $900 billion. The only way the numbers work (since Obama bargained away genuine cost controls on drugs, hospitals and insurers) is to wait 4 years before we start spending any money on premium subsidies.
Thank you. what’s so frustrating about all this is that after his election, Obama was in the position he could have asked for anything and he could have rammed it through last year. But instead taking action, he let his political capital drain away trying to reach a bipartisan deal. Reid was just quoted as saying that over a 100 Republican amendments were added to the Senate HCR bill… and for all that Reid didn’t pick up a single GOP vote.
Bear in mind, the Republican party hasn’t had a 59 senate majority since the Harding Administration in the early 1920′s and yet somehow that hasn’t stopped Republican presidents since then from pushing through their agenda…. more often than not through the reconciliation process.
I hope we’re all (or most of us, at least) basically agreed as follows:
The House bill is merely grossly inadequate. The Senate bill, a slight variation of which Obama is embracing, is downright evil, because of the individual mandate. By that mandate, it basically gives away control of our entire health care delivery system (except for Medicare, Medicaid, S-Chip, VA, and a few other government programs) to the insurance industry, which will be able to hold it and control it for decades to come, because “fix it later” will never, ever happen.
The public option promise (which will likely be reneged upon, anyway) is merely a means to fool us all into thinking that the end product will be good. But any public option will be puny and designed to fail, and will never be able to counterbalance the individual mandate.
We should act accordingly, and try by whatever means to kill the bill. If Stupak kills it for us, fine.
Yes, fearless Democrats will play hardball to pass meaningful reform instead of Corporate Welfare & Arena Football will become the national pastime.
I think that when you begin to add so many possible scenarios that would lead to the paasage of an ultimately acceptable health bill you only serve to detract rather than add to the debate.
By judging the actual Senate bill you can see that the underlying intent of the 60 Democratic Senators is to protect private profit. In the case of private insurance companies they actually found a way to increase their profits. Then the Senate added measures that would make the bill palatable to the public. Such as the often repeated limits on private isurers that would allow everyone to have private health insurance while boosting their profit.
There will also be a summ of nearly a $trillion derived from taxes on some benefits and from diverting some public money that would otherwise have been spent on the so called waste in the Medicare program. This $trillion will be used primarily to pay for the insurance premiums of the needy who will acquire policies from private insurers only. The rest of the money is not clear where that it will go.
The profits for private insurers and drug makers will of course not be touched and in fact will be increased. In order to assure the protection of these profit gains no competing entities or strategies like negotiating down prices will be proposed.
The House bill on the other hand will actually eat away at private profit by introducing a competitive public insurance plan, dissolving momopoly exemption for insurers and it taxes the wealthy. So it is a much better bill.
Measures by the Senate such as attaching a bank student loan reform proposal to its health bill at this late date, is done only for the purpose of making it harder for opponents in the House to vote down the Senate bill and to thereby stop the whole HCR effort.
Therefore the best strategy is for the House is to vote down the Senate bill as it now stands or even with a student bank loan reform proposal attached. Otherwise it could pass the current Senate bill only if they have a guarantee from the Senate that it will pass a public plan to compete and thereby diminish private profit that will be included among the fixes the House sends to the Senate for reconciliation. No other option is acceptable.
This sequence is not precluded by the current Senate rules under reconciliation or anything else. To maintain that rules need to changed or new bills introduced only serve to confuse the situation and adds nothing at this point. The fact that are over 50 Democratic Senators that are willing to adopt a public plan into its current bill is enoguh to guarantee that the reconciliation effort can go through.
I think that is true and I think this was designed to be for show. Keep in my Reid specifically arranged it so that the Senate couldn’t consider the House bill and yet there was no outrcry over this by Pelosi or Obama. Very little has been said about how the House members are being forced by their leadership into voting for the Senate bill because the leadership arranged it so that only the House would be in that position.
Knowing the game is rigged I’m not surprised about anything Congress does. One of the big problems is the lack of leadership from Obama. But then it’s all part of the larger scheme to assure the insurance, pharmaceutical and medical industries continue to make exorbitant profits, even at the expense of a bankrupt and dying citizenry.
Hooray! a Greek Mythologian.
Oh I see all that bipartisan bullsh** as just more kabuki political cover. Nobody, but nobody (I’m talkin’ about Obama) is THAT stupid.