People don’t really care about the reconciliation fixes to the health care reform bill. They are a confusing mix of minor changes to taxes, subsidy levels, and scrubbing a few state-specific deals. I doubt one in one hundred Americans understand them. Obama has already made it clear he prefers the excise tax unchanged. While members would want to undo the “Cornhusker kickback,” I fail to see where you get the grassroots or institutional pressure to push through the reconciliation package after passing the Senate bill. Reconciliation measures are not easy, and the urge to just let it fall apart would be strong. That is why the reconciliation measure needs student loan reform so House members have a guarantee the reconciliation measure does not wither on the vine.
I have always said that the reconciliation measure would collapse under its own weight unless it had a big, popular, headline item to justify its existence. Something like a public option or Medicare buy-in that could really rally progressives. No doubt the reconciliation measure will include all sorts of deals to be attacked. I could easily see attacks on the new deals quickly making the reconciliation measure more toxic than all the toxic deals it was meant to fix in the first place. The reconciliation bill would come to a stop without a big, popular, top line item. Student loan reform could possibly serve that purpose.
Knowing that reconciliation contains student loan reform makes the reconciliation measure less about fixing the Senate health care bill, and more about helping students and ending a massive corporate welfare program for banks. It gives House members assurances that there will be strong grassroots pressure to prevent the reconciliation measure from dying and leaving the House holding the bag on the Senate health care bill.
I still think it is a huge mistake to not include a public option in the reconciliation measure. It is very popular and would help rally the base. If Democrats put it in one bill with student loan reform, it would allow them to really stick it to the health insurance companies and the big banks in one grand, populist gesture. It could be a huge help for Democrats in midterms to force Republicans to unanimously vote against a bill that takes on both health insurance companies and the big banks–probably the two most hated industries in America right now. If Democrats hope to avoid a mass exodus in November, they need to make it appear that the Republicans are the ones really defending the banks and the health insurers.