Written by Paul Campbell and Maura Farrell
The Washington Post has reported that Congressional Democrats have reached a tentative agreement on President Obama’s $3.5 trillion budget, including reconciliation instructions which would allow health reform legislation to pass the Senate with only 51 votes. The agreement would charge each of the Committees with jurisdiction over authorization of healthcare legislation to find $1 billion in savings. If the agreement moves forward and is passed by the full House and the Senate (as expected), these “instructions” would allow for the Senate to bypass normal Senate parliamentary rules requiring 60 votes for approval. The tentative conference agreement would also extend for two years the Medicare physician payment “fix”. The extension reduces a budget savings needed for a complete repeal of the current payment methodology, which applies a sustainable growth rate (SGR) limit.
Reconciliation represents a win for House Speaker Pelosi, who shepherded the inclusion of the reconciliation provision in the House Budget. Pelosi’s hope was that reconciliation be included in the conference committee agreement, despite the fact that the Senate Budget Committee did not include the measure. The win also increases the House’s leverage in negotiations of health reform legislation. This process will be unlike the House Leadership’s experience with negotiations on a compromise for the American Recovery and Reinvestment Act (ARRA), when Majority Leader Reid needed to get the help of three Republican Senators to ensure passage of the stimulus bill in the Senate.
Unlike the Senate, which will move two health reform bills concurrently, the House has agreed to develop a unified plan. Notably, both Speaker Pelosi and Ways and Means Chairman Charles Rangel are strong supporters of a public plan.