Take this bill and reconcile it!

Republicans are not interested in supporting health reform.  The healthcare summit indicated they want to start over.  On issue after issue, it was pointed out that ideas that had been championed by Republicans were included in the bills which have passed the House or Senate, but still Republicans wouldn't vote for ideas they profess to support.  

I am reminded of the proposed Gregg-Conrad deficit reduction commission in the Senate, which was endorsed by President Obama, shortly before the bill was voted upon.  The bill was sponsored by Senators of both parties.  Sponsors included Republican Sensators, Sam Brownback (Kan.), Mike Crapo (Idaho), John Ensign (Nev.), Kay Bailey Hutchison (Texas), James Inhofe (Okla.) Lisa Murkowski (Alaska) and John McCain (Ariz.), none of  whom voted for the bill they co-sponsored.  (Lisa Murkowski was away from the Senate for a family matter, and didn't vote.)  That's just nuts! 


Republicans say they support the elimination of pre-existing condition exclusions, but they are opposed to the required coverage mandate included in the reform legislation.  It is impossible to rationally hold both positions.  If we aren't required to have insurance, but carriers are required to immediately cover pre-existing conditions, then no one would buy health insurance until they needed healthcare, since the carrier couldn't deny coverage for the pre-existing condition.  Insurance only works when the risk of loss is not certain.  The premiums that would have to be charged in that situation would be many multiples of today's expensive health premiums.  So Republicans can be in favor of eliminating pre-existing condition exclusions, or they can be opposed to the mandate to have health insurance, but they can't hold both positions simultaneously and expect to be taken seriously.  Healthcare is complex, and a piecemeal approach (the step-by-step approach advocated over and over again by Republicans) simply won't work.

Some Republicans (Sens. Coburn and Enzi and Rep. Cooper, for example) who attended the healthcare summit clearly understand the problem, and have ideas that I wish they would work to incorporate into the bill.  All of us would be better off if they would make a contribution to this important effort.  But of course if they did that, there might be an expectation that they would vote for the bill, and since Republicans have spent the past year working to maintain a united front of opposition to anything that might help to address the country's problems, that's apparently untenable.

Reconciliation has been described as "the nuclear option."  Originally the term was used when Republicans considered eliminating the filibuster rule entirely to enable an up or down vote on judges.  In reality, reconciliation at this point in the process is not the big deal Republicans make it out to be.  Reconciliation will not be used to pass a 2,000 plus page health reform bill.  That bill has already passed the House and the Senate (with 60 votes in the Senate).  Reconciliation will be used to true-up bills passed by the House and Senate, remove Nebraska's special deal which would have provided federal support for my state's share of the Medicaid match, end Florida's Medicare Advantage subsidies and similar tweaks.  These are changes that Republicans have complained were included in the bill which passed the Senate.  Once again, I suspect we will see no Republican votes, even for legislation to remove provisions they have opposed, and which will reduce some costs in the overall reform package. 

The healthcare bill is not perfect.  No bill is.  But this legislation includes enormous benefits that will assist Americans who are not insured, and Americans who are.  So, in the face of nonsensical but intractable Republican opposition, Democrats will need to carry this legislation across the finish line.  Take this bill and reconcile it!