Senate starts debate clock on contentious health reform reconciliation bill

The Senate has begun debate, which Democrats hope to bring to a quick close, on a health care reform reconciliation bill that "fixes" parts of the law President Obama signed Tuesday.

The Wall Street Journal: Some of the changes being debated "are significant. The implementation of an excise tax on high-cost insurance plans to help pay for the wider health-care overhaul would be delayed until 2018. Subsidies to individuals to help them afford mandatory health insurance would be increased."

The legislation will only need 51 votes in the Senate to pass under special budget reconciliation rules. "Democrats won an initial procedural vote necessary to allow the lawmakers to begin consideration of the health-care bill." There will now be 20 hours of debate during which time Republicans will "try one last time to make arguments against the sweeping health-care changes" (Boles, Yoest and AP, 3/24).

The Washington Post reports tha,t because of the reconciliation fules, the bill cannot be filibustered. "But Republicans vowed to take full advantage of their right to offer unlimited amendments, intending to sabotage the package and create turmoil among Democrats who are counting on its passage. … Republicans have two goals this week: to use reconciliation rules to strike sections of the package and to offer amendments that prove impossible for Democrats to resist. If the fixes bill is changed in any way, it must return to the House for another vote. House members insisted on the bill as a condition of their passing the Senate's health-care bill, and Speaker Nancy Pelosi (D-Calif.) is expected to keep the chamber in session until Friday in case additional action is necessary." A two-week congressional recess is scheduled to begin this weekend (Murray and Montgomery, 3/24).

The Hill: The first day had seven and one-half hours of the mandated 20 hours of debate. "Another long day and night of debate is expected Wednesday, possibly including an overnight session. A spokesman for Majority Leader Harry Reid (D-Nev.) said a sustained round of voting on amendments and procedural objections — known in Senate terms as a 'vote-o-rama' — could occur as early as Wednesday afternoon. … The evening was filled with sharp exchanges on the Senate floor." 

For instance, Sen. John McCain, D-Ariz., is advancing an amendment "to ban so-called 'sweetheart' deals for several states — basically boosts in Medicaid, Medicare and public hospital funding." In response, "Sen. Mary Landrieu (D-La.) took to the floor to accuse McCain of writing the amendment 'for television or the Internet… not for any serious debate'" (Rushing, 3/23).

Roll Call: Other Republicans are joining the amendment fray. "Sen. Tom Coburn (R-Okla.) unveiled eight amendments he will offer to the health care reconciliation bill, and many of them may prove tough for Democrats to vote against. … Coburn's first amendment deals with the politically sensitive topic of sex offenders. His proposal would ban insurance coverage of erectile dysfunction drugs for child molesters, rapists and other sex offenders" (Pierce, 3/23).

CongressDaily: "GOP leadership aides said they did not know how many amendments Republicans will offer but said they will be plentiful. ... Republicans are also hopeful they can force the House to vote on the legislation again by making the Senate Parliamentarian take out provisions that violate the so-called Byrd Rule on reconciliation that says every provision in the bill must affect the budget in some way (Edney, 3/24).

Related KHN story: How The Senate Will Tackle The Health Bill Now (Carey, 3/21)

Still, there's an air of inevitability in passage of the "fixes" bill that even Republicans are acknowledging.

Politico: "'It's going to pass here,' (Coburn) said matter-of-factly. 'It's a matter of what amendments [Democrats] want to be for and what they're not.' … There is one potential area that could blow up the debate. If Vice President Joe Biden uses his authority to overrule a decision by parliamentarian [Alan] Frumin, it could cause chaos in the chamber because that is so rarely done." Democrats say such a scenario is unlikely (Raju, 3/24).

The Associated Press: The bill's approval "at the end of this week is virtually assured, since it's being debated under fast-track budget rules … If there are only minor changes the House would be almost certain to pass the bill again with little trouble, but if Republicans succeed in knocking out a significant provision or attaching a substantive amendment there could be difficulties in the House, where the legislation passed very narrowly Sunday night" (Werner, 3/24).

USA Today: "Democrats such as Sen. Max Baucus, D-Mont., an architect of the health care effort, tried to cast the legislation as a companion bill that should not require lawmakers to debate fundamental disagreements ... 'We have before us a bill to improve the new law,' said Baucus, chairman of the Senate Finance Committee. 'We do not have to reopen every argument we've had over the last two years'" (Fritze, 3/24).