Health Care For America Now

Democrats may have the votes to pass the budget with reconciliation language for health care, so says The Hill:

Democrats appear to have the votes for a budget measure that would allow reform of the nation’s healthcare system with just 51 Senate votes.

Centrist Democrats said they could support the special reconciliation budget process to push ahead healthcare reform, even though many of them voted to ban the use of reconciliation rules for climate change regulations earlier this month.

If true, this means the option of using reconciliation will be on the table, and a minority of Senators won't be able to block health care reform. To say this would be a huge victory would be an understatement. Bill Clinton, for one, has called not using the reconciliation process his biggest mistake during the doomed health care fight of 1993.

As The New Republic explains, reconciliation has been used by Republicans to do all sorts of things over the last 20 years, which means health care fits in the mold quite well:

Whether reducing or increasing deficits, many of the reconciliation bills made major changes in policy. Health insurance portability (COBRA), nursing home standards, expanded Medicaid eligibility, increases in the earned income tax credit, welfare reform, the state Children's Health Insurance Program, major tax cuts and student aid reform were all enacted under reconciliation procedures. Health reform 2009 style would be the most ambitious use of reconciliation but it fits a pattern used over three decades by both parties to avoid the strictures of Senate filibusters.

…

The best path would be to have reconciliation as an implicit or explicit threat: if Democrats can employ it to accomplish the policy goal with only a simple majority, Republicans may be persuaded to abandon efforts to use their 41 votes to just say no and instead engage the majority constructively to find common ground. But if that is not feasible, it is perfectly reasonable for Democrats to use the process for health care reform that both parties have used regularly for other major initiatives. The result might be more piecemeal and imperfect, but it would be better than the alternative of no bill at all.

It seems this idea has broad support from Democrats, even the more conservative members. The Hill's reporting is filled with quotes from the likes of Sen. Bob Casey Jr., Sen. Jon Tester, Sen. Debbie Stabenow, Sen. Dick Durbin, and Sen. Charles Schumer supporting the option of reconciliation, and even people like Sen. Mark Pryor and Sen. Evan Bayh, who harshly criticized Obama's budget, are not ruling out the suggestion.

And, if the nearly party-line vote on Kathleen Sebelius's HHS nomination in the Senate Finance Committee yesterday is any indication, we may need the option to overcome Republican obstructionism, as Schumer hints:

"I was surprised by the fact that so few Republicans supported a moderate, qualified candidate like Governor Sebelius. It's an ominous signal of the level of cooperation we can expect from the Republicans on health care. Maybe the Republicans are telling us they want us to pass healthcare reform through the budget reconciliation process."

We've only seen obstructionism from Republicans thus far, and they don't have an alternative health care plan to add substance to their objections. I think it's safe to predict obstructionism over health care, which is why we need the reconciliation option.

Update: The New York Times is hearing similar things. Looks like reconciliation is definitely a possibility.