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Negotiations Will Occur On Health Care Bill, Progressives Have Every Opportunity To Make Them Fruitful

When I first reported Henry Waxman’s comments that the House and Senate would conference informally on the health care bill and then pass amendments back and forth between chambers rather than have a formal conference, I really didn’t consider it a big deal. It wasn’t even the main part of my story. But many other news organizations picked up on it, calling it a “freeze-out” of Congressional Republicans.

I really don’t understand the logic here. A formal conference committee doesn’t really give the kind of input to the minority party that the AP imputes above. When Republicans controlled Congress, they routinely used the conference committee to strip out anything laudable from bills that was passed through the various chambers. Here’s just one example from former Senator Jim Jeffords:

“As we began 2001, I was hopeful. With a 50-50 U.S. Senate, I expected that moderates would be a strong force and that bipartisanship would prevail. At first, this seemed true. Moderate senators from both parties worked together to make significant changes to the president’s budget when it was considered in early April. We were able to reduce the size of the tax cut from $1.6 trillion to $1.25 trillion and to add $450 billion for education. But when we sent that bill to the House-Senate conference committee, all our work, including the $450 billion for education, was stripped out of the final compromise. There were no moderates on the conference committee; it was totally controlled by the Republican leadership and the White House. More than simply disappointing, the events were a clear signal to me that the Republican leadership had no intention of working with the moderate wing of the party. Something radical needed to happen.”

Democrats are foregoing a conference committee for two reasons – to quicken the process on the front end (Republicans would have been able to delay the management of a formal conference committee for a few weeks) and to allow for flexibility between the proposals between the House and Senate, with the possibility of adding new compromise items. I have problems with Congress basically bypassing its own ethics reform law so new provisions can be air-dropped into a reconciled bill, and that’s why larger bills pretty much have opted for ping-ponging instead of conference committees. But that’s not really to cut Republicans out of the deal. They’ve made every intention known that they’re not voting for the bill anyway, and they would be outvoted in a conference committee regardless. That to me is just whining.

I think C-SPAN’s request to televise negotiations between the House and Senate on the health care bill is laudable, but let’s be honest, it’s probably not going to happen. Many progressives are concerned that a back-room negotiation will cut them out of any dealmaking. The proper answer to that is for them to make it publicly known that they won’t vote for a bill without certain items. With such a narrow margin for error, this would have the effect of opening up the negotiations and forcing them to be carried out in public. So it’s not like progressives in Congress don’t have options.

They’d certainly have plenty of backup. Health Care for America Now, the lead coalition of reform advocates, is clearly standing behind the House bill and even running ads along those lines. Any Democrat in the House or Senate could run with these proposals and demand their inclusion or else their vote is not assured. The response would be a one-way ticket to the negotiating table.

Low and middle income families must be able to afford health insurance, and employers must be asked to provide good health coverage for their employees so health care is affordable at work. Health care should not be paid for with a tax on health benefits.

If the insurance companies win, we lose. Insurance companies must be held accountable with strong regulations and consumer protections, and we must be given the choice of a national public health insurance option available on day one across the United States.

Those aren’t the only areas, there are quite literally dozens of major discrepancies between the House and Senate bills, and on most counts the House’s is superior. I encourage you to read this report from the House Tri-Committee detailing all the differences, including some things I had previously missed. Just as an example, the Senate bill grandfathers in all employer plans offering their existing level of coverage, even if it falls well below the minimum benefit guarantee. The House bill gives employers five years to improve their coverage, and that’s it.

The fact that leadership put out this document suggests they know well what needs defending in the House bill, and while they’re unlikely to get all of it, there will certainly be a negotiation.

So there will be negotiations aimed at reconciling the two bills, beginning today with a leadership meeting. And because of the nature of the party-line vote, virtually everyone who voted for the bill previously will have a chance to shape that negotiation. It’s all a matter of what they’re willing to do to get what they want.

UPDATE: David Waldman has some related thoughts.

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David Dayen

David Dayen