Dems split over how to push health agenda

Speaker Nancy Pelosi (D-Calif.) and Senate Finance Committee Chairman Max Baucus (D-Mont.) have a major disagreement over how to handle healthcare reform, one of President Obama’s biggest priorities.

Baucus wants to win Republican support for an overhaul of the nation’s healthcare system but Pelosi is willing to ram it through Congress with only Democratic votes.

{mosads}The difference boils down to an arcane procedural issue known as budget reconciliation. Handling healthcare reform under reconciliation would protect it from a GOP filibuster in the Senate.

The procedure was set up originally to make it easier for lawmakers to balance the budget but it has since been used to pass major legislative initiatives only tangentially related to fiscal housekeeping, such as the Bush tax cuts of 2001.

Pelosi told reporters Thursday morning that the House would push for protecting a future healthcare reform package under budget reconciliation. Indeed, the budget resolution passed by the House Budget Committee late Wednesday night would place a future healthcare reform package under budget reconciliation protection.

But Baucus, the Senate Democrats’ point man on healthcare reform, says this is a terrible idea.

“Reconciliation would hurt healthcare reform, it would make it partisan, it would hurt, it would stymie, it would make it very partisan,” Baucus told reporters recently. “The reconciliation route allows the Robert C. Byrd point of waiver to apply, which means that a point of [objection] lies against any provision that does not immediately raise revenue or cut spending. Healthcare reform is so large, you’re going to have many provisions that are not directly related to revenue or directly related to spending.”

Baucus also said that putting healthcare reform under budget reconciliation would require that it be sunset after five years, after the pending budget resolution is expected to expire. For example, the largest of the Bush tax cuts that passed under reconciliation in 2001 are set to expire at the end of next year.

“It has to be term-limited five years; that’s nuts,” said Baucus. “If we want meaningful healthcare reform we can’t keep coming back here every five years and redoing this thing. … Reconciliation is not a good idea.”

Baucus also said that the only way to pass “sustainable” healthcare reform would be to attract Republican support, with which reconciliation protection would not be necessary.

“If [Republicans] are on board, then it’s sustainable; otherwise, it’s partisan and it’s less sustainable.”

Senate Budget Committee Chairman Kent Conrad (D-N.D.) did not include budget reconciliation protection for healthcare reform in his proposal, a decision Baucus has applauded.

Pelosi, on the other hand, is skeptical that healthcare reform can survive Republican opposition in the Senate without reconciliation protection.

She told reporters that a healthcare reform package should pass Congress this year and she dismissed the objection that passing reform under reconciliation would set too partisan a tone for the healthcare reform.

“This is not only about the health of individuals in our country, which would be justification enough; it’s about competitiveness of our businesses,” Pelosi told reporters.

Pelosi noted that Republicans did not show any compunction over using reconciliation to ram Bush’s tax cuts through the Senate eight years ago.

House Democrats also claim that reconciliation would not necessarily require healthcare reform to sunset after five years. If the cost of reform is fully offset by tax increases or spending cuts, the so-called Byrd Rule would not apply after the expiration of the budget. But it is unclear whether deficit-neutral reform can pass the Congress.

Senate Majority Leader Harry Reid (D-Nev.) weighed in Thursday afternoon on the disagreement between Baucus and Pelosi, voicing his support for Baucus’s strategy for reforming healthcare.

Reid told reporters that reconciliation would not be included in the Senate budget. He also said that Baucus should be given a chance to win Republican support for reform before resorting to reconciliation protection.

“I am hopeful that the project that Sen. Baucus is engaged in, that is to do a bipartisan healthcare bill, will bear fruit. I think it can be done,” Reid told reporters. “We believe very strongly that Sen. Baucus should have an opportunity to see what he can do on a bipartisan basis.”

Democratic leaders in the House and Senate will resolve the dispute when they negotiate a joint budget resolution in conference talks later this spring.