As we no doubt all know, yesterday President Obama and several lawmakers spent more than seven hours talking past each other at the Blair House. Probably the most dramatic thing to come out of the meeting was the (renewed) Democratic threat to use Budget Reconciliation to push a HCR bill past a threatened filibuster. This isn't the first time this idea has been bandied about, but the threat carries more weight now that Democrats only hold 59 seats in the Senate. Republicans countered, predictably for the opposition party, that such a move is unprecedented and not appropriate for such sweeping social reform. Former Senate Majority Leader Bill Frist argued such last night on WSJ online.
Senators of both parties have assiduously avoided using budget reconciliation as a mechanism to pass expansive social legislation that lacks bipartisan support. In 1993, Democratic leaders—including the dean of Senate procedure and an author of the original Budget Act, Robert C. Byrd— appropriately prevailed on the Clinton administration not to use reconciliation to adopt its health-care agenda. It was used to pass welfare reform in 1996, an entitlement program, but the changes had substantial bipartisan support.
Since 1980, Budget Reconciliation has been used (and not vetoed) 19 times. (link is .pdf) Fourteen of those times, or 74% of the time, it was a Republican congress that has done so. The largest uses, in terms of net effect on the deficit, were:
In today's dollars, those are roughly equivalent to $670b, $738b and $398b respectively.
I'm not entirely decided on the Budget Reconciliation idea. I think Frist does have a point that HCR reform is more expansive than Bush's two rounds of tax cuts, Clinton's welfare reform and tax increases/spending cuts, and Reagan's tax and welfare/spending cuts. On the other hand, the Republican's complete refusal to participate in the process leaves the Democrats without many alternatives. Both McCain and Boehner have said they want to scrap the bill and start over from scratch. This could be shrewd political strategy. Another 9+ months of debate will probably help the Republicans this fall.
Yesterday, as the meeting was going on, I heard a congressman (Democrat I think - I wish I had caught his name) on the radio talking about the 3 legs of the Health Care Reform stool. The first was coverage for preexisting conditions. There seems to be broad bipartisan support for this idea. The congressman's point was that mandating that insurance companies cover preexisting conditions necessarily requires mandating universal coverage, which in turn necessitates government subsidies (the second and third legs of his stool). I wonder what the Conservative or Libertarian response to this is? Do they not want coverage for preexisting conditions? Or are they willing to mandate universal coverage? And if so, are they willing to subsidize insurance for the poor? Or are there other solutions to these two problems? These seem like deal breakers to me, which lends credence to the thought that Health Care Reform (that includes coverage for preexisting conditions) will not be possible without resorting to Budget Reconciliation.