Almost all of the attention as of late has been on the Senate, but the House of Representatives could prove decisive in the battle to reform America’s ailing health care system. Both chambers have already passed separate versions of the bill with the Senate voting 60-40 and the House 220-215. The House passed their version of the bill in November with the Senate voting on Christmas Eve. The President’s health care summit does not appear to have changed the math.
Percentage wise, the vote was a lot closer in the House than it was in the Senate. The reason that the Senate got all of our attention was because of the Republican’s obstruction tactics, namely the filibuster, which requires 3/5 for passage instead of a majority vote. The President and Democratic leaders in the Senate appear to be ready to break the Republican’s filibuster attempts by passing a “fixed” version of the bill using a procedural device known as reconciliation.
It’s worth noting that Republicans attacking Democrats for using procedural shortcuts are themselves using procedural roadblocks. The filibuster is not in the Constitution and it is not even a law. It is simply a rule within the Senate which can be revised at the start of each Congress. Reconciliation, however, is in fact a law that was passed in the 1970s to reconcile budget issues. This is exactly what Democrats are likely to use it for as they will make changes to their original bill such as how to pay for it.
Going back to the House, though, it is unlikely that Speaker Pelosi currently has the votes to pass the Senate bill. There are two major hurdles that Democrats will need to face before President Obama can finally sign the bill. The first is that Democrats have literally lost three of their members from resignations and a death. Representative Jack Murtha recently passed away, Rep. Neil Abercrombie resigned to focus on his bid for governor of Hawaii and Robert Wexler resigned to head the Center for Middle East Peace and Economic Cooperation. In other words, with these vacancies, the Democrats stand at 217-215, not enough to pass the bill. A majority of the chamber is 218. The sole Republican to vote with Democrats, Joseph Cao, has stated that he will likely vote against it the second time. That puts Democrats two votes short of a majority.
Is it possible for Nancy Pelosi to strong-arm Democrats that voted against the bill to vote for this revised bill? Certainly it is possible, she could threaten everything from fundraising to committee spots, but most of the Democrats that voted no are conservatives from mostly rural and/or Southern districts. She could make the argument that even Democrats that voted against the health care bill are in big trouble – perhaps because they are undercutting their base. In New Mexico, Harry Teague is trailing former Congressman Pearce by two points, even though he voted against the original bill. Would he be in a stronger position if he had voted to extend insurance benefits to the 45 million that currently live without it? Probably, especially in a relatively poor state like New Mexico.
The second problem for Democrats in the House is the issue of abortion. Bart Stupak of Michigan was successful in passing an amendment that would ban any insurance policies from covering an elective abortion in the bill’s insurance exchange, which would include policy choices from both private and public insurance plans. Democrats in the Senate sought to continue the ban on any public funds going towards abortion, but did not want to restrict private insurance plans in the exchange from offering it. It’s questionable whether pro-life Democrats will vote for the House bill if the Stupak amendment is not present and it’s equally questionable whether pro-choice Democrats will vote for a bill that includes it.
According to CNN, due to the vacancies, the majority in the House is now 217.