To pass healthcare reform, Democrats may go it alone

Party leaders may have settled on a healthcare reform strategy: muscle through legislation with only Democratic votes. But House Speaker Nancy Pelosi will face defections.

Democrats have paused and considered their options. Now party leaders may have settled on a healthcare-reform strategy: It appears they’re going to shoulder up one more time and try to muscle through legislation with only Democratic votes.

President Obama is expected to provide more details about his healthcare ideas later in the week. But at the moment, all signs point to a decision whereby the House will consider the bill that passed the Senate with 60 votes last December.

Then the Senate would take up a separate piece of legislation that would change the original bill to make it more palatable to key House Democrats.

This last Senate vote would take place under reconciliation rules, which require only a simple majority, instead of 60 votes, for passage. (Click here to read more about reconciliation.)

“I believe we will have the votes to pass this in Congress,” said Nancy-Ann DeParle, director of the White House Office of Health Reform, Sunday on NBC’s “Meet the Press.”

Here are some key questions that pertain to the developing strategy:

Does Nancy Pelosi have the votes? After months in which the White House agonized over obtaining the 60 votes needed to get a comprehensive healthcare bill through the Senate, now the administration has a new magic number to aim at: 217.

That’s the number of votes House Speaker Pelosi right now would need to pass that Senate bill. (That figure might bounce around a bit, depending on the timing of some upcoming lawmaker resignations.)

Pelosi says she’ll be able to produce that may “ayes.” “Our members, every one of them wants healthcare. They know that this will take courage,” she said Sunday on ABC’s “This Week.”

But the House passed its own version of healthcare reform with a bare five-vote majority. Pelosi will face defections from conservatives who oppose the Senate bill’s more liberal language regarding abortion, and liberals who oppose its less-generous subsidies for insurance purchase.

Is it fair to use reconciliation? Democrats argue that the Senate has already passed its main legislation and that using reconciliation to pass a further package of fixes is entirely fair.

Ms. DeParle on Sunday said that the Senate already approved healthcare reform with a supermajority of 60 votes, and that the nation needs to move on.

“All the president is talking about is: Do we need to address this problem, and does it make sense to have a simple up-or-down vote on whether or not we want to fix these problems?” she said.

Republicans point out that Democrats are resorting to reconciliation because their 60-vote margin in the Senate no longer exists. Reconciliation is meant to be used to bring bills into line with budget projections, and using it in the manner Democrats appear to intend is not proper, argues the GOP.

“We should not be addressing these issues though 51 votes,” said Sen. John McCain (R) of Arizona Sunday on NBC’s “Meet the Press.”

Should sweeping change require bipartisanship? The healthcare-reform effort involves what is arguably the most sweeping domestic legislation in a generation. Is it bad for America if that does not gain two-party support?

In 1935, Social Security was enacted with large majorities of both parties. Half of the GOP caucus backed Medicare when it was enacted.

Republicans say that healthcare represents too big a portion of the economy, and is too sensitive a topic for many Americans, to pass without substantial participation and support from the minority party. They point to polls that show most US respondents don’t want the overall current bills to be enacted.

“I’m afraid [Democrats] are aiming towards what is a political kamikaze mission,” said Sen. Lamar Alexander (R) of Tennessee on Monday in a Fox News Channel interview.

Democrats reply that they have tried to win over the GOP, and failed, and that they should not give up in the face of partisan obstruction.

“I believe that the president will keep fighting and that the American people want to have this kind of health system,” said DeParle of the administration’s current effort.