Back in the spring, there was a lot of talk about whether reconciliation could be used as a vehicle to get health reform through Congress (particularly the Senate). The FY 2010 budget resolution ultimately left the option open for Congress to use reconciliation for health reform if an agreement couldn’t be reached by October 15th. The issue has been on the back burner while Senate negotiators continue to try to forge a bipartisan plan but it is moving to the forefront as we move closer to the deadline.

In a recent blog entry on the Huffington post, Representative Keith Ellison (D-MN) argued that conservative intransigence gives policymakers the green-light to move forward with moving health reform through using the reconciliation bill. As we approach the deadline, we thought it would be a good time to refresh our understanding of the reconciliation process by re-posting the comments by guest blogger Edwin Park from the Center on Budget and Policy Priorities.

Here’s a condensed version of Edwin’s earlier post:

What is Reconciliation?

First, the basics.  A reconciliation bill is a single piece of legislation that typically includes multiple provisions (generally developed by several committees) all of which affect the federal budget — whether on the mandatory (or entitlement) spending side, the tax side, or both.  Under House and Senate rules implemented when the Democrats took control of Congress in 2007, reconciliation cannot be used for legislation that would increase the deficit so any reconciliation bill must be fully offset, that is it must include mandatory savings and/or revenue increases that pay for any higher spending and/or tax cuts in the bill.  Reconciliation, of course, can also be used, as it was originally, to reduce the deficit.  Reconciliation is generally used to speed passage of legislation through the Senate by providing special procedures that make it easier for a bill to pass.


Most importantly, reconciliation bills only require 51 votes to pass.
Under the Senate’s regular rules, 60 votes are needed to prevent a
minority of senators from blocking legislation through a filibuster
(i.e., by refusing to stop debating the measure), but reconciliation
legislation cannot be filibustered.  Accordingly, the use of
reconciliation makes it easier for the party in charge of the Senate to
pass a bill and thus can be seen as a partisan procedural tool.  In
fact, reconciliation was used to help Presidents Reagan, Clinton, and
George W. Bush (with his 2001 tax cut legislation, which increased the
deficit) overcome opposition and enact important legislation in their
first year in office.  But it also has been used to facilitate passage
of legislation that enjoyed strong bipartisan support, as was the case
for the big deficit reduction package enacted in 1990.
 

Reconciliation and the FY 2010 Budget Resolution

Reconciliation instructions to the House and Senate Committees with
jurisdiction over health care reform were included in the FY 2010
budget, but only as a fallback if the Senate is unable to pass health
reform under regular floor procedures.  For now, the looming October
15th deadline is keeping the pressure on Congress to produce bipartisan
legislation that can secure 60 votes in the Senate. 

Is Reconciliation a 51-vote Panacea for Health Reform?
 
As Congress debated its budget resolution this year, budget
reconciliation often was described as a way for Democrats to guarantee
that they could pass legislation with only a simple majority.  It is
true that reconciliation affords a major advantage once legislation
gets to the Senate floor but the process also entails very strict
limits about what types of legislative provisions can be included in a
reconciliation bill.

A key limitation is the “Byrd rule,” named after Senator Byrd of West
Virginia.  This rule dictates that all provisions in a reconciliation
bill must have a fiscal impact.  If they don’t, they are deemed
“extraneous” by the Senate Parliamentarian and dropped from the bill
unless 60 Senators vote to waive the prohibition against such
provisions.  The Byrd rule therefore gives those who oppose the bill an
opportunity to reject any waivers and thereby force key pieces of the
legislation to be dropped.  

Many policy changes that are necessary to truly reform our nation’s
health care system may not pass this fiscal impact test.  For example,
insurance market reforms, which are a critical element of guaranteeing
access to affordable coverage, may not have an impact on the federal
budget and could be dropped from the bill (though they may have an
effect on other elements of the bill, such as subsidies for the
purchase of health insurance, that do have a fiscal impact).  As a
result, Congress would likely need to package together the needed
reforms that are determined to not have a fiscal impact and move them
in a separate piece of “sidecar” legislation.  

This companion legislation, however, would be considered under regular
Senate rules and could be easily filibustered.  In other words, even
though reconciliation legislation can pass with a simple majority, to
truly accomplish health reform, the Senate would likely need to
consider a second piece of legislation that would need 60 votes. 
Securing such support could be difficult.

Moreover, as noted earlier, under the rules adopted by the Democrats,
the reconciliation process cannot be used to increase the deficit.  Yet
the mandatory savings and revenue increases that are needed to offset
the cost of health reform are turning out to be some of the most
controversial elements of the legislation to both Republicans and
Democrats. While a reconciliation bill would require only 51 votes,
there does not appear yet to be a firm consensus even among Senate
Democrats about how to pay for the bill.  While a divided caucus could
still pass a health reform reconciliation bill, that may prove to be
difficult for the Senate Democratic leadership to do.  

So, while it is true that reconciliation could speed the way to pass
health legislation, reconciliation is not a panacea.  If bipartisan
efforts fail to produce a Senate bill that can garner 60 votes,
reconciliation doesn’t mean that we’re home free.  Difficult
considerations and limitations will remain if Congress sets out to
craft legislation that complies with reconciliation’s rules. 
Reconciliation gives us a welcome “Plan B”, but the hope is to secure a
good health reform bill that enjoys bipartisan support.

The views expressed by guest bloggers do not necessarily reflect the views of the Center for Children and Families.