There are a lot of thorny issues in American politics that require a great deal of concentrated attention to grasp. The controversy over budget reconciliation and health care is not one of them. It's pretty simple, and can be explained in thirty seconds or so. And yet large chunks of the political class seem unable to grasp it.
Before we turn to the principal subject of my latest condescending lecture on this topic, let's briefly review the situation here. Last year, some Democrats considered passing health care reform through budget reconciliation, which would only need a Senate majority. Other Democrats objected, arguing that, since reconciliation bills can only change taxes or spending, it would be very hard to pass a whole health care bill this way. All the features related to regulating insurance companies and setting up exchanges would be stricken out, and the result, as Kent Conrad put it, "would look like Swiss cheese." So Democrats pursued health care reform through the regular process, passing slightly different bills through the House and Senate.
Since a bill can't become a law until the exact same bill passes through each chamber of Congress, and Democrats now lack the ability to break a Republican filibuster, they have a different plan. They'll pass the Senate bill through the House. Then, to appease House members who disapprove of certain Senate features, they'll pass a second bill through reconciliation. This will only address budgetary issues -- some taxes will be raised, others lowered, some spending will be rejiggered. In the grand scheme of things, the changes in the reconciliation bill will be minor. As National Review's Rich Lowry has noted, "Only the House vote matters."
Still with me? Okay. Last weekend, Conrad appeared on Face the Nation to explain this process:
On the question of reconciliation, I have said all year as chairman of the Budget Committee, reconciliation cannot be used to pass comprehensive health care reform. It won't work. It won't work because it was never designed for that kind of significant legislation. It was designed for deficit reduction. So let's be clear.
On the major Medicare or health care reform legislation, that can't move through reconciliation. The role for reconciliation would be very limited. It would be on side-car issues designed to improve what passed the Senate and what would have to pass the House for health care reform to move forward. So using reconciliation would not be for the main package at all.
It would be for certain side-car issues like how much does the federal government put up to pay for the Medicaid expansion? What is done to improve the affordability of the package that's come out of the Senate?
Host Bob Schieffer was totally befuddled:
Let me just throw this in because I'm not sure the White House has the same understanding of this that you do. Because the woman, Nancy DeParle, who is, kind of, in charge of Medicare over there at the White House -- I mean, health care, over there at the White House, said this morning on "Meet the Press" she thought that an up-or-down vote would be the way to go on this.
So, obviously, she's talking about trying to do it through reconciliation, Senator.
And Politico, likewise confused, reported that Conrad "threw cold water on the idea of using the reconciliation process."In fact, Conrad was endorsing the Democratic approach, which is to use reconciliation to make small budget-related changes to a health care bill, but not to pass a whole health care bill.
An irked Conrad commented in an interview with Ezra Klein, "I’ve never seen so much misreporting. It’s like they heard the first three sentences of what I said and not the next three." He proceeded to explain it again:
What I’ve said all year is that reconciliation for comprehensive health-care reform wouldn’t work. It wouldn’t work for two reasons. First, the Byrd rule. The Byrd rule says that only things that score for budget purposes can be in a reconciliation package. If they don’t score, or the score is only incidental to the aims of the policy, they’re subject to strike. That would mean the insurance market reforms and delivery reforms would be stricken. And many of us believe them to be the most important part of the bill. So I never thought reconciliation would work for a comprehensive bill. But we don’t need to use reconciliation for the comprehensive bill. That bill passed with the supermajority, with 60 votes, not using reconciliation.
If the House passes that legislation as well, it can go straight to the president. But there’s a potential role for reconciliation in what we call a sidecar. It’s there to improve or perfect the package, and it only will include items that score for budgetary purposes.
Perhaps suspecting that further explanation was required, Conrad proceeded to write a Washington Post op-ed laying out the distinction one more time:
Reconciliation is not being considered for passing comprehensive health-care reform. Major health-care reform legislation passed the Senate without reconciliation on Christmas Eve. If the House now passes that legislation, it can go immediately to President Obama's desk to be signed into law. What the president and others have suggested is that, after the House acts, reconciliation could then be used to pass a much smaller "fixer" bill to allow for modifications to the comprehensive bill that will have passed under regular order.
When I read the op-ed, I figured it had to be totally redundant. What sentient being who's following this closely could not understand it by now? I give you Politico's Mike Allen, writing Saturday:
When Senate Budget Committee Chairman Kent Conrad (D-N.D.) made this confusing argument last week on “Face the Nation,” we weren’t sure he was being deliberately disingenuous. It was, in fact, spin. Now, he’s made the same case in a similarly obtuse WashPost op-ed, “Reconciliation is not an option for health-care reform.” Don’t misread it: It’s an Alice-in-Wonderland argument FOR the use of reconciliation as part of the recipe for getting comprehensive health reform to the president’s desk
Confusing? Obtuse? Does Conrad need to stop by Politico's offices with a picture book and some finger puppets? I understand perfectly well how intelligent people who don't follow this debate closely might not catch on to the distinction. But this is what Mike Allen does all day -- and, as I understand it, much of the night and the wee hours of the morning as well. How can anybody still not understand this? I'm at a loss here. Look, there's an endless list of topics I don't understand at all. I went through an entire semester of pre-Calculus in high school and was never able to understand what a function is. I still don't. It's a complicated subject and I was a lazy student. But this reconciliation distinction is easy, and Mike Allen is (legendarily) not lazy. So, what the hell is going on here?