It’s Time To Enact Health Care With 51 Senate Votes

This week the President is hosting a bipartisan gab-fest at the White House to try to tease out some Republican votes for health care. It’s a total waste of time. If Obama thinks he’s going to get a single Republican vote at this stage of the game, he’s fooling himself (or the American people). Many months ago, you may recall, the White House and Democratic leaders in the Senate threatened to pass health care with 51 votes – using a process called “reconciliation” that allows tax and spending bills to be enacted without filibuster – unless Republicans came on board. It’s time to pull the trigger.

Why haven’t the President and Senate Dems pulled the reconciliation trigger before now? I haven’t spoken directly with the President or with Harry Reid but I’ve spent the last several weeks sounding out contacts on the Hill and in the White House to find an answer. Here are the theories. None of them justifies waiting any longer.

  • Reconciliation is too extreme a measure to use on a piece of legislation so important. I hear this a lot but it’s bunk. George W. Bush used reconciliation to enact his giant tax cut bill in 2003 (he garnered only 50 votes for it in the Senate, forcing Vice President Cheney to cast the deciding vote). Six years before that, Bill Clinton rounded up 51 votes to enact the Children’s Health Insurance Program (CHIP), the largest expansion of taxpayer-funded health insurance coverage for children in the U.S. since Medicaid began in the 1960s. Through reconciliation, we also got Medicare Advantage. Also through reconciliation came the COBRA act, which gives Americans a bit of healthcare protection after they lose a job (“reconciliaton is the “R” in the COBRA acronym.) These were all big, important pieces of legislation, and all were enacted by 51 votes in the Senate.
  • Use of reconciliation would infuriate Senate Republicans. It may. So what? They haven’t given Obama a single vote on any major issue since he first began wining and dining them at the White House. In fact, Senate Minority Leader Mitch McConnell and company have been doing everything in their power to undermine the President. They’re using the same playbook Republicans used in the first two years of the Clinton administration, hoping to discredit the President and score large victories in the midterm elections by burying his biggest legislative initiative. Indeed, Obama could credibly argue that Senate Republicans have altered the rules of the Senate by demanding 60 votes on almost every initiative – a far more extensive use of the filibuster than at any time in modern history – so it’s only right that he, the President, now resort to reconciliation.
  • Obama needs Republican votes on military policy so he doesn’t dare antagonize them on health care. I hear this from some quarters but I don’t buy it. While it’s true that Dems are skeptical of Obama’s escalation of the war in Afghanistan and that Republicans are his major backers, it seems doubtful R’s would withdraw their support if the President forced their hand on health care. Foreign policy is the one area where Republicans have offered a halfway consistent (and always bellicose) voice, and Dick Cheney et al would excoriate them if they failed to back a strong military presence in the Middle East. This is truer now than ever.
  • Reid fears he can’t even get 51 votes in the Senate now, after Scott Brown’s win. Reid counts noses better than I do, but if Senate Dems can’t come up with even 51 votes for the healthcare reforms they enacted weeks ago they give new definition to the term “spineless.” Besides, if this is the case, Obama ought to be banging Senate heads together. A president has huge bargaining leverage because he presides over an almost infinite list of future deals. Lyndon Johnson wasn’t afraid to use his power to the fullest to get Medicare enacted. If Obama can’t get 51 Senate votes out of 58 or 59 Dems and Independents, he definitely won’t be able to get 51 Senate votes after November. Inevitably, the Senate will lose some Democrats. Now’s his last opportunity.
  • House and Senate Dems are telling Obama they don’t want to take another vote on health care or even enact it before November’s midterms because they’re afraid it will jeopardize their chances of being reelected and may threaten their control over the House and Senate. I hear this repeatedly but if it’s true Republicans have done a far better job scaring Americans about healthcare reform than any pollster has been able to uncover. Most polls still show a majority of Americans still in favor of the basic tenets of reform – expanded coverage, regulations barring insurers from refusing coverage because of someone’s preexisting conditions and preventing insurers from kicking someone off the rolls because they get sick, requirements that employers provide coverage or pay into a common pool, and so on. And now that many private insurers are hiking up premiums, co-pays, and deductibles, the public is even readier to embrace reform.

So what’s been stopping Obama from using reconciliation? Even if some of the arguments held water before now, none does any longer.

My free advice to the President: If you want to get healthcare enacted you must use reconciliation and quickly. Host your bipartisan gab fest at the White House on Thursday. Tell Republicans you’ve been eagerly awaiting their ideas for over a year, but the American public can’t wait any longer. Explain to them how our current economic mess is directly related to the health care mess — we’re paying 16 percent of our GDP for health care while health insurers are hiking rates and Americans are losing their health insurance every day.

robert_reich.jpgThen tell the House and Senate to get to work on putting their bills together (or tell the House Dems to enact the Senate bill and then save their disagreements for reconciliation), and tell Harry Reid you want the Senate bill on a fast track of reconciliation.

Explain to the American people you understand their impatience. The Constitution does not require 60 votes in the Senate to pass legislation. A majority will do. That’s called democracy.

by Robert Reich

This article first appeared on Robert Reich’s Blog. Republished with permission


  1. MyLeftMind says

    Huh, that’s funny Elaine, I thought Robert Reich wasn’t being progressive enough. He’s still pushing for passage of the “Insurance Industry Profit Protection and Enhancement Act” even though Obama has completely abandoned the public option. The current bill will force us by law to buy insurance, not health care. We’ll forever lose the opportunity to pool our resources to create a viable and sustainable health care system in America. We’ll be forced to pay the very insurance companies that have destroyed our health care system with their greed. Sound familiar? Obama did the same thing for the banksters, and most liberals didn’t bat an eye. BTW, don’t believe him when he says the rich will pay for this new boondoggle. The middle class always has and always will pay the government’s bills. The Democrat’s faux healthcare reform is simply another wealth redistribution scheme from the middle class to the super rich, albeit with built in healthcare-welfare for the poor and those who choose to suck off the system. Still, the middle class is going to get soaked once again.

    We need to stop blindly trusting our Democrats in Congress. Many of them are bought and paid for by the insurance industry just like Republicans are. If progressives want true healthcare reform, we need to demand Obama and Congress drop the individual mandate and simply give us a public option in the form of expanded Medicare at cost, along with the sensible reform ideas in the bill (allow purchasing across state lines, remove preexisting condition limitations, reduce prescription prices by removing Bush era constraints, create the exchange and find ways to get Medicaid recipients into it, and tort reform to reduce out of control medical malpractice claims).

    This solution I’m suggesting is not socialized medicine or a government takeover, because people can still choose to pay the rip-off insurance companies if they want. By providing the public option at a less expensive price than what for-profit insurance companies can offer, with a the additional reform ideas that stabilize the non-federal system, we’d be actually utilizing our government for one of its major purposes – the opportunity to pool our resources to create systems that can provide more than what individual citizens could have on their own. Like roads and environmental programs, the government is the perfect vehicle to allow us to join forces and create a viable and sustainable health care system in America. But we’re not going to get there unless we get the insurance industry out of the loop. The fact that they actually wrote parts of Obama’s bill, and that he had secret meetings with industry leaders, should be a clue that this bill won’t be in our best interests.

    Robert, I hope you’ll stop encouraging people to support Obama’s plan. It’s a false choice to assume we need this plan or we’ll get nothing done. We actually can and should demand Obama and our Democrats give us true healthcare reform, not this faux reform that codifies yet another wealth redistribution scheme from the middle class to the super rich.

  2. Elaine says

    By the way. GOP have a plan that has been on the internet for a while now. Obama just doesn’t like it because he cannot get control of us & cannot collect taxes from us on GOP plan.

  3. Elaine says

    Robert Reich is a Progressive that does not know what he is talking about or else he wants 1/6 of the economy to be taking over by the government. We do not want health care like they have in the UK or Canada. It is a rationed, socialized, government run that is going to cost us more & give us less coverage. And if you are in your 60’s you might as well realize that you are not going to be considered a worthwhile save & certain costs you will not have the advantage of. You will just be sent home to die with pain pills.
    Why to you think people in the UK or Canada that can afford to come to the states to get medical care because they can’t get it in their own countries & will die from the disease? How stupid do you want us to be? The Congress, the Senate, Obama & his administration & czars & the Great Almighty Unions all get to keep their good insurance while they ram this stuff down our throats. They work for us, We do not work for them. So if this plan of theirs is so good why aren’t they going to have to take it but we do? Wake Up People! They are treating us like 2nd class citizens. 85% of us have insurance & want to keep it but if this bill passes government will put them out of business & eventually we will all be on this rationed health care. NO THANK YOU! Robert Reich you better explain yourself better to the American people before calling for a 51 vote.Tell people what this health care bill really is! If they push through with only 51 votes there will be a lot of them that will become history. We are a free country not a socialist country.

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