'Reconciliation' May Not Save Democrats' Health Bill
GUY RAZ, host:
Reconciliation may not be the first thing that comes to mind when you think about the relationship between Democrats and Republicans these days. But reconciliation, the congressional procedure, is very much on the minds of many Democrats. Having lost their filibuster-proof 60th vote in the Senate, some think reconciliation is the key to passing health care overhaul.
But what is reconciliation?
Sarah Binder is a senior fellow at the Brookings Institution. And she's here to break it down for us.
Professor SARAH BINDER (Senior Fellow, Governance Studies, Brookings Institution): Hi, there.
RAZ: Let's start with the obvious question: Explain reconciliation.
Prof. BINDER: Okay. Reconciliation is one part of a much larger process by which Congress sets the budget for the federal government. When Congress passes a budget resolution at the beginning of the process, it sets targets: How much will we spend, how much will we take in? And when it sets those targets, if it turns out that Congress actually has to change the laws in order to meet those targets, you do that in reconciliation.
So let's say Congress says we want to spend less on Medicare. Well, the only way to do that is it pass a law that changes Medicare.
RAZ: And you don't need 60 votes in the Senate to do this. You just need a majority to get it passed.
Prof. BINDER: Well, the way the process was written in the 1970s is absolutely, they put a time limit on how much could be spent debating reconciliation. And almost by definition, that means you really can't filibuster it, you just need 51 votes.
RAZ: But originally, it was just meant to be a fine tuning mechanism to deal with issues of spending and taxation, right?
Prof. BINDER: Absolutely. Reconciliation wasn't anticipated to be a sort of vehicle for major policy change. It was anticipated to be this sort of cleanup mechanism.
Prof. BINDER: But remember, it's also being created in 1974 when Congress is in the middle of a huge dispute, a constitutional dispute with President Nixon over spending. And in order to protect Congress' ability to legislate, they put the filibuster ban in there to make sure that its decisions go through quickly.
RAZ: So let's fast-forward now. How does this all relate to health care?
Prof. BINDER: Well, the possibility here is that reconciliation could be used because, of course, to change health care laws. We're talking about how taxes are raised to pay for health care. And we're talking about revenues to be saved by changing Medicare law. So the opportunity arises to use reconciliation to make those changes in laws affecting health care.
RAZ: Can they use reconciliation to push through the bill that the Senate has already agreed on?
Prof. BINDER: What's envisioned is a two-part process here. First, that the House would take up that Senate-passed bill and vote for it, approve it, and thus essentially get it ready for the president to sign. But then, at the same time, they would like the Senate - to go, going first - to pass a fix through reconciliation to take care of things like the Cadillac tax and other issues that they think are acceptable under reconciliation.
And then you'd have two bills ready for the president. He would sign the larger health care overhaul first and then sign the reconciliation fix into law.
RAZ: Has reconciliation ever been used to achieve major policy decisions?
Prof. BINDER: There have been 19 uses of reconciliation. And, in fact, major changes have occurred in them. We've seen welfare reform in the 1990s. We've seen tax cuts in 2001 and 2003. We've seen what we all call COBRA, right, changes that allow us to keep our health insurance when we leave a job. All those were done through reconciliation.
RAZ: So, do you think it's likely that Democrats will turn to reconciliation in the end to try and get health care passed?
Prof. BINDER: I think there a lot of steps and hurdles that have yet to be addressed here. Over the years, Congress, and the Senate in particular, have clamped down, or tried to clamp down, on the use of reconciliation for major policy changes, and they've done that through the creation of what's known as the Byrd rule, named for Senator Robert Byrd.
The Byrd rule says you can't put things into reconciliation if they don't affect spending revenues. And it's not quite clear that all of health care reform - say, banning insurance companies from imposing pre-existing condition limits - it's not clear that all of health care reform can actually fit under and be kosher under the reconciliation process.
Prof. BINDER: Why is that a problem to get rid of the Byrd rule? If someone says, whoop, you're violating the Byrd rule, it actually takes 60 votes to waive the Byrd rule. So it's not the great majoritarian solution that it's often made out to be, right? There are supermajority thresholds built into reconciliation.
RAZ: Sarah Binder is a congressional expert and a senior fellow in governance studies at the Brookings Institution.
Sarah Binder, thanks so much for coming in.
Prof. BINDER: Thanks for having me.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.