The Health Care Nuclear Option, also known as reconciliation, is being considered by liberal politicians to insure that Obamacare makes it to the President’s desk by Easter. According to The New York Times, the plan is to have the President submit reconciliation legislation to be posted on the internet this weekend. The legislation will be crafted in a manner so that it can be passed using special reconciliation procedures created solely to enact laws to reduce the deficit as part of the annual budget. The next step is for the President to conduct his half day bipartisan summit at the Blair House on February 25th. With that faux-bipartisan stunt over with, the President will be free to pass legislation in a partisan manner that tosses aside the regular rules of business in the Senate.
Here is how the NYT writes it up:
President Obama will put forward comprehensive health care legislation intended to bridge differences between Senate and House Democrats ahead of a summit meeting with Republicans next week, senior administration officials and Congressional aides said Thursday.
The legislation is being crafted in a way to allow for partisans in the House and Senate to pass the legislation without any support from Republicans and it a way that avoids a 60 vote threshold of a filibuster in the Senate.
Democratic officials said the president’s proposal was being written so that it could be attached to a budget bill as a way of averting a Republican filibuster in the Senate. The procedure, known as budget reconciliation, would let Democrats advance the bill with a simple majority rather than a 60-vote supermajority.
Yet again, the Obama Administration has tossed aside transparency and has crafted this legislation behind closed doors. Not even all Congressional Democrats have been looped into this secret proposal:
During a conference call on Wednesday night, the House speaker, Nancy Pelosi, told the White House chief of staff, Rahm Emanuel, and the Senate majority leader, Harry Reid, that she could not agree to a proposal until rank-and-file lawmakers returned from a weeklong recess. A House Democratic caucus meeting is set for Monday evening. … Kathleen Sebelius, the secretary of health and human services, said the president would “take some of the best ideas” from the House and the Senate and “put them into a framework.”
The plan is for the House would pass the Senate version of Obamacare and use the special reconciliation process as a means to amend it. This special procedure is clearly an abuse of the reconciliation procedure and helps liberals to toss aside the filibuster in the Senate. As Charlotte Davis explained earlier:
Reconciliation was not intended to be the procedure of last resort when other means fail, and to do so would be a complete abuse of reconciliation rules. Some may bring up other examples of massive legislation passed through reconciliation bills as proof that using reconciliation bills to explode government spending is okay, but past instances of wrongdoing does not make it acceptable to add $2 trillion dollars worth of health care spending.
This is also a means to empower Vice President Joe Biden to act as President of the Senate during this debate so that he can ignore Republicans who will be outraged by the process. The election of Scott Brown to the Senate in liberal Massachusetts was a strong referendum against Obamacare. Add that to the polling that indicates that a large majority of Americans are opposed to the President’s health care proposal (see Real Clear Politics) and one can understand why Congress was backing away from the proposal.
But The New York Times article indicates that the Obama Administration and liberal Members of Congress are willing to use the Nuclear Option to get the unpopular bill through the House and Senate.
As President Obama’s recently-released budget for 2011 reveals, with or without a health care reform bill, Medicaid stands to receive a big, taxpayer-funded bailout. Again. The 2011 Budget includes $25 billion in additional funding for state Medicaid programs as an extension of the bailout that was included in the 2009 economic stimulus bill.
As Heritage analysts Dennis Smith and Nina Owcharenko argued then, depending on federal bailouts to carry Medicaid through economic hardships is bad policy.
The stimulus bill provided increased federal matching rates for Medicaid programs in all fifty states. This splurge in spending was accompanied by no caveats or strings attached to require true Medicaid reform, which is sorely needed. Instead, the federal government succeeded only in propping up the failed policies behind the broken government program, encouraging continued sluggishness in actual improvements to the system.
What is more, federal bailouts of state Medicaid programs set states up for short-term dependency on federal dollars which will lead to long-term budgetary problems when these funds expire. Nothing could make this clearer than the Medicaid bailout extension included in President Obama’s 2011 budget.
In a recent article in the Wall Street Journal, Janet Adamy explains that additional Medicaid funding was included to respond to Congress’ stalled efforts to achieve comprehensive health care reform. Both of the health care bills would have expanded Medicaid and increased federal matching rates. According to Adamy, “Some states were so confident Congress would pass a health bill that they included the extra Medicaid funds in their state budgets.” Thus the need for additional bailout money: state fiscal irresponsibility, encouraged by Washington.
If Congress had structured the previous bailouts correctly in the first place, this additional bailout may not have been necessary. Smith and Owcharenko outline how this should have been done. Of course, the economic stimulus should not have included increased government spending in the first place. Rather, tax cuts should have been used to invigorate the economy.
That aside, a Medicaid bailout should have established criteria to ensure that states accepting more funding took the necessary steps to improve their programs. States should have also been required to submit plans for long-term reform. Medicaid beneficiaries currently suffer from lack of access to care due to outdated reimbursement systems. Addressing this would improve the quality of care for enrollees. Lastly, both state and federal governments should have made a commitment to achieving serious entitlement reform as a part of the bailouts, assuring they would not be needed in the future.
But none of this happened. Instead, once the extra federal funding expires, states will be left to deal with balancing their budgets and footing the bill for the same low-performing Medicaid programs.