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Health Care Reform – Dead or Alive?

January 21, 2010

(News analysis by health insurance expert Scott Lyon, SBAM’s Vice President Small Business Services)

Prior to Tuesday night, Speaker Nancy Pelosi, Majority Leader Harry Reid and representatives of the White House were working behind closed doors to merge the differences between the House of Representatives’ version of health care reform and the Senate’s version.  But the upset win by Scott Brown in the Massachusetts special election for the Senate (the seat previously held by Ted Kennedy) throws a rather large wrench into their plans. 

Why is that?  Because as soon as Brown is sworn in, the Democrats no longer will hold a supermajority of 60 votes in the Senate necessary to get past a Republican filibuster.  As a result, Democratic health care reform advocates are scrambling to decide on a course of action  by weighing the political message of the Massachusetts election against their desire to pass comprehensive health care reform.

The following are possible scenarios currently being discussed:

  • The House of Representatives could pass the Senate bill under an agreement that high priority items of concern between the two versions would be addressed in separate legislation under budget reconciliation rules, which require only a simple majority vote. Examples of what the House would like to see addressed under budget reconciliation include the deal unions made with House and Senate leaders to delay for five years the “Cadillac Tax” on health insurance for their members, as well as the administration and House preference for a national health insurance exchange over a state-based exchange.
  • Continue negotiations with congressional leaders and the administration with the expectation that they can reconcile House-Senate differences, send a final bill to the Congressional Budget Office for scoring, and allow the bill to be posted for 72 hours before a final vote is taken.
  • Scale back a bill that can garner Republican votes in the Senate and pass in the coming weeks or months.
  • Let the bill die altogether and start over.

House and Senate leaders spent the better part of 2009 attempting the massive overhaul of the health care system. President Obama made it his number one domestic agenda item beside the stimulus legislation. Going forward, each option listed above comes with its own barriers and political consequences. Now congressional leaders will have to weigh the consequences of not passing a bill ,where so much political capital has been spent, versus passing some form of health care reform in the face of  the historic election in Massachusetts.

While much has changed in the last 24 hours, what has not changed is the need for health care reform.  For the small business community finding a way to make quality health insurance affordable is still the number one priority.  SBAM and our national affiliate the National Small Business Association (NSBA) will carry that message and our suggestions on a reasonable health care reform bill that serves the needs of all small business owners and their employees.

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