Healthcare fixes move to Senate, reconciliation gridlock looms

With historic healthcare reform now the law of the land, this week’s marathon debate in the Senate over House healthcare “fixes” to that bill won’t change the outcome. But it gives Republicans a last shot to target what they see as “fundamental flaws” in the law.

As recently as Monday, Republicans claimed they had found a “fatal flaw” in the package of fixes that would kill the effort to move it through reconciliation, where only a simple majority is needed for passage. But the Senate parliamentarian, in an advisory opinion on Monday evening, disagreed.

What’s left to Republicans are opportunities to raise amendments and procedural motions over a 20 hour period, followed by back-to-back votes that can go on for days – or as long as Republicans can stay on the floor requesting them.

Healthcare 101: What the bill means to you

It sets the stage for a sort of mini-filibuster – days of politics to test the Democrats' fortitude as much as their grasp of parliamentary procedure.

“The [Senate] Democrats have committed to the House Democrats that they’ll pass this bill that has even greater Medicare cuts, even greater tax increases, even more special deals,” said Senate Republican leader Mitch McConnell. “We’re going to treat it as a serious legislative exercise.”

Republicans vs. Democrats: where they stand

Senate Democrats emerged from a caucus luncheon Tuesday resolved to block any changes in the House fixes.

“This is just going to be parliamentary games,” says Sen. Claire McCaskill (D) of Missouri. “It will be death by gotcha votes – dozens of them. We have to stand up and be strong and say: Sorry, we are not going to play.”

This companion bill – the promise of which was the only way to secure passage of the unpopular Senate bill through the House – increases subsidies for low- and middle-income Americans and it adjusts funding to lower deficits. It also includes a measure that makes the federal government the exclusive provider of student loans.

Sen. Judd Gregg (R) of New Hampshire wants to focus public attention on the student loan provisions. The nationalization of the student loan industry, quasi-nationalization of the financial system, nationalization of the auto industry, and quasi-nationalization of the health industry will “drive this country down a road towards a European-style government,” he says.

Sen. Jon Kyl (R) of Arizona cautioned that government will increase to the point that rationing will result. “People won’t see it right away,” he said. “It could be several years before that begins to happen, although you’re already beginning to see it in Medicaid.”

Parts of the law take effect right away

Meanwhile, Americans will see features of the new law kick in immediately.

Small businesses that want to offer health insurance to their workers will have new tax credits up to 35 percent of the premiums, effective today. Seniors can access $250 rebates for Medicare prescription drug costs if they run up against the “donut hole,” also effective today.

In 90 days, people who cannot obtain health insurance due to preexisting conditions will have access to a new, high-risk pool.

In six months, popular health insurance reforms take effect. Insurance companies can no longer drop coverage due to illness, deny coverage to children with preexisting conditions, or set lifetime limits on coverage. Parents will have the option of keeping children on the family
insurance policy until age 26.

“The president has signed a major health reform bill, and we have made a commitment to pass the fixes,” said Sen. Byron Dorgan (D) of North Dakota. The effects of that bill now begin to speak for themselves.