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Republicans are promising that Democrats will pay a price this fall for passing such a sweeping and controversial bill this way - and they may be right. "A raw exercise of legislative power," Senate minority leader Mitch McConnell called the emerging game plan. He vowed, "It will be the issue in every race in America this fall." Yet this use of the reconciliation procedure - ironically misnamed, given the antagonism it has stirred - would not be as radical a maneuver as Republicans claim. Created in 1974, reconciliation has been used 21 times, mostly by Republicans, who employed it to, among other things...
...path to enactment, as it is envisioned now, requires two steps. First, the House would pass the exact bill that cleared the Senate on Christmas Eve - even though it is loaded with provisions that many in the House say they would not accept in a final product. Next, the two chambers would fine-tune that bill with a set of compromises that they would pass under a filibuster-proof procedure known as budget reconciliation, which requires only 51 votes to clear the Senate...
House Democrats are unlikely to agree to pass the Senate bill without some kind of ironclad guarantee that the Senate will actually follow through on its promise to make changes to its original measure. Among those: scaling back the so-called Cadillac tax on very expensive health care policies and stripping the bill of sweetheart deals for individual Senators, such as the now infamous "Cornhusker kickback" that Nebraska Senator Ben Nelson arranged to exempt his state from having to pay additional costs for expanding Medicaid. One possibility under discussion would have at least 51 Senators signing a letter promising...
...even if all these pieces fall into place, there's still no assurance that the Democrats can find the votes to pass the bill in any form - especially in the House. Speaker Nancy Pelosi has virtually no room to maneuver: since her chamber adopted its original measure in November, a death, several retirements and the defection of the bill's lone GOP supporter have cut her five-vote margin to zero. She's facing revolts in her caucus on a number of fronts; dozens of Democrats, for instance, have given notice that they will not accept the Senate's more...
Ultimately, Pelosi may have to change the votes of a handful of conservative Democrats who voted against the original House bill in November. She'll argue that the newer version is smaller and less expensive. It also does not include a government-run public option for providing coverage to the uninsured - a provision of the original House measure that had been anathema to those who saw it as the leading edge of what they feared would be a government takeover of health care...