The ACP Advocate Blog

by Bob Doherty

Monday, January 4, 2010

Meet the New Year, same as the old year

Congress returns to Washington tomorrow to begin the difficult process of bridging the differences between the health reform bills passed by the Senate and House. Usually, this would involve creation of a conference committee - consisting of members appointed by the House and Senate leadership and from the committees of jurisdiction - to lead the negotiations on producing a common bill - called a conference agreement - which would then be voted on as a substitute to the original bills as approved earlier by the respective chambers.

But as Jonathan Cohn reports today in the New Republic, Democrats are "almost certain" to substitute informal negotiations for a formal conference process to "avoid a series of procedural steps--not least among them, a series of special motions in the Senate, each requiring a vote with full debate - that Republicans could use to stall deliberations" as they did in November and December. Read Paul Blumental's Sunlight Foundation blog for a good explanation of how the decision to bypass the conference process will allow for speedier consideration of the bill while "potentially limiting both the public's and many of their elected official's ability to consider the changes to the bill."

The decision to forgo the conference process is not that unusual. Both political parties have muscled legislation through, without a conference report, when they have had the majority, and even when a conference committee has been convened, it often has been more of a showcase than the open and transparent process described by House and Senate rules.

But this time, a decision to forgo a conference agreement creates political risks for President Obama, since he ran on a promise of transparency. Politifact, an independent fact-checking web site, reported earlier this year that President Obama promised during the campaign to bring "all parties together, not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are, because part of what we have to do is enlist the American people in this process."

I am sure that administration and its Democratic allies will argue that it is Republican obstructionism that has forced them to bypass the conference process, but my gut tells me that this will play into the hands of critics. They will argue that it is more evidence that the legislation is the product of secret backroom deals, and this will make it harder for President Obama and his Democratic congressional allies to persuade a public that already is distrustful of Washington that the final bill is good for them. At the same time, I also have no doubt that the GOP would use a formal conference process to delay a vote as long as possible, during which they would work to intensify public opposition to its passage.

It would have been nice to think that both parties might have resolved to play nicer in the New Year, but 2010 is starting off the same way as last year, with both parties locked into a take-no-prisoners conflict that leaves no room for bipartisanship.

Today's question: What is your opinion of the Democrats' decision to bypass a conference agreement?


Blogger Steve Lucas said...

I feel the Democrats are making the statement that they are in charge. As noted the political bickering is totally out of hand. We also see a majority of Americans now have serious questions concerning the health care debate, questions that are being politically manipulated to achieve only one goal: The passing of health care reform that will remake the way we do medicine in this country.

While there will be good and bad in the bill, avoiding the process will make this a Democratic bill and only a Democratic bill.

Steve Lucas

January 5, 2010 at 11:13 AM  
Blogger Rich Neubauer MD said...

Here’s an interesting juxtaposition from up here in a solidly RED state (touched occasionally with a fringe of blue). Our local news rag has had a series of letters criticizing our recently elected democratic senator for selling out cheap. In the writer’s views, as a potential “60th vote” he should have demanded that the Arctic National Wildlife Refuge (ANWR) be opened for oil drilling in return for his positive vote on the Senate Health Care Bill (which is viewed up here by many as a socialist conspiracy). The mayor of Anchorage openly adheres to this view. At the same time, the local conservative columnist lambasted senators from Nebraska and Louisiana for having the gall to make US pay more taxes to support boondoggles for their states that do nothing to benefit us.

My point is that this long ago left the bounds of being a rational debate. Assuming there is final passage of a bill, Health Care Reform will be viewed as a Democratic initiative not as a bipartisan effort. As such, for better or worse, Republicans will be using any problematic events that transpire from its implementation as a political weapon.

My view remains that the current bill, for all its flaws (many inflicted by the nature of our political process), is a necessary first step in what will hopefully be an ongoing process of reform. While I find myself wishing for more from the current effort, I’m supportive of the party in power doing what needs to be done to get this done.

January 5, 2010 at 2:26 PM  
Blogger Jay Larson MD said...

Some times you do what you gotta do to get things done.

If the Republicans truely were interested in helping shape health care reform and were not solely interested in partisianship, they would have participated by now. They have had 2 years to step up to the plate.

January 6, 2010 at 10:01 AM  

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Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog

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