Health Care: In the End, It's Policy, Not Process, That Will Matter

Washington Matters

Health Care: In the End, It's Policy,
Not Process, That Will Matter

All the smoke over legislative tactics obscures what's really important to the public.

Health care will finally reach President Obama's desk this month because House and Senate Democratic leaders were able to plot and execute complex procedural chess tactics. Not illegal, unconstitutional or even unprecedented tactics, but certainly zero-hour, near-desperation moves employed to find a way -- any legal way -- to pass health reforms debated for more than a year and now politically critical for Democrats and President Obama to pass.

Crunch time often brings out crunch moves.

The contortions the House went through before clearing the Senate-passed health bill and the use of “budget reconciliation”to avoid a Republican filibuster in the Senate will almost certainly open a chapter of even more partisan sword clashing in Congress for a while.

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But for how long?


The firestorm that will ensue has become part of the nature of modern political discourse, fueled by the harsh rhetoric that characterizes much of today’s cable TV, radio and Internet chatter. It will also reflect an energized body politic, some of it well informed, some less so. And most of all, it will be part of an effort to rally the base of each party, which will be so crucial in the low-turnout midterm elections. Much is at stake in those elections, with Republicans sure to gain seats in both chambers, maybe even enough to win control. Conventional wisdom says the tactical cramming through of health care reform will be a huge backdrop to those elections. But that’s far from certain. In the weeks and months ahead, the national debate is more likely to be about the merits and ramifications of the complex legislation, not about the legislative maneuvers that allowed it.

Republicans will be incensed for weeks. That’s a given. They’ll probably use their own procedural techniques to slow work in the House and Senate to vent and to make a point. Sen. Orrin Hatch (R-Utah) went so far as to say the tactics of reconciliation and deeming would “destroy the modern Congress by trampling on the tradition of minority rights. There’ll be hell to pay.”

That’s more than a bit overblown. Both parties have used reconciliation and deeming resolutions before, often with several in the minority up in arms about it. The Senate has passed 22 reconciliation bills in less than four decades -- including to win approval for the Bush tax cuts, which carried a price tag well above that of the health care bill. Reconciliation was also used for welfare reform and to make significant changes in Medicare. In the House, deeming resolutions have been used by both parties, too, albeit not for landmark bills.

The war over reconciliation and deeming won’t last for too long. Members of Congress know they have important work on tap, including the annual budget, job creation, financial services reform and food safety legislation, to name a few. And the public cares far less about congressional tactics than about what Congress does and doesn’t do and how it affects them, their jobs and their family and community.

It’s typical of Washington. Oftentimes the passionate debate, as we’ve seen in these recent weeks, end up being more about the legislative process than about the merits of the legislation. The latter is where this debate really deserves to be for the public benefit. No procedural tactic will change that.