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What Happens After the Senate Passes Their Health Care Bill?

December 8, 2009 - by Donny Shaw

Senate Democrats are reportedly close to a deal on the public option that they believe will get the 60 votes needed to break a Republican filibuster and pass. If the votes do in fact line up behind the deal, the Senate could vote on final passage of the bill early next week.

At that point, Congress will be looking at two very different health care bills from the Senate and the House. The Senate could still change their bill in some major ways in an attempt to placate progressives, so we can’t pin down what all those differences will be quite yet. But on the most contentious issue in the bills — the public option — the difference between the bills will be huge. The House bill will include a public option plan and the Senate bill won’t.

Before President Obama can sign a final bill into law, both the Senate and the House need to pass the same exact version of the bill. So how do we get from two bills that are worlds apart on major issues to a single bill that both chambers can agree on? There are basically two options on the table.

The conventional method is to bring both bills to an ad hoc “conference committee” made up of members of both the Senate and the House to iron out the differences into a final version that the committee can agree to. The committee bill, known as a “report,” then goes back to both the Senate and the House for a final vote. No amendments can be considered to conference reports, but senators can filibuster it and require 60 votes for it to pass.

The conference committee method presents a few problems for the health care bill. First, the Democrats want to get the bill done quickly. With a deal imminent, there is some renewed hope among the Democrats that they can get a bill to Obama to sign into law according to his original timeline by the end of December. WIth the health care bill being so contentious and having so many moving parts, the conference committee process could be slow. Second, an more importantly, Democratic leaders worry that whatever deal the Senate has in place would be the best deal they can get, i.e. the most progressive bill they can possibly pass over the objections and dilatory tactics of the Republicans. If the conference committee drew up a compromise between the more progressive House bill and the more conservative Senate bill, it simply would not get the 60 votes it would need in the Senate.

That has Democrats considering a Plan B for reconciling the bills. "There is increased chatter on Capitol Hill about a possible “ping-ponging” of the Senate health care bill: that chamber would pass its health care bill, send it to the House and the House would be asked to pass it with no changes and send it directly to the president," reports Ryan Grim at the Huffington Post. Ping-ponging bills from the Senate to the House is not that uncommon. The 111th Congress has already used this method several times to pass some substantial bill, including legislation allowing the FDA to regulate tobacco (H.R. 1256), reforming the credit card industry (H.R. 627), the GIVE Act (H.R. 1388) and expanding S-CHIP (H.R. 2).

Ping-ponging the bill would speed up the process and preserve the Senate’s carefully negotiated bill, but would the House go along with it? Many progressive Democrats in the House feel like they have been shut out of the health care process from the beginning. For them, the public option is a compromise from single payer, the plan to require the public option to use negotiated reimbursement rates is a compromise from their preference that the rates be tied to Medicare, and so on. The whole process has been moving away from them in favor of the conservatives. The Senate-House conference committee has long been seen as their last stand to defend some of the element of the bill they care about most, like the public option. There has even been some hope that they could win back some of their earlier concessions in the conference committee.

Progressive Democrat Rep. Janice Schakowsky [D, IL-9] basically rejected the ping-ponging idea. β€œThe House intends to negotiate with the Senate. We expect those deliberations to be vigorous. The House is not simply going to sign on the dotted line,” she told Greg Sargent. Rep. Jerrold Nadler [D, NY-8], another progressive, added: β€œThe House is not going to be dictated to.”

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