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The Budget Reconciliation Cycle Begins Anew

April 6, 2010 - by Donny Shaw

The Democrats’ foresight to included health care reform instructions in the 2010 budget resolution was what really gave them the edge they needed to get their bill out of Congress and signed into law. When Congress comes back on April 12, the 2011 budget resolution will be one of the top items on their agenda. Jon Walker at FireDogLake, who calls reconciliation instructions the “best hope for progressive legislation,” is starting to think about what reconciliation items the Dems might include in this year’s budget bill.

He’s hoping they include instructions to “improve” the new health care law and avoid a Republican filibuster (if need be). Here’s his list of suggestions on that front:


  1. 1. National public option
  2. 2. Medicare buy-in
  3. 3. Direct Medicare drug price negotiations
  4. 4. Force/encourage the adoption of a single provider reimbursement negotiator (an all-payer system) for all insurers in the state, or at least for all policies sold on the new exchanges
  5. 5. Remove the cruel five-year Medicaid waiting period for legal immigrants
  6. 6. Increase minimum medical loss ratio to 92%
  7. 7. Create a national exchange (to get around the Byrd rule, if need be, possibly improve the new OPM exchange and provide financial incentives to states not to start their own exchanges)
  8. 8. Reduce annual out-of-pocket caps
  9. 9. Strengthen risk adjustment mechanisms and/or add rewards for quality payments on the exchange
  10. 10. Improve the state opt-out provision (would potentially allow for state single payer)
  11. 11. Allow for extended COBRA coverage until 2014
  12. 12. Replace convoluted free rider provision with a real employer mandate
  13. 13. Tax direct-to-consumer prescription drug advertising

And he adds these ideas for other non-hcr uses of reconciliation he thinks the Dems should consider for reconciliation this year:



  1. 1. Cap and trade and/or a new greenhouse gas tax

  2. 2. Public financing of federal elections to deal with some fallout from the Citizens United ruling

  3. 3. Some form of banking regulation to deal with “too big to fail” (new taxes/fees on over-leveraging, firms over a set size, certain transactions, firms with  commercial and “shadow” banking, etc., could make it unprofitable/impractical for banks to get too big to fail )

  4. 4. Reforms to corporate welfare farm subsidy programs

  5. 5. General tax reform to deal with egregious loopholes and corporate welfare programs

What reconciliation instructions do you think should be included in the 2011 budget bill? Remember, everything done under reconciliation rules must be  more than incidentally related to the budget.

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