Policy, Politics, Procedure and Press
Okay, so I've graduated from yelling at regular news networks to yelling at the Daily Show about this, so I thought, it's about damn time I write this already.
I plan on addressing a few things in this post:
1) The policy actually inherent in the healthcare reform bills that have passed the House and Senate, and how it might change in the process of trying to get the actual thing passed.
2) The politics involved in why it is the Democrats have to jump through hoops to get this passed despite having 60 freaking votes in the Senate (hint: FILIBUSTER)
3) Where we go from here and what the everliving god is going on.
Note: This is definitely editorial, with my opinions backed up with solid fact, and I am a pro-choice feminist liberal, but I did my best to be very even-handed. I hope it comes across.
1) POLICY
Speaking as someone who watched both House and Senate debate on this stuff, trust me, you don't want me going into painful detail. You want more info, I plan on giving citations later.
The House bill and the Senate bill, as you may or may not know, are two very different bills. There's a lot of essentials that are similar, but there's two glaring differences between the House and Senate bills.
A. The House bill creates a "public option," what some call "government-run healthcare." The Senate bill does not create a public option.
Important note: the public option is only created to compete with privately-run healthcare, and operates on the same level. People wouldn't be forced to participate, nor at any age; you could buy your way in with subsidies, or with your own money, if you so chose. It's not socialized medicine by any means or even a step closer to it; it's actually a capitalistic effort to force private health insurers to compete with a straight-up not-for-profit office that would be accountable to taxpayers. Competition! It's good for you.
B. The House passed an amendment attached to the healthcare bill called the Stupak-Pitts amendment. This limits access to abortion.
I won't go into the history of access to abortion. I will say that most of the discussion around this amendment and the question of abortion in the healthcare debate has been purposefully obtuse. There are claims that federal, taxpayer money goes towards abortion at this moment, and the Stupak-Pitts amendment was necessary in the case of the creation of the public option, where a federal agency would presumably have some people paying for coverage with a federal subsidy, and some women might attempt to buy an abortion under said coverage.
The fact of the matter is that federal and private funds are segregated and have a great big firewall between them when it comes to two things: money that goes towards abortions, and money that goes towards churches. The former was set in stone in 1976 with the passage of the Hyde Amendment. It is, as I said, obtuse to say otherwise. No matter how you feel about the issue, this is SOLID FACT.
In the guise of remedying this fact, the Stupak-Pitts amendment goes further. I can't put it better than Rep Jerrold Nadler did here:
"Under the Stupak proposal, if a woman is of low- or moderate income and receives assistance to afford the premiums for a health plan she purchases through the Exchange, she cannot choose a plan that covers abortion services. And if a woman chooses the public option, she cannot receive abortion coverage - even if she pays for the plan entirely by herself.
The Stupak amendment says to women - if you think you might have an unintended pregnancy, you should purchase separate insurance. Put another way, this amendment requires women to plan that they will encounter an unplanned pregnancy. This defies logic and is absurd."
SO. There you go. The House bill has the anti-choice, nominally "pro-life" Stupak amendment as well as the public option built into it. The Senate bill does not have a public option, but the Nelson-Hatch-Casey amendment, which duplicated the Stupak amendment language, was also not passed.
Things the bills have in common:
1. No denial of coverage for pre-existing conditions.
2. The mandate. Once the reform kicks in, everyone has to buy health insurance or they'll be fined or potentially jailed if they don't pay the fine.
-- Note: Plenty of states have similar laws re: auto insurance. This one is controversial on both sides of the aisle; the left says there's not enough reform without the public option to assume that the low-income uninsured will actually be able to purchase coverage, and the right seems to view this as "the first time we've ever been mandated to buy anything." Reform's supposed to drop the price so that it's actually plausible for even the lowest-income person to have coverage, and there is an argument that the system is bleeding money due to the uninsured showing up in ERs and needing treatment. There are, however, exemptions to the mandate/fines/etc. That one's up in the air; like I said, this one has Issues.
3. You can buy insurance across state lines! Especially if you're a small business.
4. Both create exchanges (basically, a pool of insurance options for people or small businesses who might have trouble buying into the regular market, let's call it the Walmart or Target of health insurance) and allow for the creation of small health CO-OPs (I'm not being obnoxious, it's an acronym that just happens to also be a word).
5. Both expand Medicare coverage to some individuals (children, pregnant women, parents, and adults without dependent children) at a certain poverty level (House bill 150% of poverty, Senate 133%). This is not most people, but it'll mean that a LOT of low-income people get covered, no matter which number gets picked.
There's other stuff but that's all the stuff that isn't, you know, insanely detailed. Any questions, I can whip out my citations and try to answer (I've been reading the whole spectrum from crazy left-wing to crazy right-wing on this stuff for months, quiz me, I dare you), but that's all I can think of.
A main citation I used just now was this page at the Kaiser Family Foundation (they are non-partisan, not-for-profit and have nothing to do with Kaiser Permanente, in case you were wondering).
Moving on!
2) POLITICS
This is why I was yelling at my TV/computer screen.
The funny thing is that a majority in the Senate is in fact exactly what you'd think it would be -- 51%. And the math on 51% of 100 is so easy even I can do it -- 51 votes.
So why is it that the journalists these days keep saying that the Democrats absolutely need 60 votes to pass anything, especially healthcare reform? And why did it take the Senate all the way until the morning of Christmas Eve? Are they incompetent? Are they remedial? Can they not do math?
Some people might argue yes to those last three questions but the answer is pretty straightforward. NO. It's much more straightforward than that.
See, there's this myth about the filibuster. I think we've all at least heard of it. There's the filibuster in Mr. Smith Goes to Washington, there have been some really interesting ones in Senate history. If a Senator really doesn't like a bill, he or she can just stand up there and "debate" for as long as he or she can stand up straight without any support and continue to talk. I put "debate" in quotes because the usual stereotypical thing that's actually read aloud for as long as these filibusters go is something like Shakespeare or a cookbook rather than any actual debate. This was created to allow unlimited debate when the Senate was smaller. There was no real means to stop it besides sitting through it until 1917, when the Senate adopted Rule 22, which allowed the Senate to stop a filibuster if they had a two-thirds majority vote. This was called cloture.
So, to sum up -- stand up as long as you can, read out loud anything you want, meanwhile everyone is scrambling around trying to get the votes and no real legislative action can get done. It takes, at this point, 67 votes to break a filibuster. As you can imagine, getting 67 votes in the Senate for anything is like herding cats, so usually filibusters went on until the guy doing the talking decided to shut up.
But in 1975, the Senate decided to change things, so they dropped cloture to 60 votes. This is significantly easier to get, still not too easy to get, and besides, filibusters are rare because they're hard to do, right? ... Right?
Wrong! Barbara Sinclair, a UCLA political scientist, looked into it. 70% of bills in the last decade were threatened with or actually faced down a procedural or literal filibuster. A procedural filibuster basically means that you can get away with holding things like, oh, judicial nominees and major legislation in bureacratic hell while the people who put the nominee/legislation forward have to scramble for 60 votes.
And if you can get a cloture vote, it means you have to go through 30 hours of debate before you can make the next, necessary cloture vote. (There were three on the Senate healthcare reform bill. THREE cloture votes. This is why it took them from December 19 to December 24 to pass a bill, this is why there were 1 AM votes. It was filibuster/cloture timing.)
This is what the Republicans did to HR 3590, the Patient Protection and Affordable Care Act. The Senate health reform bill. Yeah, I know, I didn't hear that on ABC/NBC/CBS either!
But the Democrats have 60 votes, right?
Not exactly. They have 60 people in their caucus, but not all of them agree with a lot of the tenets of healthcare reform as the majority party tends to see it. You have Sen Joe Lieberman (I-CT), a conservative independent who ran for VP on the Democratic ticket then backed Sen John McCain on the 2008 campaign trail. You have Sen Bernie Sanders (I-VT), a self-described democratic socialist who is a strong advocate for single-payer healthcare, AKA socialized medicine, the Canadian/French/UK etc system. Senator Ben Nelson, Senator Russ Feingold, Senator Mary Landrieu -- I could go on. It's a big freaking tent and not everyone agrees, not even remotely.
So one of these people can step out of line and suddenly that filibuster kills the bill, and they have to go all the way from the start. Thus someone like Lieberman can kill the public option in the Senate by threatening to defect, and Senator Ben Nelson can get Nebraska free Medicare (although that's not going to be in the final bill, apparently), all NOT because the Democrats in the Senate are disorganized, but because the Republicans are filibustering.
When someone holds up your store, and your coworker bargains his way out by offering to show the criminal the safe he probably didn't even know was there, you can be pissed at your coworker for being a rat, but that doesn't change the fact that someone's holding up your store. The guy with the gun is to blame for even putting you in the situation.
To sum up:
Republicans put a filibuster on the final Senate healthcare bill.
Democratic caucus has exactly 60 votes.
Because of the filibuster, the Majority Leader NEEDED all 60 votes to pass the bill, and therefore the bill was held captive.
What's funny is I keep hearing about this "liberal media," but you think a "liberal media" would be pissed that a minority of 40 Republicans had managed to delay and obstruct this legislation without contributing anything substantive to the debate, while allowing conservative Democrats to demand deals for their votes.
Google "filibuster" and "healthcare." I'm pretty sure you'll find exactly what I found -- that none of the major news outlets even bothered explaining WHY 60 votes were necessary. I even had trouble confirming that there was in fact a filibuster.
There WAS a filibuster. It wasn't a Mr Smith Goes to Washington filibuster. It was a procedural filibuster. It made a vote and debate that could've taken one, two days, and gotten the Senate home by December 21, 2009, tops, stretch all the way until 7 AM on Christmas Eve -- and that was after a compromise, when the filibuster was dropped. And maybe I'm in the minority for finding both the fact and the lack of reporting on it infuriating, but I wish I wasn't. There is something seriously wrong when 40 Senators get away with almost killing a bill, no matter what bill it is, while the vast majority has to scramble for a party-line vote in order to get anything done.
Okay, that was long, but important, I think. Next!
3) Where do we go from here?
Both bills were passed! Yay! But they're different, and the same bill has to pass through both chambers before landing on the President's desk. So there are a few options:
1. The House can pass the bill that was passed by the Senate. Basically this requires convincing the conservative Democrats to be okay losing the Stupak amendment and the liberal Democrats to be okay losing the public option. They're really considering this one, because it means not having to go through the filibuster thing again with the Senate.
2. The Senate could pass the House bill, and then we can all go ice-skating in Hell.
3. A conference committee, which is basically all the Democratic leaders of both the House and the Senate figuring out a bill that they can both pass.
You know, I was going to talk about the procedural stuff but here's what looks like is actually happening:
Speaker Pelosi, Majority Leader Reid and of course President Obama -- along with other Democratic leaders -- have been meeting and talking about this. As far as anyone can tell, it looks like they're working out the prospects of a bill that both the House and Senate can pass through, most likely BEFORE the State of the Union. This will be an impressive feat, as the State of the Union is on January 27 and the Senate returns TODAY, January 21, which is why they started soon after the House came back on January 5.
No telling what's really going to be in the bill. Odds are good it's not going to be the same as the Senate bill, and obviously not the same as the House bill. We're probably looking at something more similar to the Senate bill, because the House Democrats can probably swallow their pride, but there's still a filibuster in the Senate.
And, wow, that's all I've got.
4) Citations
So you don't think I'm making this stuff up.
An interesting report on filibusters and cloture written by the Congressional Research Service.
The side-by-side comparison of any of the bills from the Kaiser Family Foundation.
That Barbara Sinclair interview re: her findings about filibusters in recent years.
Congressional Quarterly's take on filibusters.
The Senate historians' take on filibusters and cloture.
I think I may have overclocked my brain writing this. But again -- open to questions and debate if anyone's interested.
I plan on addressing a few things in this post:
1) The policy actually inherent in the healthcare reform bills that have passed the House and Senate, and how it might change in the process of trying to get the actual thing passed.
2) The politics involved in why it is the Democrats have to jump through hoops to get this passed despite having 60 freaking votes in the Senate (hint: FILIBUSTER)
3) Where we go from here and what the everliving god is going on.
Note: This is definitely editorial, with my opinions backed up with solid fact, and I am a pro-choice feminist liberal, but I did my best to be very even-handed. I hope it comes across.
1) POLICY
Speaking as someone who watched both House and Senate debate on this stuff, trust me, you don't want me going into painful detail. You want more info, I plan on giving citations later.
The House bill and the Senate bill, as you may or may not know, are two very different bills. There's a lot of essentials that are similar, but there's two glaring differences between the House and Senate bills.
A. The House bill creates a "public option," what some call "government-run healthcare." The Senate bill does not create a public option.
Important note: the public option is only created to compete with privately-run healthcare, and operates on the same level. People wouldn't be forced to participate, nor at any age; you could buy your way in with subsidies, or with your own money, if you so chose. It's not socialized medicine by any means or even a step closer to it; it's actually a capitalistic effort to force private health insurers to compete with a straight-up not-for-profit office that would be accountable to taxpayers. Competition! It's good for you.
B. The House passed an amendment attached to the healthcare bill called the Stupak-Pitts amendment. This limits access to abortion.
I won't go into the history of access to abortion. I will say that most of the discussion around this amendment and the question of abortion in the healthcare debate has been purposefully obtuse. There are claims that federal, taxpayer money goes towards abortion at this moment, and the Stupak-Pitts amendment was necessary in the case of the creation of the public option, where a federal agency would presumably have some people paying for coverage with a federal subsidy, and some women might attempt to buy an abortion under said coverage.
The fact of the matter is that federal and private funds are segregated and have a great big firewall between them when it comes to two things: money that goes towards abortions, and money that goes towards churches. The former was set in stone in 1976 with the passage of the Hyde Amendment. It is, as I said, obtuse to say otherwise. No matter how you feel about the issue, this is SOLID FACT.
In the guise of remedying this fact, the Stupak-Pitts amendment goes further. I can't put it better than Rep Jerrold Nadler did here:
"Under the Stupak proposal, if a woman is of low- or moderate income and receives assistance to afford the premiums for a health plan she purchases through the Exchange, she cannot choose a plan that covers abortion services. And if a woman chooses the public option, she cannot receive abortion coverage - even if she pays for the plan entirely by herself.
The Stupak amendment says to women - if you think you might have an unintended pregnancy, you should purchase separate insurance. Put another way, this amendment requires women to plan that they will encounter an unplanned pregnancy. This defies logic and is absurd."
SO. There you go. The House bill has the anti-choice, nominally "pro-life" Stupak amendment as well as the public option built into it. The Senate bill does not have a public option, but the Nelson-Hatch-Casey amendment, which duplicated the Stupak amendment language, was also not passed.
Things the bills have in common:
1. No denial of coverage for pre-existing conditions.
2. The mandate. Once the reform kicks in, everyone has to buy health insurance or they'll be fined or potentially jailed if they don't pay the fine.
-- Note: Plenty of states have similar laws re: auto insurance. This one is controversial on both sides of the aisle; the left says there's not enough reform without the public option to assume that the low-income uninsured will actually be able to purchase coverage, and the right seems to view this as "the first time we've ever been mandated to buy anything." Reform's supposed to drop the price so that it's actually plausible for even the lowest-income person to have coverage, and there is an argument that the system is bleeding money due to the uninsured showing up in ERs and needing treatment. There are, however, exemptions to the mandate/fines/etc. That one's up in the air; like I said, this one has Issues.
3. You can buy insurance across state lines! Especially if you're a small business.
4. Both create exchanges (basically, a pool of insurance options for people or small businesses who might have trouble buying into the regular market, let's call it the Walmart or Target of health insurance) and allow for the creation of small health CO-OPs (I'm not being obnoxious, it's an acronym that just happens to also be a word).
5. Both expand Medicare coverage to some individuals (children, pregnant women, parents, and adults without dependent children) at a certain poverty level (House bill 150% of poverty, Senate 133%). This is not most people, but it'll mean that a LOT of low-income people get covered, no matter which number gets picked.
There's other stuff but that's all the stuff that isn't, you know, insanely detailed. Any questions, I can whip out my citations and try to answer (I've been reading the whole spectrum from crazy left-wing to crazy right-wing on this stuff for months, quiz me, I dare you), but that's all I can think of.
A main citation I used just now was this page at the Kaiser Family Foundation (they are non-partisan, not-for-profit and have nothing to do with Kaiser Permanente, in case you were wondering).
Moving on!
2) POLITICS
This is why I was yelling at my TV/computer screen.
The funny thing is that a majority in the Senate is in fact exactly what you'd think it would be -- 51%. And the math on 51% of 100 is so easy even I can do it -- 51 votes.
So why is it that the journalists these days keep saying that the Democrats absolutely need 60 votes to pass anything, especially healthcare reform? And why did it take the Senate all the way until the morning of Christmas Eve? Are they incompetent? Are they remedial? Can they not do math?
Some people might argue yes to those last three questions but the answer is pretty straightforward. NO. It's much more straightforward than that.
See, there's this myth about the filibuster. I think we've all at least heard of it. There's the filibuster in Mr. Smith Goes to Washington, there have been some really interesting ones in Senate history. If a Senator really doesn't like a bill, he or she can just stand up there and "debate" for as long as he or she can stand up straight without any support and continue to talk. I put "debate" in quotes because the usual stereotypical thing that's actually read aloud for as long as these filibusters go is something like Shakespeare or a cookbook rather than any actual debate. This was created to allow unlimited debate when the Senate was smaller. There was no real means to stop it besides sitting through it until 1917, when the Senate adopted Rule 22, which allowed the Senate to stop a filibuster if they had a two-thirds majority vote. This was called cloture.
So, to sum up -- stand up as long as you can, read out loud anything you want, meanwhile everyone is scrambling around trying to get the votes and no real legislative action can get done. It takes, at this point, 67 votes to break a filibuster. As you can imagine, getting 67 votes in the Senate for anything is like herding cats, so usually filibusters went on until the guy doing the talking decided to shut up.
But in 1975, the Senate decided to change things, so they dropped cloture to 60 votes. This is significantly easier to get, still not too easy to get, and besides, filibusters are rare because they're hard to do, right? ... Right?
Wrong! Barbara Sinclair, a UCLA political scientist, looked into it. 70% of bills in the last decade were threatened with or actually faced down a procedural or literal filibuster. A procedural filibuster basically means that you can get away with holding things like, oh, judicial nominees and major legislation in bureacratic hell while the people who put the nominee/legislation forward have to scramble for 60 votes.
And if you can get a cloture vote, it means you have to go through 30 hours of debate before you can make the next, necessary cloture vote. (There were three on the Senate healthcare reform bill. THREE cloture votes. This is why it took them from December 19 to December 24 to pass a bill, this is why there were 1 AM votes. It was filibuster/cloture timing.)
This is what the Republicans did to HR 3590, the Patient Protection and Affordable Care Act. The Senate health reform bill. Yeah, I know, I didn't hear that on ABC/NBC/CBS either!
But the Democrats have 60 votes, right?
Not exactly. They have 60 people in their caucus, but not all of them agree with a lot of the tenets of healthcare reform as the majority party tends to see it. You have Sen Joe Lieberman (I-CT), a conservative independent who ran for VP on the Democratic ticket then backed Sen John McCain on the 2008 campaign trail. You have Sen Bernie Sanders (I-VT), a self-described democratic socialist who is a strong advocate for single-payer healthcare, AKA socialized medicine, the Canadian/French/UK etc system. Senator Ben Nelson, Senator Russ Feingold, Senator Mary Landrieu -- I could go on. It's a big freaking tent and not everyone agrees, not even remotely.
So one of these people can step out of line and suddenly that filibuster kills the bill, and they have to go all the way from the start. Thus someone like Lieberman can kill the public option in the Senate by threatening to defect, and Senator Ben Nelson can get Nebraska free Medicare (although that's not going to be in the final bill, apparently), all NOT because the Democrats in the Senate are disorganized, but because the Republicans are filibustering.
When someone holds up your store, and your coworker bargains his way out by offering to show the criminal the safe he probably didn't even know was there, you can be pissed at your coworker for being a rat, but that doesn't change the fact that someone's holding up your store. The guy with the gun is to blame for even putting you in the situation.
To sum up:
Republicans put a filibuster on the final Senate healthcare bill.
Democratic caucus has exactly 60 votes.
Because of the filibuster, the Majority Leader NEEDED all 60 votes to pass the bill, and therefore the bill was held captive.
What's funny is I keep hearing about this "liberal media," but you think a "liberal media" would be pissed that a minority of 40 Republicans had managed to delay and obstruct this legislation without contributing anything substantive to the debate, while allowing conservative Democrats to demand deals for their votes.
Google "filibuster" and "healthcare." I'm pretty sure you'll find exactly what I found -- that none of the major news outlets even bothered explaining WHY 60 votes were necessary. I even had trouble confirming that there was in fact a filibuster.
There WAS a filibuster. It wasn't a Mr Smith Goes to Washington filibuster. It was a procedural filibuster. It made a vote and debate that could've taken one, two days, and gotten the Senate home by December 21, 2009, tops, stretch all the way until 7 AM on Christmas Eve -- and that was after a compromise, when the filibuster was dropped. And maybe I'm in the minority for finding both the fact and the lack of reporting on it infuriating, but I wish I wasn't. There is something seriously wrong when 40 Senators get away with almost killing a bill, no matter what bill it is, while the vast majority has to scramble for a party-line vote in order to get anything done.
Okay, that was long, but important, I think. Next!
3) Where do we go from here?
Both bills were passed! Yay! But they're different, and the same bill has to pass through both chambers before landing on the President's desk. So there are a few options:
1. The House can pass the bill that was passed by the Senate. Basically this requires convincing the conservative Democrats to be okay losing the Stupak amendment and the liberal Democrats to be okay losing the public option. They're really considering this one, because it means not having to go through the filibuster thing again with the Senate.
2. The Senate could pass the House bill, and then we can all go ice-skating in Hell.
3. A conference committee, which is basically all the Democratic leaders of both the House and the Senate figuring out a bill that they can both pass.
You know, I was going to talk about the procedural stuff but here's what looks like is actually happening:
Speaker Pelosi, Majority Leader Reid and of course President Obama -- along with other Democratic leaders -- have been meeting and talking about this. As far as anyone can tell, it looks like they're working out the prospects of a bill that both the House and Senate can pass through, most likely BEFORE the State of the Union. This will be an impressive feat, as the State of the Union is on January 27 and the Senate returns TODAY, January 21, which is why they started soon after the House came back on January 5.
No telling what's really going to be in the bill. Odds are good it's not going to be the same as the Senate bill, and obviously not the same as the House bill. We're probably looking at something more similar to the Senate bill, because the House Democrats can probably swallow their pride, but there's still a filibuster in the Senate.
And, wow, that's all I've got.
4) Citations
So you don't think I'm making this stuff up.
An interesting report on filibusters and cloture written by the Congressional Research Service.
The side-by-side comparison of any of the bills from the Kaiser Family Foundation.
That Barbara Sinclair interview re: her findings about filibusters in recent years.
Congressional Quarterly's take on filibusters.
The Senate historians' take on filibusters and cloture.
I think I may have overclocked my brain writing this. But again -- open to questions and debate if anyone's interested.