The End Is Near

House Speaker Nancy Pelosi is thrilled that President Obama has delayed a trip to Asia so that he can help drum up support for health care reform.

Image: Getty Images

House Speaker Nancy Pelosi is glad President Barack Obama has delayed his departure for Asia from March 18 to March 21 to accommodate Congress’ work on health care reform legislation.

"I’m delighted the president will be here for the passage of the bill,” Pelosi said today. “It’s going to be historic."

That’s a pretty confident prediction, not only on the timing of the House’s vote on health care reform but also on its outcome.

Pelosi quickly backtracked on when she expected the House to pass the legislation, saying she hopes it will happen before the president flies across the Pacific. Politico reported that Pelosi told House members today to clear their schedules for next weekend, in case the vote is delayed until then.

The exact timing will depend on when the Congressional Budget Office completes its analysis of changes that will be made in the Senate’s version of health care reform. That hadn’t happened as of this morning.

Democrats also hadn’t decided yet on a critical process question. The original idea was for the House to pass the Senate bill, then approve a separate bill that would change parts of the Senate measure that are unacceptable to the House, such as the tax on high-end insurance plans. This second bill would go back to the Senate under a budget-related procedure known as reconciliation, which can’t be filibustered, meaning 60 votes won’t be necessary.

The fact that this bill will require only a simple majority in the Senate makes House members more confident that the Senate will follow through on their end of the bargain, Pelosi said. But House members are looking for assurances from Senate Democrats that the reconciliation bill will pass, she said.

“It will take a little faith,” Pelosi said.

Otherwise, the Senate bill—with all its warts, like the “Cornhusker Kickback” deal on Medicaid—would become law.

The House’s distaste for the Senate bill is so strong that many members don’t want to have to vote for it. That’s why House leaders are considering an alternative strategy—adopting a rule that would “deem” the Senate bill passed by the House if the House approves the reconciliation package of fixes. That would save members from actually voting on the Senate bill.

That kind of trick is going to be tough to explain to voters. So will the apparent decision to include a measure overhauling student loans in the reconciliation legislation. What’s that doing in a health care bill?

Lack of confidence in the Senate is only one reason why Pelosi may not have the votes she needs to get the Senate bill passed.

A small group of pro-life Democrats contends the Senate bill doesn’t go far enough in prohibiting the use of government funds to pay for abortions. Will they vote against the bill for this reason, even though their votes could kill health care reform?

What about Representative Dennis Kucinich and other strong supporters of a single-payer “Medicare for all” insurance system? Kucinich voted against the House health care reform bill the first time around, contending it wouldn’t solve the nation’s health care problems. Will he do so again, even if it means his vote will torpedo health care reform?

Then there are moderate Democrats in swing districts, the ones that Rahm Emanuel, now White House chief of staff, recruited in 2006 to help Democrats win control of the House. They’re not nearly as liberal as Pelosi and other Democratic leaders, but Republican Scott Brown’s victory in the Massachusetts Senate special election has them feeling vulnerable. Will some moderates who voted for the House bill in November balk at voting yes for a different bill now?

We should know the answers to these questions in a week or so. If the House passes the bill (or bills, depending on what strategy is used), health care reform should become a reality.