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Obama Directs Congress to Finish Health Care Reform

March 3, 2010 at 12:00 AM EDT
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As President Obama pushed for Congress to complete health care reform legislation in the next few weeks, Jim Lehrer talks to Washington Post reporter Ceci Connolly and political analyst Norm Ornstein about the tactics Democrats might use to try to pass their reform plans without Republican support.

JIM LEHRER: And we take a look now at what the situation is with Ceci Connolly, who covers health reform for The Washington Post, and Norm Ornstein, a longtime observer of Congress and politics at the American Enterprise Institute.

Ceci, the — Ceci, the Republicans said this is a new sales pitch. On substance alone, was there anything really new in what the president said?

CECI CONNOLLY, health policy reporter, The Washington Post: Not terribly, no. And that probably explains why I have been feeling like Yogi Berra the past week or so. I mean, this is really deja vu all over again. We’re essentially back to where President Obama began, literally the same room in the White House, the East Room, where he launched this with very similar rhetoric.

All of the major fundamentals in the legislation remain the same. What we have been seeing over the past few weeks are really in the category of what I would call adjustments.

JIM LEHRER: It’s — the elements that are now labeled the new elements — quote — “new” elements that are quote — are — that are labeled Republican, do they — do they — are they substantial in terms of the debate that’s happened over this last year?

CECI CONNOLLY: Well, certainly, in terms of the scope of this legislation and the price tag and the people affected, no, they’re fairly small.

But they are important steps. I mean, putting more money into state grants and experiments on different ways to deal with malpractice lawsuits could have an important impact over the long term.

Republicans, for a long while, have wanted to be able to use health spending accounts more freely. That would also be a significant step. But these are not going to be large components of the overall legislation, by any means, and they’re also, quite candidly, not structured in exactly the way that the Republicans would have preferred.

On malpractice, for instance, they would like to have caps on damages in lawsuits, and the Democrats are not talking about that.

JIM LEHRER: And, Norm, is the — is the conventional wisdom right, that what the president outlined today isn’t probably going to gain any Republican votes?

NORMAN ORNSTEIN, resident scholar, American Enterprise Institute: No, it look likes there will not be a single Republican, unless some miracle happens, in the Senate, who is going to sign on to this. And it’s quite probable that the one Republican in the House, Joseph Cao of Louisiana, who voted for it the first time will vote against it this time.

JIM LEHRER: So, the — the bottom line here, if there is, in fact, a bottom line here…


JIM LEHRER: … is that what the president…

NORMAN ORNSTEIN: Wait a couple of months.


JIM LEHRER: We will get to that in a minute.

That the president said, OK, I will — I will put this on the table, and — but without the hope that it’s really going to change anything.

NORMAN ORNSTEIN: Well, the hope, frankly…

JIM LEHRER: Expectation. Let’s put it that way.

NORMAN ORNSTEIN: The expectation is that he will rally Democrats now and get enough votes for a Democratic Party that, after the Massachusetts Senate election, turned pretty wobbly in many cases.

And getting the 50 votes necessary in the Senate, 50 Democrats, even though they had 60 before, 59 available now, was not going to be an easy task. Keeping at what may be 216 votes now in the House — the majority has dropped a little because of vacancies — is a tough battle.

What’s happened over the last few weeks is designed to try and shore up those votes and win a few more over.

JIM LEHRER: Do you see it the same way, Ceci? And do you think that what the president offered today adds anything helpful to Democrats who are looking for a way to vote for this thing?

CECI CONNOLLY: I absolutely agree with Norm. This game since January the 20th, the day after that Massachusetts election, was all about shoring up Democrats in Congress, who I think wobbly was probably generous.

In the aftermath of Massachusetts, they were absolutely panic-stricken about this issue and how it might affect their own political reelection campaigns come — come fall. So, it’s very much an effort to kind of bolster those Democrats, to give them the confidence to go ahead.

JIM LEHRER: What kind of Democrats? Is it possible to characterize the groupings here of the Democrats?

CECI CONNOLLY: Well, that’s — that’s an excellent question, because, as we have seen throughout this debate, Jim, there has been anxiety in sort of different wings of the Democratic Party in Congress.

Now, all along, especially in the House, there were those conservative Democrats — they’re often called the Blue Dogs — who were among the ones that voted against this bill the first time around. Now, interestingly, Nancy…

JIM LEHRER: They thought it was too liberal?

CECI CONNOLLY: They thought it was too liberal…


CECI CONNOLLY: … too expensive.


CECI CONNOLLY: Interestingly, House Speaker Nancy Pelosi now has an opportunity to go and say to them, look, the Senate bill is more to your liking. It’s not as expensive. There’s more of what we call cost containment in it.

That will be a key way that she will try to bring some of them back along. But we have been hearing from the liberals that are very upset about losing their public option.

JIM LEHRER: Now, let’s talk process for a moment, Norm.

The word is that the Senate will do its reconciliation first, before the House does anything. Is that — is that what you understand?

NORMAN ORNSTEIN: Probably not, Jim.

JIM LEHRER: Probably not?

NORMAN ORNSTEIN: Yes. More than likely, we’re going to have the House act first. The Senate is going to have to give the House Democrats, who do not trust the Senate Democrats at all, some assurance that they will in fact have the 50 votes to vote for a reconciliation package.

But the first thing that is likely to happen is that the House will accept the Senate bill. Just for a second, the normal legislative process is, the House passes the bill, the Senate passes the bill, they reconcile them in a conference committee…


NORMAN ORNSTEIN: And then they vote on that package.

They can’t do that now, because it would take overcoming a filibuster in the Senate for that conference. So, they’re finding a way around that process. And the way is that the House will just accept what the Senate did. Then you won’t have to vote on it again in the Senate. And now we will do the adjustments through this process called reconciliation.

But the House probably has to take that leap off the cliff first, and hope that — or have something that goes beyond a little bit of hope — that the Senate will follow.

JIM LEHRER: And what kind of assurance — will the House even take the vote if they don’t have these kind of assurances going in from the Senate? What do they have to gain from doing that?

NORMAN ORNSTEIN: Well, one thing that is happening is that, over the last few weeks — and I think key to the summit, the president’s initial offer to move forward, the way he acted in the summit, which really was to try and find common ground, and what’s followed, some of the House — the Senate Democrats who have been leery about voting for reconciliation, people like Mary Landrieu of Louisiana, Joe Lieberman, Kent Conrad, the chairman of the Budget Committee, who is a real…

JIM LEHRER: Moderate or conservative Democrats, right.


They’re now coming on board. So, the likelihood of getting the 50 votes will be there. And, along the way, they have got to come up with a substantive package of changes that everybody finds acceptable. But I think they have probably got that close to being in the bag.

JIM LEHRER: Now, I don’t want to go too much into the weeds on this, Ceci, but the — the process in the Senate, the way you then move to a way where you don’t need the 60 votes, you can do it on 51 votes, does that mean there are no filibusters?

CECI CONNOLLY: It does mean that there are no filibusters.

And it’s interesting, because, of course, we have been hearing everyone use the phrase simple majority. But I like to remind that there’s going to be nothing simple about this process, because you can have amendments. And we know for sure that the Republicans are already preparing quite a stack of amendments.

There will also be a lot of arguments over parliamentary procedure. And now, in Washington, there’s a lot of reading the tea leaves about who is this parliamentarian, and how is he going to rule on these tough votes?

And Vice President Biden might have to sit in the chair for hours or days, and make rulings on some of these fights. So, it could still be a fairly long, drawn-out, messy process.

JIM LEHRER: Long, like what?

CECI CONNOLLY: Oh, a good month, I think. They keep talking about this August recess — pardon me, Easter recess.

JIM LEHRER: They may be talking about August.

CECI CONNOLLY: Please, no.

Easter recess.


CECI CONNOLLY: But that could be anywhere from March 26 to April 8 or 9, so a good month.

JIM LEHRER: You agree, at least a month?

NORMAN ORNSTEIN: Yes. I think we have got several steps along the way before we get to a vote in the Senate. And that includes coming up with a package that will make it under reconciliation, because there are only things that you can include.

They have to be things that affect spending or taxes and substantial…

JIM LEHRER: Now, why is that? Why — is that — that’s just part of the rules of the United States Senate, right?


Well, it’s part of the — the law involving reconciliation, and as it’s been amended, and the rules of the Senate.

JIM LEHRER: I knew I shouldn’t have asked you that.

NORMAN ORNSTEIN: That’s right.

NORMAN ORNSTEIN: But it goes back to 1973. And this is a process where you take whatever bills pass the House and Senate between budget resolutions and reconcile them to the ceilings.

So, the only way you can expedite action, limited debate, no filibusters, is by making sure that these affect the budget directly. So, they have got to design those things. Then they have to get them scored by the Congressional Budget Office. Then we get to all of the complications that Ceci talked about.

JIM LEHRER: Who decides whether or not it fits the category correctly?


JIM LEHRER: In other words, is this really a budget thing, rather than a health care reform thing on another — you know.

NORMAN ORNSTEIN: Well, of course, as President Obama pointed out today — and we know — many things, including almost everything substantial in the health care world over the last 20 years, other than the Medicare prescription drug bill, COBRA, this plan that extends health insurance for the unemployed, it’s for the Omnibus Budget Reconciliation Act.

So, lots of substantive things…

JIM LEHRER: There’s precedent for that.

NORMAN ORNSTEIN: There’s precedent for that. The welfare reform came under reconciliation.

The parliamentarian, Alan Frumin, who is a 30-plus-year veteran of the Parliamentarian’s Office, and…

JIM LEHRER: Nonpartisan?

NORMAN ORNSTEIN: Nonpartisan. He actually was brought in by the Republicans. They’re now saying that he’s too partisan as a Democrat.

But he makes an initial judgment. The parliamentarian gives advice. And, as Ceci suggested, it’s the — it’s the presiding officer, who will be Joe Biden, the president of the Senate, can make an ultimate ruling. And then it can be challenged, but a majority can uphold it.

JIM LEHRER: In other words, we have got a lot of fun ahead of us, Ceci.

CECI CONNOLLY: That — that’s certainly one way of — full employment for health care journalists, I’m afraid to say.


NORMAN ORNSTEIN: Full employment for journalists, we’re for that, whoever they may be.

JIM LEHRER: OK. OK. Thank you both very much.