As Obama readies reform proposal, Reid backs use of reconciliation

The Senate's top Democrat said he would use a legislative process known as reconciliation to unstick the now-stalled effort to reshape the $2.5 trillion per year U.S. healthcare sector.

Senate Majority Leader Harry Reid (D-Nev.), appearing on the Nevada news show Face to Face with Jon Ralston late Friday, said he would likely use the legislative maneuver to pass a smaller-scale bill that harbors a number of provisions already negotiated by House and Senate leaders.

“I think we will not have to do a major bill,” Reid said. “We'll do a relatively small bill to take care of what we've already done.”

Reid said the reconciliation bill could be passed within the next 60 days. Presumably, the move would have to hold until the House passes the Senate's version of the bill first—something it has previously been reluctant to do.

The comments were made just days before the White House plans to post its own reform proposal online—expected tomorrow—and nearly a week before President Barack Obama's highly publicized, bipartisan healthcare summit.

Televised live, the Feb. 25 forum will be the most visible marker yet on what the president is willing—and unwilling—to accept as part of a legislative package to change how care is paid for and delivered across the country.

Republicans, too, will be in attendance, but many have said that they are increasingly leery that their own tenets for reform will get short shrift from the White House as well as their Democratic counterparts.

Speaking Sunday on the news show Meet the Press, Rep. Mike Pence (R-Ind.), chairman of the House Republican Conference, said that his party would welcome a “good faith” effort to start over on health reform, but added he was skeptical it would happen.

“If we were talking about really starting over with a clean piece of paper, scrapping the bills that have already passed the House and the Senate—and also renouncing the abuse of the legislative process known as reconciliation—Republicans are ready to work,” he said.

Though complicated, the reconciliation process effectively allows legislation to pass the Senate on a simple majority vote rather than the typical 60 votes needed to overcome a filibuster.

But it's the lack of a clear understanding on what the White House wants, coupled with the fact that many lawmakers have been away from Washington for more than a week and have had little contact with the key framers of such a proposal, that has the healthcare industry puzzled over what to expect next.

Jack Cochran, executive director of the Permanente Federation, said he has muted expectations for this week's conference at the Blair House—the site just across the street from White House and the scene for Thursday's sit-down.

When asked if he thought it would be a make it or break it week for the reform effort, Cochran, in Washington to address the National Governors Association, said it likely would be neither. Instead, he opted to highlight the challenges that are at the crux of comprehensive reform.

“They're treating it like a game of chess,” where one piece takes another in an attempt to ultimately check the opponent into submission, he said. “But it's not a game of chess. It's a game of dominoes.”

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