Weekly Pulse: Flipping the Byrd on Health Care Reform


This week, the healthcare reform debate churned on behind the scenes
as the economic crisis and treasury secretary Geithner’s latest bank
rescue plan dominated the news cycle. Meanwhile Democrats weighed
various strategies to advance healthcare reform even without a
filibuster-proof majority in the senate. Drug policy made headlines
this week. Attorney General Eric Holder expanded upon the
administration’s new found tolerance towards states that permit medical
marijuana. Plan B will soon be available
to 17-year-olds over-the-counter, thanks to a ruling by a New York Federal judge.

"Could an obscure Senate rule free Barack Obama from the filibuster and enable health-care reform?" asks Ezra Klein
in the American Prospect. Democrats are eager to maintain momentum for
their ambitious healthcare reform agenda, but the potential of a
filibuster could derail the plan. It all comes down to numbers: If a
healthcare reform bill were introduced in the Senate, the Democrats
would not have the 60 votes they need to block a Republican filibuster.

However, as Klein explains, it’s possible to pass a healthcare bill with a simple majority in the Senate:

Imagine you want to run health reform through the
reconciliation process. Here’s how it works: Congress includes
reconciliation instructions in the budget. Those instructions direct
certain committees – say, the Finance Committee and the Health, Energy,
Labor, and Pensions Committee – to produce health-reform legislation
hitting certain spending targets by a certain deadline. Once finished,
the legislation is tossed back to the Budget Committee, which staples
it together into an omnibus bill and sends it to the floor of the
Senate for 20 hours of debate followed by an up-or-down vote.

There’s always a catch. In this case, Klein explains, the catch is a
provision known as the Byrd Rule, which states that only provisions
directly related to spending or deficit reduction can be inserted
during budget reconciliation. Everyone seems to agree that healthcare
reform will have a profound impact, for good or ill, on the nation’s
bottom line-but would healthcare legislation "count" under the Byrd
test? Klein says that nobody knows because the final decision would
rest with the inscrutable Senate parliamentarian, Alan Frumin . George
W. Bush used the reconciliation process to pass everything from oil
drilling to trade policy, but there’s simply no way to know whether the
parliamentarian would indulge the Democrats on healthcare. Klein
writes, "It’s the legislative equivalent of deciding a bill on penalty
kicks."

Even so, the Republicans aren’t taking any chances. The Washington Monthly’s
Steve Benen recently chided Sen. Judd Gregg (R-NH) for saying that
using the reconciliation process to pass healthcare reform would be a
step towards "mob rule".

Public interest lawyer Roy Ulrich argues in AlterNet that we may not see healthcare reform until we see campaign finance reform.
Ulrich notes that most liberals, President Obama included, want
healthcare reform to included a publicly-financed health insurance
option. However, even some of the Democrats in the Senate are hostile
to that idea, notably Sen. Max Baucus (D-MT), who has received more
than $413,000 over the past four years from drug companies and health
insurance carriers.

Drug policy continues to make headlines this week. Steve Benen of the Washington Monthly
follows up on Attorney General Eric Holder’s announcement that he will
no longer raid medical marijuana facilities in California, where the
drug is legal with a doctor’s prescription: Holder stated that on his
watch, federal authorities would only target traffickers posing as legitimate dispensaries, bona fide purveyors of medical marijuana.

Benen notes that Sen. Chuck Grassley (R-IA) is giving an
unpredictable justification for his entirely predictable outrage: "This
Attorney General is not doing healthcare reform any good," said
Grassley. "The first rule of medicine – ‘do no harm’ – is being
violated by the Attorney General with this decision."

Yes, that’s the same Chuck Grassley who cheers on Rush Limbaugh for
telling lies about comparative efficacy research (CER) and healthcare
reform. I’m not making this up. Chris Hayes of the Nation has the details.
Limbaugh, Fox News and other right wing media outlets have been
deliberately circulating misinformation about the president’s
comparative effectiveness research program. In reality, CER is a tool
for doctors to make better treatment deisions. Limbaugh and his cronies
are claiming that it has something to do with healthcare rationing and
Grassley is cheering them on.

Despite some deescalation on the medical marijuana front, President
Obama has shown a troubling willingness to further militarize other
aspects of the drug war, Democracy Now reports.

And finally, a big step forward for birth control, thanks to a
federal judge in New York. Thanks to the judge’s ruling, Plan B, also
known as the morning after pill, will be available over-the-counter to
women over the age of 17 within the next 30 days, Dana Goldstein notes in the American Prospect. The judge found the FDA erred in restricting access to Plan B during the Bush era.

Like this story? Your $10 tax-deductible contribution helps support our research, reporting, and analysis.