On November 18, 2009, Senate Majority Leader Harry Reid (D-NV) released the Senate Democratic leadership’s version of a comprehensive health reform bill, the Patient Protection and Affordable Care Act (H.R. 3590). This legislation is the product of weeks of work by the Senate leadership to combine the health care reform bills passed by the Senate Health, Education, Labor & Pensions (HELP) Committee in July, and the by the Senate Finance Committee in October into one bill for consideration on the Senate floor.
The process Majority Leader Reid and the Democratic leadership will need to go through is dictated by the very complicated Senate rules of procedure described below.
On November 19, 2009, Senator Reid filed a cloture motion to proceed on H.R. 3590 and bring it to the floor. This is a three-day process with filing on the first day (November 19), a review day on day two (November 20), and a vote on the third day (November 21). Republicans have reportedly agreed not to read the entire 2,072-page bill aloud into the Senate record at this time (a process that could take more than 48 hours) in exchange for two days of debate on whether or not the discussion on this particular health reform bill should even continue at all. Sixty senators then must vote yes on the cloture motion or H.R. 3590 cannot be brought to the Senate floor for consideration.
Over the past few weeks, many moderate Democrats have been bargaining with their leadership to secure their votes to move forward. As of today, it looks like Senator Reid will eventually get the votes he needs. Many moderate senators have voiced serious concerns about the bill, but have made the distinction between the procedural vote to move forward and support for a final bill on the floor.
Assuming the motion to proceed is successful, the Senate will recess for Thanksgiving and return on November 30, when floor debate will begin. The process is expected to be a slow one, filled with consideration of hundreds of floor amendments.
Relative to the floor debate, Senator Reid made a huge concession when he completely ruled out using budget reconciliation rules to pass the bill — a major shift from previous statements. Using the reconciliation process would have allowed him to pass portions of the bill under limited debate rules and with a simple majority of 51 votes. But all provisions that did not have a direct federal budgetary impact would have been required to be abandoned, making the bill next to impossible to conference with the House-passed legislation. Also, many Senate Democrats have been vocal in their complete opposition to the use of this procedural trick to pass health reform.
As the bill moves to the Senate floor, it is important to remember that you still have ample opportunity to influence the political process and the outcome of any legislation.
This will make very interesting discussion over the next month or two. Clearly, the country is divided on health care reform. What does “reform really mean and do” as the bill evolves into final form.
My one suggestion is we all need to read the proposed bill and its amendments, and what is written, not what is said on the airways. Each person needs to determine what it will ultimately mean to them, their family, benefit plan, business and ultimately, access and care.
This will be the major issue of our times.