The Health Care Debate On The Left

by Patrick Appel

Nate Silver posed 20 questions to those on the left who want to kill the bill. Kos and John Walker at FireDogLake replied to each and every one. Silver followed up here. Silver gets the better of the debate, if for no other reason, because he has a more realistic expectations for the reconciliation process. Nate:

I'm not a process wonk, but the overwhelming opinion among people who are is that, although the public option might survive the reconciliation process, things like the ban on denying coverage for people with pre-existing conditions, the additional regulations on insurers, and the creation of the health insurance exchanges would almost certainly not. Plus, the bill would have to be deficit neutral over five years and would be subject to renewal every five years.

If your lone objective were to end up with something that you could call a public option, then yes -- reconciliation offers some possibility of that. But I don't see how you're likely, on balance, to wind up with a better bill -- losing the guaranteed issue provision alone would probably outweigh the inclusion of a public option.

A few months ago, I ask a friend who works for a congressman why Congress couldn't pass the bill through reconciliation. His response was you would have a difficult time getting a bare majority in the House if you were unable to cram in concessions to various politicians. Reconciliation makes the buying of votes through pork impossible because reconciliation rules prohibit it. The chances of passing anything at all drop dramatically if you enter the reconciliation process. First Read has a good primer on the process.