What's next for health care reform?
J. Lester Feder of The Nation has a good summary of the next steps for health reform.
The Senate passed its version of the bill on Christmas Eve. Now, congressional leaders will combine the House and Senate versions of the bill to create a hybrid bill known as a conference report, which must pass both the House and the Senate before the president can sign it into law.
On the whole, the House bill is more progressive than the Senate version. For example, the House bill includes a public option, but the Senate bill doesn't, thanks to Joe Lieberman. The House bill would pay for reform by taxing the wealthy, the Senate version would tax high-cost health care plans.
Chances are, the final bill will look more like the Senate version. Amanda thinks that many observers are underestimating Speaker Nancy Pelosi:
I’ve been a little cowardly and not posting too much on the actual Senate bill because I don’t want to deal with the “kill the bill” crowd---or worse, people starting to talk third parties and other such nonsense---but I have been tweeting in support of getting through this process with our wits about ourselves, including reminding people that, contrary to mainstream media insinuations to the contrary, the House does matter. The continued dismissal of Nancy Pelosi’s power has left me really uneasy, because I detect more than a whiff of unintentional sexism to it, though part of the reason that people overlook Pelosi is that she’s a publicly unassuming person.
Sadly, thanks to the institutional filibuster, the House really doesn't matter as much as the Senate. As Nate Silver explains at 538, Pelosi has way more flexibility than Reid when it comes to passing health care. Nate estimates that Pelosi has between 240 and 245 potential "yes" votes for final passage, of which she only needs 218. So, she can afford to lose some of the progressives who voted for the bill the first time if she makes up that support from more conservative Dems who voted "no" the first time. Reid absolutely needs 60 votes or the whole thing goes down in flames.
This flexibility is a drawback when it comes to negotiating in conference. Pelosi and Reid both want the final bill to pass. Reid knows that if the bill deviates from Ben Nelson's strictures on abortion, or Joe Lieberman's prohibition on the public option, the bill will die. In all probability, Pelosi can pass a bill without a public option. There's no way Reid can pass a bill that includes one. So, Pelosi has a lot less leverage in conference.