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51 Vote Rules May Force a Public Option Too Liberal for Some Dems

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Sen. Harry Reid (D-NV) and Sen. Charles Schumer (D-NY)

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As Senate leaders begin work on a Democrat-only health care bill, they're finding themselves confronted with an unexpected irony: Though the caucus has reached an uneasy consensus around a public option that's modeled in many ways after a private insurer, it may be necessary to make the public option more liberal, and thus, more politically radioactive, if it's to overcome a number of unique procedural hurdles.

This is the needle Democrats may have to thread if they want a public option, and at the same time, want to bypass a Republican filibuster. And the key for them will be keeping conservative Democrats on board.

"A very robust public option that scores significant savings would presumably be easy to justify doing through reconciliation," says a Senate Democratic aide. "But it is still being studied whether other, more moderate versions of a public option could pass parliamentary muster."

According to Martin Paone, a legislative expert who's helping Democrats map out strategy, a more robust public option--one that sets low prices, and provides cheap, subsidized insurance to low- and middle-class consumers--would have an easier time surviving the procedural demands of the so-called reconciliation process. However, he cautions that the cost of subsidies "will have to be offset and if [the health care plan] loses money beyond 2014...it will have to be sunsetted."

And there the irony continues: Some experts, including on Capitol Hill, believe that a more robust public option will generate crucial savings needed to keep health care reform in the black--and thus prevent it from expiring. But though that may solve the procedural problems, conservative Democrats have balked at the idea creating such a momentous government program, and if they defected in great numbers, they could imperil the entire reform package

It's a very technical conundrum with huge policy ramifications. So it's not surprising that Republicans are on to it, and preparing for war.

Sen. Judd Gregg (R-NH)--ranking member on the Budget Committee--says the only way for the public option to survive the process is for it to be "very aggressive in setting rates, price controls and rationing," a fact which may cost Democrats a number of conservative votes within their own party. However, if it's too weak, and doesn't meet the procedural demands of the reconciliation process, Gregg says the Republicans are preparing myriad objections to it and other aspects of the Democrats' reform plan.

Each year, Congress passes a budget, but sometimes it has to enact a separate bill to raise or reroute funds in order to meet the budget's demands. That's the reconciliation bill--and it's so important that Senate rules exempt it from a filibuster. But they also prevent it from being a vessel for any old provision that the majority party wants enacted. The specifics of these limits (enshrined in the so-called Byrd rule) are complex, but the overarching rule of thumb is that provisions passed through this process must have a significant budgetary component (i.e. involve the moving around of federal money) and that the legislation should not, in the long run, increase the federal deficit. (A recent historical example: the 2001 Bush tax cuts were passed via the reconciliation process. They survived the Byrd rule because they had a huge budgetary impact, but since they vastly increased the federal deficit, they sunsetted, and had to be renewed after five years.)

As Gregg and Paone and the Democratic source indicate, a more liberal public option might be easier to push past these procedural hurdles than the public option that's currently on the table. But That doesn't mean some of the less robust options are completely off the table. According to Paone, "sufficient funds would probably be needed from the general revenue to subsidize the public option or to provide "seed" money for a coop plan," if either of them were to survive, indicating that creating private co-operative in lieu of a public option may still be feasible under the reconciliation process.

But that doesn't change the underlying dilemma. The path of least political resistance is beset by procedural obstacles; and the path of least procedural resistance is beset by political ones.

Comments (117) | Join the Conversation!

Recommend Recommend (1)

September 1, 2009 12:23 PM   

So the Conservative Democrats want to avoid passing a bill that's too effective. Great.

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September 1, 2009 12:35 PM    in reply to traitorjoe

That's the real irony here. If the plan is effective at saving money, it doesn't get the conservative/centrist stamp of approval.

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September 1, 2009 1:13 PM    in reply to miguelitoh2o

But, but, but that would make their stated concerns about the deficit seem less then honest...?

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February 18, 2010 4:29 PM    in reply to henk

Of course and 50 VOTES ARE WHAT'S NEEDED with Joe Biden breaking any tie.

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September 1, 2009 4:34 PM    in reply to miguelitoh2o

"If the plan is effective at saving money, it doesn't get the conservative/centrist stamp of approval."

But that savings to the general public will come out of some M/Billionaire's bloated pocket.

That is the issue in a wingnutshell.

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September 1, 2009 6:36 PM    in reply to JEP07

There doesn't appear to be a "dilemma" confronting Senate Dems either. There's no downside to crafting a good bill. The only people who it will anger are Republicans and insurance company lobbyists.

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September 2, 2009 2:06 AM    in reply to betpinson

and insurance company lobbyists

And therein lies the dilemma.

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September 1, 2009 1:52 PM    in reply to traitorjoe

OH, I"m shocked! What I knew when summer began actually happened! The Tea Party movement, if not led by the GOP at the outset, became it's field operations for August. The big bucks of the right-wing shadow government (consultants, corporations) swung into action. The administration,the DNC, were taken by surprise that the right-wing has the discipline?

And the Left sort of diddled around. Perhaps thinking once again that because the Republicans were out of power, and to a large extent out of favor, that the Dems could just argue the "moral" high ground. Well friends, if the rise of fascism in the 30s, and the tactics they employed weren't taken into consideration, then we once again underestimated the vileness of the Republican party (OK, I'll admit I was taken by surprise to some degree by the outright lies...).

It might just come down to this choice: Either go for broke with the public option centered plan - and risk getting nothing if it fails - or go for a "generally acceptable" Bill - minus the public option, of course -that can perhaps get passed with one or two Republicans (and all Democrats).

Finally, when will the DNC learn how to manipulate opinion? Yes, that's politics. Why hasn't
Obama had a national speech where USING VISUALS SUCH AS A COUPLE OF CHARTS clearly spelled out that the number one priority is GETTING CONTROL OF COSTS, and the risks if that isn't done. By drumming that fiscal message into the public's mind, it becomes so much easier to demonstrate how absence single-payer, a public option is the best way to go about it.

But NO...we didn't see it. We saw....diddling and doodling and bumbling, from Obama on down.

And please, may I never again have to read that the administration was SURPRISED by the
vile tactics of Republicans.

Finally, I fear the cycle will be repeated: Dems will squander opportunities, Repubs will capitalize on it to get back power, where they will once again demonstrate they hate government, and then lose power....but that will be yet another 10 years down the road.

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September 1, 2009 4:32 PM    in reply to dnegri

"The big bucks of the right-wing shadow government (consultants, corporations) swung into action."
"And the Left sort of diddled around."

Sad, but true, and strangely enough, despite the lack of blind unity in the Democratic Party, we still managed to beat the furry, pliant lemming mob in 2006 and 2008.

Unity is great, as long as it isn't blind.

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September 1, 2009 2:42 PM    in reply to traitorjoe

So then a simple single-payer option would be easier to pass than the bloated hodge-podge that they are trying to pass now.

If the bill said,....

"All US citizens have medicare from the time they become citizens until the time they die or are no longer citizens, and all money that the federal government spends on health care and health care assistance at any level will hereafter only be used to administer Medicare coverage to US citizens."

.....then it would be easier to overcome the objections because it moves a lot of money around and it would save the most money for the foreseeable future.

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September 2, 2009 2:42 AM    in reply to Darrius

"So then a simple single-payer option would be easier to pass than the bloated hodge-podge that they are trying to pass now."

I wish you anti-gov't jackasses would pay attention:

1. There are FIVE -- 5 -- FIVE proposed bills in the House.

2. There is one proposed bill in the Senate.

3. Once the FIVE -- 5 -- FIVE in the House are reconciled into ONE bill, that bill will then have to be reconciled with the Senate bill.

If you're going to whine and moan, get the facts FIRST.

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September 1, 2009 3:34 PM    in reply to traitorjoe

OH, I"m shocked! What I knew when summer began actually happened! The Tea Party movement, if not led by the GOP at the outset, became it's field operations for August. The big bucks of the right-wing shadow government (consultants, corporations) swung into action. The administration,the DNC, were taken by surprise that the right-wing has the discipline?

And the Left sort of diddled around. Perhaps thinking once again that because the Republicans were out of power, and to a large extent out of favor, that the Dems could just argue the "moral" high ground. Well friends, if the rise of fascism in the 30s, and the tactics they employed weren't taken into consideration, then we once again underestimated the vileness of the Republican party (OK, I'll admit I was taken by surprise to some degree by the outright lies...).

It might just come down to this choice: Either go for broke with the public option centered plan - and risk getting nothing if it fails - or go for a "generally acceptable" Bill - minus the public option, of course -that can perhaps get passed with one or two Republicans (and all Democrats).

Finally, when will the DNC learn how to manipulate opinion? Yes, that's politics. Why hasn't
Obama had a national speech where USING VISUALS SUCH AS A COUPLE OF CHARTS clearly spelled out that the number one priority is GETTING CONTROL OF COSTS, and the risks if that isn't done. By drumming that fiscal message into the public's mind, it becomes so much easier to demonstrate how absence single-payer, a public option is the best way to go about it.

But NO...we didn't see it. We saw....diddling and doodling and bumbling, from Obama on down.

And please, may I never again have to read that the administration was SURPRISED by the
vile tactics of Republicans.

Finally, I fear the cycle will be repeated: Dems will squander opportunities, Repubs will capitalize on it to get back power, where they will once again demonstrate they hate government, and then lose power....but that will be yet another 10 years down the road.

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September 1, 2009 3:39 PM    in reply to traitorjoe

Traitorjoe is exactly right..God help it being effective legislation and what the people want!!!!..Call the fools--- 1.800.828.0498 or 1.866.220.0044.

Send this argument to others it is well written and mostly to the point..about political jockeying not workable legislation! Might offend those donors putting $1.4 million a DAY in the congressional coffers!!!

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February 18, 2010 4:26 PM    in reply to traitorjoe

NO. The CBO scoring should bring them to our side. Draw up a robust PO and see how it lowers the deficit. That will win in red states.

That is one of the objectives Obama is looking for.

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September 1, 2009 12:25 PM   

Then threaten to primary them.

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September 1, 2009 4:58 PM    in reply to Rich in NJ

Don't just threaten, promise.

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September 2, 2009 8:57 AM    in reply to Rich in NJ

OK.

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September 1, 2009 12:27 PM   

Corporate Dems are selfish. They're more worried about getting re-elected than passing a bill that would be too effective in the long run, but leave them open to political attack in 2010.

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September 1, 2009 4:32 PM    in reply to Walter Mitty

Over the last 8 months, I have been watching all that Obama has been doing and becoming more and more disgusted with him for having played this supporter for such a risible fool.

In this 8th month of Obama's administration, I am reminded daily of an adage my Mom used to quote to me many years ago, "Show me your company and I'll tell you what you are." Oh, how true that is of President HOPEless and CHANGEless.

Obama's company or BFFs: Summers, Geithner, Emanuel, Messina, Baucus, Grassley, Conrad, Ben Nelson, PhRMA, Insurance, Goldman Sachs, AIG, Bush & Co (including all policies), Iraq warmongers, Afghanistan warmongers, etc., etc.

Now, what would you say Obama is? If you say Right leaning capitalist who never intended to do anything he promised during the campaign, then you're right. Anything else is simply trying to provide some explanation for the kick in the guts Obama is giving the little people!

So.....with regard to health care, Obama does not want to do anything that would hurt the insurance industry or PhRMA. He does not really want a public option that would allow for affordable premiums and quality health care without restrictions. He is no fool--he know very well how to present even the most difficult scenario to the public and make it clear and understandable to the least of us. He also knows how to twist arms and get what he wants from difficult colleagues--he did it in Chicago, didn't he?!? He did it to win the presidency, didn't he?!? So, it ain't the foolish "dems" and it ain't the greedy "Blue Dogs." It's Obama with the help of the Blue Dogs (starting with Rahm, the biggest and most aggressive of all Blue Dogs).

So, folks, Obama's company, Blue Dogs, Insurance and PhRMA. What is he? He's an anti health care reformer. As has been said, Obama Punked Us!!!!!

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September 1, 2009 7:00 PM    in reply to PJCoco

I smell a troll. "All" Bush policies, "warmongers"? Nice try.

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September 1, 2009 12:28 PM   

Just to make sure I have this correct:

So a more robust public option that actually is most effective in cost control and reducing deficit impact is actually the one with the least amount of support from conservative Democrats?

(shakes head)

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September 1, 2009 12:37 PM    in reply to LarsThorwald

The logic is quite simple my friend, "Conservative" Dems are worried about insurance company profits. FULL STOP, thats why they dont want effective cost control

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September 1, 2009 12:52 PM    in reply to 3star2nr

Sadly.... keep the insurances healthy, even if the people are sick!

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September 1, 2009 11:23 PM    in reply to TheraP

This is why Lieberman wants to delay, for example. Connecticut is the insurance company state.

Obama needs to lead, really lead, and get us a good bill passed despite these tools and their worst intentions.

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September 2, 2009 2:46 AM    in reply to Overreach THIS!

Connecticut is the insurance state. And the insurance industry sits at the right hand of "God".

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September 1, 2009 12:28 PM   

And the problem is?

Nelson, Landrieu, Lincoln, Bayh, Conrad, Baucus is only 6. Who else is conservative enough to vote no?

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September 1, 2009 12:33 PM    in reply to TBender

mark warner's one.

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September 1, 2009 1:46 PM    in reply to nova voter

I believe Warner said he'd support the PO just recently.

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September 1, 2009 12:33 PM    in reply to TBender

Ok...I'll throw in TJ's avatar and namesake. That's 7.

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September 1, 2009 12:37 PM    in reply to TBender

where's jim webb on the issue/spectrum?

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September 1, 2009 2:00 PM    in reply to mike from Arlington

And to follow up....Warner has been out there fighting against all the misinformation. This is a winner for VA with both Webb and Warner on board this late in the game. We're now left with about 5-6 faux conservatives that mask as fiscal conservatives when instead they are protecting corporate interests.

http://warner.senate.gov/public/index.cfm?p=Contact#form_f9db6196-2dc7-4cda-8add-f8435a71318a

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September 1, 2009 2:48 PM    in reply to TBender

Baucus will vote for the public option too.

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September 1, 2009 3:24 PM    in reply to TBender

Where's Lieberman on this? With the people of Connecticut, or the insurance companies in Hartford?

I know he wants to delay, but if push comes to shove, how will he jump?

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September 3, 2009 1:53 AM    in reply to cwnidog

In favor of Israeli settlements.

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September 1, 2009 12:29 PM   

Who the heck do these guys work for? It's obviously not their constituents. This just makes me so frustrated and angry!

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September 2, 2009 2:20 AM    in reply to Lynn Dee

Of course they are working for their constituents, Grasshopper. You are merely confused as to who their constituents are. You have been laboring under the illusion that their constituents are the voters. Once those illusions drop from our eyes, our minds can become clear.

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September 1, 2009 12:34 PM   

Maybe I'm dreaming -- probably -- but I wonder if there aren't Republican congresspersons who understand that health care reform with a public option is what's best for their constituents, but who at the same time need to make a hell of a good show of opposing health care reform so the health care industry doesn't take their money elsewhere. Thus, we might have the craziness on the surface (and how!) but underlying it the understanding that Obama can still put the ball through the goalposts using reconciliation. Watch carefully to see how hard they fight in this very arcane and technical battle to frustrate the reconciliation process, should it end up being Obama's choice for getting things done.

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September 1, 2009 12:45 PM    in reply to JimmyBobby

The real opposition will occur behind closed doors when they're crafting the bill. If the conservatives can slip in enough to make the bill financially effective, but not too effective they may still justify their opposition based on its costs. If they are allowed to do that, you can bet they will have had some assistance from Dems in the pocket of the insurance industry. Smoke and mirrors.

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September 1, 2009 12:35 PM   

They have no choice. They WILL need to support the public option,, and fall in line, This is exactly what we want to happen.

Its not liberal enough after all its not single payer

But its looking like a good bill. I hope they include the kuccinich amendmentt

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September 1, 2009 12:38 PM   

A note to TPM:

Thank you for this article. I am hearing a lot of screaming about the need--nay, the demand-- for a public option from progressives, and very little critical and realistic discussion of what it takes to get it done. This kind of nuts and bolts analysis helps me better understand exactly how steep the curve is, and whether a public option will be in the bill.

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September 1, 2009 12:47 PM   

Judd Gregg's going to lead the Byrd Rule Fight

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September 1, 2009 12:51 PM   

Maybe this is why Reid wanted Gregg out of the Senate...

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September 1, 2009 12:58 PM    in reply to Walter Mitty

No-- it's just Gregg is ranking on the Budget Committee and very knowledgeable on the intricacies of the Budget Act under which the Byrd Rule applies.

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September 1, 2009 1:31 PM    in reply to Headlight

He's also really knowledgeable about the intricacies of the Senate rules and such and a good strategist. I think Reid and Obama tried to pull a fast one by trying to get him out of the Senate, of course Gregg was only interested in getting out if he could control the census.

I bet he runs for re-election in 2010.

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September 2, 2009 7:55 AM    in reply to Walter Mitty

And that's a bet I'm not going to take.

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September 1, 2009 12:54 PM   

The Right Wingers are breaking their arms patting themselves on the back for derailing the public option. And these are the "middle class" dolts who have won the right to see their insurance premiums rise 15% a year, a small price to pay for hurting Obama's approval rating.

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September 1, 2009 12:55 PM   

I still don't understand the Gang of 6 strategy. Did Baucus intend to use Grassley and Enzi as surrogates for moderate/conservative Dems or as a stalking horse to secure their support? The former is just plain dumb, the latter too clever by half for why do by indirection that which you can do directly?

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September 1, 2009 12:55 PM   

Note the google ads that pop up with a headline calling something "too liberal." I got 2 ads from national right-to-work committee and one from the RNC attacking the health care bill!

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September 1, 2009 1:08 PM    in reply to Headlight

That old lady sure looks pissed. Maybe someone's told her that Republicans have been against Medicare since it was introduced and have been trying to kill it ever since.

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September 1, 2009 12:56 PM   

There's another way a public option could be included in the final bill - enforce party discipline and demand that all 60 Democrats (including Lieberman and Kennedy's replacement, who hopefully will be named by the Mass governor soon - yes, I know, a lot of moving parts here) vote for cloture, even if they plan to vote no on the bill itself. This would require Harry Reid (I know) and the rest of the leadership (I'm looking at you, Mr. President) to arm-twist, cajole, and if need be threaten with removal of committee chairmanships any Dem caucuser who refused to vote for cloture. Maybe it's asking too much for the Democratic Party to actually take advantage of the historic opportunity they've been given, and maybe there are too many of them who are afraid of losing their corporate financing. But if a lousy bill gets passed (no public option, mandated coverage, weak regulations on the insurance industry) then Obama is looking at a one-term presidency, and Democrats are looking at being back in the minority by 2012.

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September 1, 2009 1:02 PM    in reply to commie atheist

This would require Harry Reid (I know) and the rest of the leadership (I'm looking at you, Mr. President) to arm-twist, cajole, and if need be threaten with removal of committee chairmanships any Dem caucuser who refused to vote for cloture

Insufficient

Only 58 votes or did you not see poor Sen Byrd sitting there in a wheelchair waving an American Flag on Saturday at the Capitol Senate Steps?

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September 1, 2009 1:07 PM    in reply to JohnMcCSF

Is Byrd incapacitated? It's 60 if Byrd can vote and a replacement for Kennedy is named before the final vote.

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September 1, 2009 1:19 PM    in reply to commie atheist

Didn't see him on the Senate steps waving the American flag did you

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September 1, 2009 2:01 PM    in reply to JohnMcCSF

Unfortunately, I did. However, he can vote from a wheelchair.

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September 1, 2009 1:03 PM    in reply to commie atheist

Don't forget that the Democrats might also be able to get a few Republicans (Snowe and Collins are the most likely) to support cloture.

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September 1, 2009 1:10 PM    in reply to agio

Only if one or both of them plan on pulling a Specter before their next campaigns.

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September 3, 2009 1:59 AM    in reply to commie atheist

As Republicans, they have to watch their backs: the winds are blowing Democratic throughout New England.

And you know the Kennedy family is full-court-press lobbying.

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September 1, 2009 12:58 PM   

Thanks to Beutler for finally helping dispel a myth that has captivated too many progressives for too long - the Myth of Reconcilliation.

"Now if we can't do a bipartisan bill, then we will do a partisan bill. I don't want to do that," [Reid] said. "Under the rules of the Senate, we passed a budget resolution that says we can do, with a simple majority, we can do education and health care. I don't want to have to do that. Because if you're talking to me right now about what I could do with reconciliation, it would be only three-fourths of what I could do with a bipartisan bill."

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September 1, 2009 1:04 PM    in reply to JohnMcCSF

I also think it's important to point out that reconciliation isn't some magical technique that will make everything right, but I take exception to Reid saying he'll get less done with a reconciliation process than he would with a bipartisan bill.

At this point, given the public statements that have been made, "bipartisanship" is just as real as unicorns. So he's not going to get anything with bipartisanship.

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September 1, 2009 1:08 PM    in reply to CT Voter

Take exception all you want.

That's the hard truth
That's the entire point....a bill via a cloture is NOT interchangeable with one through reconcilliation

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September 1, 2009 1:53 PM    in reply to JohnMcCSF

So Reid saying he'll get more done via bipartisanship (which is nonexistent at this point, or so it seems) is akin to Reid saying he'll get more by getting nothing. Doesn't make much sense.

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September 1, 2009 1:09 PM    in reply to CT Voter

He needs 2-3 Republican votes to bring a bill to the floor under normal procedures

Call it what you will

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September 1, 2009 3:33 PM    in reply to JohnMcCSF

"Balls!", said the Queen. "If I had 'em, I'd be King!".

Harry needs to wake up to the fact that a bipartisan bill isn't going to happen when only one party is interested in seeing anything passed.

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September 1, 2009 1:00 PM   

unbelievable. this health care issue at this moment is one complete mess, honestly.

The Dems at this point should just throw themselves on the political sword, get healthcare pass, and whatever happens in 2010 so be it.

because its looking more and more likely that it will be hard to get an effective health care plan and the Dems keeps congress in 2010. That is starting to look unlikely.

They may lose congress anyways with or without passing effective healthcare. might as well get something done and tell their grandkids they voted for health reform.

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September 1, 2009 1:05 PM    in reply to BossDrop

That would require the ability to see beyond the next election cycle, something most politicians are congenitally incapable of doing.

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September 1, 2009 5:18 PM    in reply to agio

Well they are going to have to look pass the next election...especially the blue dog democrats.

Look, lets be frank here. These Blue Dog Constituents are itching for a reason to replace them. Most of these votes are in conservative area where....I'm going to play it....They still can't get pass the fact that Obama is black and they won't get the massive black and minority turnout as coattails because Obama is not running in 10.

So, lets look at the options.
Reconciliation is War. If the blue dogs vote for that I believe its going to make turnout in next yr's midterm remarkable...because the GOP machine is going to go rabid and I think that will cost maybe not all...but quite a few of the blue dogs.

I don't like this sunset issue. That is IMO...a delay tactic to kill the bill....and the blues still might lose because they supported HCR.

or lastly....No bill, a repeat of 1994, Dems lose. I don't think that can happen, a bunch of lawyers can't be that stupid to do the same thing that sank them 15yrs ago.

60 Dems to prevent filibuster....NOT!

I'm a Demococrat, but these Blue Dogs are Done!. There ain't nothing they can do about it, stick a fork in them. They might as well vote for HCR while they are in congress...because no matter what happens, they are OUT next yr.

Sucks to be them.

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September 1, 2009 1:06 PM   

One thing a bit further down the road..


If as seems likely reconciliation produces, if not a "Swiss Cheese", then certainly a 3/4 health care bill, the Senate can still go to conference with the House.

The key now it seems to me is to pass a House Bill next week and turn up the pressure on the Senate

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September 1, 2009 1:16 PM   

In a new CBS poll, 69 percent of Republicans find the proposed reforms confusing as do 58 percent of Democrats.

Just wait until the Senate passes a bill through reconciliation!

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September 7, 2009 1:30 PM    in reply to JohnMcCSF

"In a new CBS poll, 69 percent of Republicans find the proposed reforms confusing as do 58 percent of Democrats. "

If this is true, then how can 69% of Republicans and 58% of Democrats offer an opinion on it? And who should pay the least bit of attention to them if they do?

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September 1, 2009 1:21 PM   

"Sen. Judd Gregg (R-NH)....says the only way for the public option to survive the process is for it to be "very aggressive in setting rates, price controls and rationing," a fact..."

A Fact? Who the hell says that "setting rates, price controls" and the big bad wing nut boogie man of them all "rationing" are FACTS! Judd Gregg? I really want to know where these "Facts" are coming from, because for all I've seen, and I do watch this pretty closely, no one, NO ONE, is talking about rationing, except as a scare tactic. Maybe I missed it but setting rates and price controls don't seem to be on the table either.

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September 1, 2009 1:51 PM    in reply to henk

What he is saying or threatening is a point of order against the bill. He's softening up the parliamentarian on the question of fiscal impact which is crucial to a Bryd rule point of order

How the CBO scores the public option will be an important, highly relevant FACT in the parliamentarian's ruling

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September 1, 2009 2:11 PM    in reply to JohnMcCSF

I'd say it's the only relevant fact, and the CBO is notorious for underestimating savings and overestimating costs.

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September 1, 2009 1:21 PM   

Help me out.

I know the House Democrats had a dial-in caucus during the recess and voted to support a public option.

Here's the statement from the article: "Though the caucus has reached an uneasy consensus around a public option." The rest of the article interchangeably uses Senate and Congress.

Does this statement refer only to the House dial-in caucus? Has the Senate also held a caucus like the House and voted in support of the public option? Or are we referring to our own nose-count of Democratic Senators being for/against the public option?

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September 1, 2009 1:24 PM   

A more liberal Public Option is considered "politically radioactive"? The thing that most people want and would provide the most good for the nation is untouchable?

What a stupid country this is. An absolute embarrassment. Even the euphemisms for corruption are insulting to your intelligence.

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September 1, 2009 1:29 PM   

I want to know why the Big Dog hasn't been sent to meet with some of these conservative Dems. I mean, if Bill can secure the release of political prisoners from North Korea, surely he could get at least a couple blue dogs to see the light.

Right?

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September 1, 2009 1:42 PM    in reply to Septic

So either the bill will actually be good or there'll be no bill? Works for me.

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September 1, 2009 1:50 PM    in reply to Septic

How do you know what Obama is or isn't doing behind the scenes?

And your comparison to what Clinton did is just nonsense.

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September 1, 2009 2:35 PM    in reply to Viva!America!

Sorry, I assumed the tongue-in-cheek came through. My fault.

But I agree, we don't know what's being done behind the scenes, and while it would be nice to know that some traction is being gained, I get that you don't want to telegraph any movement (especially during the recess) in order to avoid as much right-wing pushback as possible. While part of me does want to see some of these conservative Democrats called out publicly for being shills for the insurance companies, I understand the need for party unity, or at least the appearance of such.

I know the blue dogs can have a hard time of it back home, but if they want the perks of belonging to the majority, a line must be drawn somewhere and they have to be made to understand that they need to "man up", otherwise the Dems have absolutely nothing to offer them in the way of protection from the Republicans.

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September 1, 2009 3:48 PM    in reply to Septic

I'm begin to wonder if Obama is doing anything "behind the scenes".....We had all this evidence during the campaign that he was playing possum, and outsmarted everyone, etc etc.....But I sure haven't seen much of that ability in the past few months. Hope I'm wrong...

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September 1, 2009 1:47 PM   

WWLD?

What Would Lyndon Do?

The Times Picayune and other Louisiana papers are pressing hard right now for more effective Katrina recovery assistance. No question but that this is THE issue for Louisiana at this point. I believe Obama is set for a visit soon

Would you advise President Obama to send Rahm over to Mary Landrieu's office with a message?

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September 1, 2009 3:40 PM    in reply to JohnMcCSF

Landrieu! Speaking of opponents to the public option. I think she's also waffling on EFCA, and
I wouldn't count on her on any immigration reform plan either.

If the Dems can't get key legislation like the above passed in the Senate because of people like Landrieu, then I say let's dump her. Let the Repubs pick up that seat. (Never thought I'd hear myself say it, but I did). Or maybe she'll save us the effort and do a reverse Specter.

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September 1, 2009 1:54 PM   

Agree with Viva, Obama's got to show leadership and get this done. Chicken Harry can't do it.

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September 1, 2009 2:09 PM    in reply to traitorjoe

Sorry. Obama isn't the Messiah

The Senate Democrats will have to do their jobs themselves

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September 1, 2009 2:10 PM    in reply to JohnMcCSF

I wish he were Hitler though now that I think on it

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September 1, 2009 2:11 PM    in reply to JohnMcCSF

Health Care Reform by Enabling Act!

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September 1, 2009 1:57 PM   

Pass health care reform with 60 votes. O

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September 1, 2009 1:59 PM   

Wow! TPM can't wait to push the "Dems FAIL" headline as hard as they can. Awesome job.

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September 1, 2009 2:00 PM   

Obvious: pass the strongest bill you can devise with 51 votes.

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September 1, 2009 2:07 PM    in reply to dustbunny44

That's what I think. Go to conference with swiss cheese or if you can get it, with Asiago...doesn't matter

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September 1, 2009 2:03 PM   

This sounds like the elements of a deal. Make each side bear the risk that their assumptions are incorrect. The progressive Dems get a robust public option but it sunsets if it doesn't save money. The Blue Dogs can say that it will lose money, and therefore will sunset, so it's worth the risk. Of course it exposes the Blue Dogs' real problem--they want to save money only at the expense of poorer people and not at the expense of their donors and high-end constituents. But still. What's the
harm in trying it for 5 years? That it might succeed and expose the insurers? Let's say so then.

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September 1, 2009 2:18 PM    in reply to Mimi katz

I'm with you to an extent. I'm about 65% for a sunset clause on a public option. Here is my train of thought: Even if you separate the anti-reformers into two groups (Evil pro-corporate Republicans vs. Confused but well-meaning Rs and Inds) you still have a fairly sizable portion of people who are either confused or don't support HCR because of the horrible mis-info campaign. Like it or not, that is the environment we are dealing with (and it is Obama's and Dem leaders fault but that's neither here nor there in this discussion). Imho, a sunset clause would allay the fears of otherwise more moderate Rs and Inds. If the program looks like it's not deficit neutral as promised, reform the bill. If it is looking like it is working as promised, maybe upgrade it. If it is doing well to great, push for single-payer.

I do think it has some potential political upside, gets something solid in place, but allows the American public (who are about 15 years behind the progressive community) some time to catch up without scaring them about a govt takeover that won't happen.

Again, I'm not entirely behind the idea, just thinking out loud. Anybody have any thoughts? Pitfalls for this type of strategy?

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September 1, 2009 3:32 PM    in reply to Shrubbit

At first blush, I like the idea of a trigger for a sunset strictly as an accountability device. A trigger has to be arbitrary to be effective, but I can see some downsides depending on how it' designed. I'd be concerned about who will track it and how. Real financial gains don't always show up on an individual spread sheet. If some states quit eating a significant number of ER bills, would any credit be given to the programs balance sheet, etc? I would also be concerned about disparities and peculiarities in local application. Imagine New Orleans pushing the program into the red but trending black.

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September 1, 2009 7:17 PM    in reply to Shrubbit

Theoretically, it could allay handwringers' fears but any chronological line in the sand gives powerful opponents a clear target to shoot for; by hook or crook find methods to trip up the program. They certainly have the motive, resources, and lack of morals to do it.
Not trying to sound fraidy cat here but...y'know?

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September 1, 2009 3:13 PM    in reply to Mimi katz

I agree. The key question for me is: will the ground rules for the public insurer be the same as for private insurers, or will it be crippled so as to make it overly dependent upon taxpayer funding or simply a "poor man's" health plan that doesn't adequately cover what employer paid private plans can provide? Another "goddamn entitlement."

It could end up being insurance for the unemployed who, history has shown don't have much clout. And let's face it, providers see Medicare/Medicaid as a drag on their finances. If we get medicare for the unemployed for five years there won't be much political support for renewal and lots of support for canning or diminishing it.

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September 1, 2009 2:05 PM   

Republicans will do and say anything to kill health care. Watch this video of Hannity and guest claiming that Democrats care more about Kennedy's vote than they do about Kennedy himself.

Just vulgar!

http://progressnotcongress.org/?p=2764

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September 1, 2009 2:08 PM   

Message for Mendendez?

Dear John,

The 2010 Senate races are really heating up now.

From Democratic Rep. Charlie Melancon jumping into the Louisiana race against Sen. David Vitter, to upcoming special elections, the map is constantly changing. Keeping up-to-date on the latest political machinations is crucial as we make plans to defeat the "Party of No" and expand our Senate majority. President Obama's change agenda depends on it.

That's why we at the Democratic Senatorial Campaign Committee wanted to let you know about a unique opportunity to hear from DSCC Chairman Robert Menendez. Senator Menendez will be holding a conference call at 2 p.m. Thursday, Sept. 3, and we want you to take part

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September 1, 2009 2:29 PM   

This creates an interesting dilemma (for the Blue Dogs). Nate Silver at 538.com has been the most consistent and accurate predictor of elections for some time. He has stated more than once that the Blue Dogs are most at risk (maybe the only ones at risk) if insurance reform doesn't pass. If it fails, then Republicans in moderate states argue they won, and have momentum going into the next election cycle. The more liberal and progressive Dems are generally pretty safe, so even if it fails, they are likely to retain their seats.
Headline: Blue Dog Policy Bites Emmanuel in Ass. From a purely academic observation of politics, this makes me chuckle. Emmanuel created the Blue Dog caucus. He (I'm sure) is substantially responsible for Obama's meager involvement in pushing for a specific bill, and has been orchestrating the watering down and delays of the various proposals. Now, his own tactics may force a more robust public plan, and the Blue Dogs either support it, or lose in the next election. Boo hoo!

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September 1, 2009 2:50 PM   

I still think they can pass a health care reform bill with 60 votes.

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September 1, 2009 3:03 PM   

"Saving money" "Cutting costs" "increased competition"

All being talked about and all the bane of private insurers.

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September 1, 2009 3:16 PM   

60 votes to invoke cloture or 50+1 votes and reconciliation?

How about the third option: let the Republicans filibuster! But make them do it old school - a quorum always in session, speakers on the floor speaking at all times, and no other Senate business until the filibuster ends and the vote is taken! That's how the Civil Rights Act of 1964 was passed.

Let's not kid ourselves. Health Care Reform is the most important item on the Senate agenda this session. It is perfectly reasonable to halt all business until the vote is taken.

Listen to James Carville, who recognizes that a filibuster would be a disaster for the Republicans, a flashback to Gingrich shutting down the Federal Government, the move that assured Clinton's re-election.

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September 1, 2009 3:28 PM    in reply to CareyInLA

Wish it were possible, but the Senate Rules no longer require that. We now have the non-filibuster filibuster. Republicans just get to say the word, and everything is stopped. Democrats, however, get to have a gang of 14 who promise to make nice while the Republicans work their magic of misgovernance.

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September 1, 2009 3:35 PM    in reply to Salmo

What's the use of having a majority if you can't change the rules in your favor?

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September 1, 2009 5:16 PM    in reply to Schmed

Exactly! It only takes a majority vote to change the rules, and this can't be spun as some "nuclear option" it is simply going back to the "good old days".

The non-filibuster filibuster as almost destroyed the Senate as a functioning institution.

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September 1, 2009 3:50 PM   

I do wonder if we have a consensus as to why the public option is necessary?

I mean, what is the indispensable element that it represents?

And I don't mean just viewing it as a poor man's single payer alternative....

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September 1, 2009 3:53 PM   

I want Medicare now! I'm paying for all those "deathers" coverage and if they have their way Medicare won't be there when I turn 65. Medicare for all NOW!

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September 1, 2009 3:56 PM   

This problem is a reflection of our weaknesses in our organizing. The people who live in these Blue Dog senate states need to start/keep organizing. If we as progressives have friends/relatives/folks in these states we need to call/email/organize them to attend a HEALTH INSURANCE REFORM EVENT- by going to Barackobama.com

We are at a critical time in our nation. The Civil Rights Act was passed because of the CIVIL RIGHTS MOVEMENT. We need to keep pushing these politicans by way of organizing ourselves. We need to educate and convince the American people and keep momentum going- old school style.

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September 1, 2009 4:07 PM   

This is what I like to call the best of both worlds lol.

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September 1, 2009 4:11 PM   

Dems will NEVER have 60 votes because Bayh is married to the health insurance industry.

They could get Snowe and likely all of the Corporatist Dems and a few other Republicans if there was a public option trigger that would only be enacted if the insurance industry didn't lower/control costs to an agreed to (by Congress) level. If the Dems gave up on the PO now in exchange for writing the trigger level, that might be the way to a compromise bill.

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September 1, 2009 4:43 PM   

Still think, if they beat back the public optin, there's a chance for a non-profit to be created that does essentially the same thing via the private sector.

Call it predatory policy writing.

Just form the cheapest, most basic slimmed down, V*%gra/ rogaine-free health-care system ever devised, let people buy into it until there's no big-profiteers left who can compete, then craft legislation to transition that non-profit into single payer.

Simply put, create a private sector insurance provider that is cheap, denies all vanity medicine and treatment, and is modeled after a single payer system. Then convert to it completely once the wasteful, profit-centric providers have been forced out by simple capitalism.

However, the more we look at the polls and the more we see these town halls getting past the angry outbursts and allowing the majority to voice an opinion, the more obvious it becomes that WE ARE WINNING, no matter how often we hear "the votes aren't there."

Like Bob said...

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September 1, 2009 5:36 PM    in reply to JEP07

The non-profit solution is a sham. It must be public option.

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September 1, 2009 6:34 PM   

Sorry, but I reject the premise that a stronger public option is politically unpopular. There's no evidence to support that assertion and plenty to contradict it.

If conservative Senate Dems are uncomfortable supporting a more rigorous and "liberal" version of HCR for reconciliation, they'll need to come up with a better excuse than "its unpopular". It isn't.

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September 1, 2009 10:32 PM   

They want a tea-bag, I'll give 'em a tea-bag.

Deez Nuts all up in their grills.

Slurp, sheeple!

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September 2, 2009 10:29 AM   

There is no such thing as "too liberal" when we are talking about the American Healthcare "system." Better liberal than anything we currently have or to continue in the direction we are going. The alternative is a waste - of lives!

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September 3, 2009 12:51 AM   

This is a fascinating argument! Who needs the Finance committe bill, or 60 votes?

I will say I thought the public option should be geared to make a modest profit after setup costs and the first year or two, and those profits should go to support Medicare. I hope that wouldn't make it ineligible for reconciliation?!

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June 12, 2010 4:29 PM   

Maybe I'm dreaming -- probably -- but I wonder if there aren't Republican congresspersons who understand that health care reform with a public option is what's best for their constituents, but who at the same time need to make a hell of a good show of opposing health care reform so the health care industry doesn't take their money elsewhere. Thus, we might have the craziness on the surface (and how!) but underlying it the understanding that Obama can still put the ball through the goalposts using reconciliation. Watch carefully to see how hard they fight in this very arcane and technical battle to frustrate the reconciliation process, should it end up being Obama's choice for getting things done.

m65 kamagra

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