DJP Update 3-11-2010 Senate Parliamentarian “kills an option for moving health bill”; more about the quest for votes; Meanwhile AMA plans phone conf sometime in future
ITEM ONE: Senate Parliamentarian…
ITEM TWO: More about quest for votes
ITEM THREE: AMA plans “potential” phone conference… (and a few words from Senate Harkin about “SGR” and perhaps a fix “a few years away.”
ITEM ONE: Senate Parliamentarian states Senate bill must be passed and signed by President before Senate can act on a companion reconciliation bill.
DJP comment. If these media reports are correct, then the only way the Senate Majority can get around this is to have the U.S. Vice-President overrule the Parliamentarian OR fire the Parliamentarian and get one with a different view. Either would be a media disaster!
http://www.rollcall.com/news/44110-1.html
Ruling Kills an Option for Moving Health Bill
By David M. Drucker
Roll Call Staff
March 11, 2010, 2:30 p.m.
The Senate Parliamentarian has ruled that President Barack Obama must sign Congress’ original health care reform bill before the Senate can act on a companion reconciliation package, senior GOP sources said Thursday.
The Senate Parliamentarian’s Office was responding to questions posed by the Republican leadership. The answers were provided verbally, sources said.
House Democratic leaders have been searching for a way to ensure that any move they make to approve the Senate-passed $871 billion health care reform bill is followed by Senate action on a reconciliation package of adjustments to the original bill. One idea is to have the House and Senate act on reconciliation prior to House action on the Senate’s original health care bill.
Information Republicans say they have received from the Senate Parliamentarian’s Office eliminates that option. House Democratic leaders last week began looking at crafting a legislative rule that would allow the House to approve the Senate health care bill, but not forward it to Obama for his signature until the Senate clears the reconciliation package.
Meanwhile, Senate Majority Leader Harry Reid (D-Nev.) moved Thursday to put Senate Republicans on the defensive over health care, sending a letter to Minority Leader Mitch McConnell (R-Ky.) in which he dared the GOP to vote against reform.
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Also see article about Parliamentarian at: http://www.businessweek.com/news/2010-03-11/health-care-bill-path-complicated-by-parliamentarian-update1-.html
Excerpt:
House Democrats are seeking assurance that the reconciliation changes will become law. Lawmakers in the chamber originally sought to have the Senate act first on reconciliation; then they wanted Obama to delay signing the 10- year, $875 billion Senate bill until the changes were passed.
Jim Manley, a spokesman for Senate Majority Leader Harry Reid of Nevada, declined to comment. Illinois Senator Dick Durbin, the No. 2 Senate Democrat, said on March 9 that he understands why some House Democrats might not want to trust that the Senate will act on the reconciliation changes.
‘Right to Be Skeptical’
“The House has a right to be skeptical,” Durbin told reporters. “They have almost 300 bills they’ve passed” that are “somewhere lost in the Senate.”
The news from Senate Republicans, who are unanimously opposed to the legislation, comes on the same day that House and Senate leaders said they had reached agreement on the majority of the language in the new reconciliation bill. The leaders presented the outlines of the plan to House Democrats today.
“The decisions are made, the choice has to be made” by lawmakers, House Speaker Nancy Pelosi told reporters.
Reid today formally notified McConnell that the Democrats plan to use reconciliation. Republicans say the process would be an abuse of Senate procedures.
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ITEM TWO: New information about the potential votes for and against the Senate bill when it gets into the House.
Dems Look To Health Vote Without Abortion Foes
The Associated Press
Erica Werner
March 11, 2010
http://www.ajc.com/business/dems-look-to-health-363244.html
EXCERPTS:
WASHINGTON — House leaders have concluded they cannot change a divisive abortion provision in President Barack Obama’s health care bill and will try to pass the sweeping legislation without the support of ardent anti-abortion Democrats.
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“We will finish the job,” Senate Majority Leader Harry Reid, D-Nev., wrote in a letter to his Republican counterpart describing the path ahead.
Said Sen. Tom Harkin, D-Iowa: “The stars are aligning for victory on comprehensive health reform. The end is in sight.”
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ITEM THREE: AMA sent out an email to delegates and alternates under the name of the Speaker and Vice-Speaker (Sent: Wed, Mar 10, 2010 5:15 pm.) Unfortunately, as a former president of AMA who has a non-voting seat in the House of Delegates with microphone privileges, I am not on the email list for this information. Fortunately, one of the delegates on the DJP Update list sent it to me. In summary, the AMA email said things are “fluid” and
“The AMA will review the legislative language for the reconciliation bill promptly when it is finalized and made available. This work could be completed as early as next week. Wehope to convene an HOD conference call after we have reviewed and analyzed the final legislative language. Please watch your email for scheduling and logistical information on the potential upcoming HOD conference call.”
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DJP: Meanwhile “Rome is burning” and the U.S. House will vote the MOMENT the vote count gives a majority. That could be any hour. The closed doors will open and the vote will be taken. The AMA “potential upcoming HOD conference call” will be like ordering one more test on a patient who is bleeding and needs immediate operation. The patient may die in the interim. Decision-making is critical in leadership. If AMA came out against the onerous Senate bill, the bill would not pass in the House as AMA opposition would give “cover” to those Democrats who are on the fence.
Meanwhile, the big “SGR” negotiation has another surprise, namely the statement by Senator Harkin:
Date: March 9, 2010
© Inside Washington Publishers
Julian Pecquet and Seth Freedland
Harkin Acknowledges Permanent SGR Repeal Could Be A Few Years Away
A permanent ‘doc fix’ is unlikely this year and may have to wait a “couple, three years” for the federal budget to get in order, Senate health committee Chair Tom Harkin (D-IA) said Tuesday morning. The comments come just days after the American Medical Association sent a letter to Senate leaders saying it opposes a short-term payment patch of any duration.
Answering a question during a CQ/HealthBeat conference, Harkin said Congress “should have fixed it a long time ago,” but now “with the deficit as high as it is, it’s hard to think about taking all that money and moving it up front to fix the problem. It’s much easier to dribble it out a little bit at a time, year after year. But at some point, we’re going to have to bite the bullet.”
“Now, is that going to happen this year?” Harkin said. “I don’t think so. Hopefully if we get out of our slump in the next couple, three years, start moving up, then perhaps we can make some fix in that.”
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DJP Comment: I predict Senator Harkin is correct. There will be no permanent fix of the SGR this year! If that is what our AMA is waiting for in the negotiations, AMA will be waiting like the Spartans at Thermopylae. But the Spartans put up such a heroic fight that history remembers them for all time. AMA can be a powerful voice and a powerful actor. Time to act. Time to operate. Medicine is in shock. Words mean something but actions define the person and the organization. And yes, if AMA policy was passed into law, the right to privately contract without penalty, we would not have to spend a minute on “SGR” or other price-fixing schemes. The issue would be between politicians and the public. How long must we tolerate these abuses!
Today was my seminar I teach at Tulane Medical School entitled “Leadership in Medicine”. A good group of young, soon to be graduate doctors. I try to give them hope that Medicine can be saved from the politicians. Their future is bright if they are allowed to use their creativity and conquer diseases that we now can only offer comfort for. Let’s give them a chance and not shackle them.
Stay well.
Donald
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