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Lobbyists Can’t Ignore Possible Passage of Health Care Bill in Reconciliation

Paone, who spent three decades on the Hill and is now a lobbyist at Timmons and Co., said many of the health care reform proposals can’t be scored by the CBO and would not be able to go on reconciliation, unless there was a 60-vote majority willing to waive the Budget Act.

“A lot of people don’t understand how difficult it is to meet all the Byrd rule exclusions,” he said, adding that Democrats looked at the idea back in 1994 during health care negotiations.

Dove said the only person who knows what could, and could not, be included under reconciliation is Alan Frumin, the current Parliamentarian.

“There are a lot of gray areas, and he will make those decisions,” Dove said. “He will keep his powder dry until the last possible moment.”

If health care reform gets lumped into reconciliation, Dove said the process will not be pretty.

“It involves weeks, sometimes months, of people coming in and going through in detail what it is they’re arguing for or against, and then the Parliamentarian weighs the back and forth,” Dove said. “It’s not fun.”

He added, “It’s not a process that lends itself to health care reform, and that’s the very reason it was not used in 1994.”

Senate Budget Chairman Kent Conrad (D-N.D.) has warned of the pitfalls of doing health reforms on reconciliation because much would be left on the cutting room floor. However, lawmakers have floated the idea of putting all the health care reforms that have scorable budget implications on reconciliation and moving other matters into another bill.

“Then the question is, could you take two roads and end up at the same place,” Rother said.

Ron Pollack, executive director of Families USA, said his organization has given thought to the idea. “But all of our energies are on getting legislation through the regular legislative process,” he said. “It’s far too premature to work within the context of reconciliation.”

Whether reconciliation or regular order, there will be trade-offs, Pollack said. “The regular legislative process means that compromises must be reached and means the legislation may not be as crisp if you didn’t have to compromise,” he said. “On the other hand, in the reconciliation process, not everything that would be part of a normal bill would be allowed. As a result, it makes most sense to give it the best shot through the regular legislative process.”

Rother, who was at AARP pushing for the Medicare prescription drug benefit that ultimately passed in 2003, said he sees similarities between that fight and health care reform. That time Republicans were in charge, and this time it’s the Democrats in control.

“The politics of this is almost the mirror image of getting the prescription drug benefit through,” he said. “If you think about the process that was used for the drug bill, it’s an interesting exercise. It passed and is now popular, so it has a happy ending, but it sure was messy at the time.”

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