Industry stakeholders that have spent the past year working overtime to influence almost every aspect of the massive health care reform bill are now struggling to put their imprint on a final product that likely will be shaped by the arcane budget reconciliation process.
Lobbyists said that reconciliation does not lend itself well to outside pressure because rules limit the substance of the bill to issues directly tied to the budget. Furthermore, they say now that President Barack Obama has outlined what he wants to see in the measure, there is less leeway for input from industry groups.
The majority of issues in play are unlobbyable at this point, said Andy Rosenberg, a principal in the firm Thorn Run Partners. Rosenberg said that K Streeters can still provide valuable advice to clients by explaining what is happening with the legislation on Capitol Hill and helping them handicap the likely outcomes.
Democrats are charting a two-pronged approach to pushing health care reform over the finish line. The strategy calls for the House to vote on the health care measure already approved by the Senate. Then the chamber would take up a reconciliation measure that would include some of the changes that lawmakers and the White House want to see made to the Senate bill. The Senate would take up the reconciliation measure, which requires only a simple majority to pass.
The Senate Parliamentarian would be the referee in deciding which provisions in the reconciliation bill meet the budget-related requirements. Since Republicans are expected to raise numerous objections to the bill, Ralph Neas, president of the National Coalition on Health Care, predicted the Democratic leadership would be judicious in the crafting of the measure.
I think it will be as narrowly constructed reconciliation bill as possible, he said. I think there will be a significant limitation on the range of debating points.
One longtime health care lobbyist predicted that for K Street the debate over reconciliation will be more of a viewer spectacle than an interactive game. A lot of lobbyists around town have morphed into reporters.
The lobbyist said that most of the lobbying will likely take the form of grass-roots campaigns back in lawmakers districts.
But others disagree that little can be done to influence the reconciliation process. Well-prepared advocates can arm lawmakers with arguments on whether certain provisions either favored or opposed by their clients meet the reconciliation criteria, according to one health care lobbyist. Those talking points could indirectly sway the Parliamentarian, said the lobbyist, who added that it is not considered good form for K Street to directly try to influence the Parliamentarian.
This is a different kind of lobbying. It is just more granular now, the lobbyist said.
The rules governing reconciliation would likely preclude its dealing with a number of hot-button issues perhaps the most contentious being abortion coverage.
Therefore, anti-abortion groups are spending much of their time focusing on convincing conservative Democrats to vote against the Senate bill when it comes up in the House.
Matthew Faraci, spokesman for Americans United for Life, said his group has been mobilizing its grass-roots supporters to urge 40 House lawmakers, who backed anti-abortion restrictions authored by Rep. Bart Stupak (D-Mich.) that were contained in the House bill, to oppose the Senate bill.
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