We’ve already heard repeatedly, and will hear incessantly during and after tomorrow’s health care summit, that use of the budget reconciliation process to enact changes to the Senate-passed bill represents an effort to “ram through” controversial legislation through some sort of obscure, draconian procedure. Conservatives have taken to calling it the “nuclear option” (appropriating a term that actually referred to the Republican threat in 2005 to outlaw all filibusters of judicial nominees).
Aside from the fact that the House and Senate have both duly enacted health reform legislation, and are utilizing reconciliation simply to make changes in the Senate bill that Sen. Scott Brown has promised to block, the idea that reconciliation is not a legitimate way to deal with health care issues is wrong from any historical point of view, particularly for Republicans who have resorted to it regularly.
Long-time health care journalist Julie Rovner has an important article up on the NPR site documenting the long history of reconciliation bills with major health care components. To hit a couple of highlights, SCHIP was created via a reconciliation bill (the 1997 Balanced Budget Act touted by Republicans at the time as an epochal achievement), and so, too, was the legislation allowing people to continue health insurance policies terminated by their employers (the term for this procedure, COBRA, refers to the Consolidated Omnibus Budget Reconciliation Act of 1986).
Sometimes Republicans claim that reconciliation is inappropriate for health care legislation because the procedure was designed for provisions strictly intended to reduce the federal budget deficit. According to CBO, of course, the House and Senate health care bills do in fact reduce budget deficits. Moreover, this particular Republican complaint rings rather hollow since GOPers used reconciliation to enact the mother of all budget busters, the Bush tax cuts of 2001.
The reality is that reconciliation, at least after its incredibly expansive use by the Reagan administration in 1981 to enact much of its agenda, has long been understood as the way Congress gets important business done on a broad array of issues that affect federal spending. Calling it the “nuclear option” or “draconian” doesn’t change that history, and progressives really need to push back on that distorted construction.