How the Democrats may solve their health-care problem

There is no question that Democrats have looked weak in responding to the Massachusetts election. The notion that they would just shelve health care after all they have put into it -- the message they have gotten across, even if that’s not exactly what they have all been saying -- paints a portrait of a party that, to say the least, lacks persistence and conviction.



But there is a good reason behind all the confusion. The core problem is that the House Democrats no longer trust the Senate Democrats. And let’s be honest: There is no reason in the world for House Democrats to trust the Senate Democrats at this point, or even to feel very kindly disposed toward them.



That’s why there is resistance in the House to the most straightforward solution, which is for the House to pass the Senate health-care bill and send it to the president, and then to use the reconciliation process (which requires only 51 votes in the Senate) to pass the changes in the bill that House and Senate negotiators have agreed to -- or, at least, as many of those changes as is procedurally possible. They can’t get all the changes into law that way, but they could get a lot of them.



The catch is that the House Democrats don’t believe the Senate Democrats will necessarily keep their word and pass the reconciliation bill containing the amendments. And it’s not only the question of trust: anyone who has watched the Senate for the last year can be forgiven for wondering if it is even functional enough (given Republican obstruction and a lack of cohesion in the Democratic caucus) to keep a promise sincerely made.



So here’s an idea, I have been told reliably, that leaders of both Houses are considering: The House would pass a version of the reconciliation bill containing the various amendments and send it to the Senate. The Senate would change it slightly (in ways that the House agreed to), which would require the House to vote on it again. Only after it got the revised reconciliation bill would the House take up the Senate bill. The House could then pass both bills and send both to the president. Problem solved, health-care passes, and we move on.

Not all the difficulties with this scenario have been worked through, and it is not a slam dunk. For one thing, House Speaker Nancy Pelosi faces a revolt on her left against passing the Senate bill without changes. Some may still have to be persuaded to make sure it gets the votes it needs. There are also some House Democrats from moderate-to-conservative districts who are wary, after Massachusetts, of voting for a health-care bill, period. And there are a lot of procedural issues that need to be ironed out.



Nonetheless, for those (and I’m one of them) who believe in health-care reform -- and who think the Democrats would be committing suicide if they gave up on health care now -- it’s heartening to hear that serious people are making serious efforts to get a health bill through. In a pinch, I think that enacting the Senate bill into law without changes is far preferable to passing nothing. But I also understand that there are aspects of the Senate bill to which House members have legitimate objections. Solving this problem will require Democrats to pull themselves together across many lines of division -- notably between the House and the Senate, and between moderates and liberals. Can they do it? The answer to that question depends in part on leadership from President Obama. Can he do it?

