The political media remains obsessed with the propriety of using budget reconciliation to pass health care reform. Unfortunately, many of them continue to not understand what they're talking about. Let me explain again. Last year, some Democrats considered using the reconciliation process – an expedited procedure that can't be filibustered -- to pass health care reform. They decided against it, in part because reconciliation only lets you make changes that mainly affect the budget. (Things like regulating insurance wouldn't qualify.) They passed a plan through the Senate using regular procedure.

Now their plan is to have the House pass the Senate bill, and then use reconciliation to patch up the bill. That means enacting a handful of relatively modest changes to the Senate bill, changes that would be budget related. This would not be some unprecedented use of reconciliation. As uses of reconciliation go, it would actually be quite minor, applying small changes to a health care bill that’s already been passed.

But many reporters and commentators still seem to think the issue on the table is using reconciliation to pass the whole bill. Here’s Kent Conrad trying to explain this to Bob Scheiffer and a pair of Republicans on Face the Nation:

CONRAD: On the question of reconciliation, I have said all year as chairman of the Budget Committee, reconciliation cannot be used to pass comprehensive health care reform. It won`t work. It won`t work because it was never designed for that kind of significant legislation. It was designed for deficit reduction. So let`s be clear.

On the major Medicare or health care reform legislation, that can`t move through reconciliation. The role for reconciliation would be very limited. It would be on side-car issues designed to improve what passed the Senate and what would have to pass the House for health care reform to move forward. So using reconciliation would not be for the main package at all.

It would be for certain side-car issues like how much does the federal government put up to pay for the Medicaid expansion? What is done to improve the affordability of the package that`s come out of the Senate?

BLACKBURN: It shouldn`t be done at all.

CONRAD: But it would not be used. Well, that`s not a reasonable position to take, congresswoman. We know that repeatedly for health care certain provisions, for example, children`s health care, the CHIP program was done through reconciliation. COBRA, for people who lose their jobs, that was done through reconciliation.

(CROSSTALK)

CONRAD: On relatively minor issues, it`s totally reasonable.

BLACKBURN: But this is not a minor issue.

CONRAD: Well, health care reform at large would not be -- I`ve just said, health care reform, the major package would not be done through reconciliation. That would be unreasonable. But that`s not going to happen here.

SCHIEFFER: What were you going to say, Congresswoman?

BLACKBURN: Well, I think that, on the reconciliation issue, if they had the votes, we wouldn`t have had the summit. And if they try to go through reconciliation, it will be a change in semantics. Instead of the American people saying stop the bill or kill the bill, it`s all going to be about repealing the bill. That`s not the kind of discussion that they want.

And when we were talking about the expanded Medicaid coverage, we rolled the dice on this in Tennessee over a decade ago, made the gamble that near-term expenditures could be offset by long-term savings.

Those savings never materialized. And that`s from a Democrat governor in our state. And as we have all watched it, savings never materialized in Tennessee. They didn`t materialize in Massachusetts. They didn`t materialize in Maine. It is not going to yield the savings that you`re expecting an expanded coverage program to -- to yield.

SCHIEFFER: Let me just throw this in because I`m not sure the White House has the same understanding of this that you do. Because the woman, Nancy DeParle, who is, kind of, in charge of Medicare over there at the White House -- I mean, health care, over there at the White House, said this morning on "Meet the Press" she thought that an up-or-down vote would be the way to go on this.

So, obviously, she`s talking about trying to do it through reconciliation, Senator.

CONRAD: I`d say this to you, Bob. I have said all year, I am chairman of the committee in the Senate; I think I understand how reconciliation works and how it can`t work. The major package of health care reform cannot move through the reconciliation process. It will not work.

SCHIEFFER: It will not work?

CONRAD: It will not work because of the Byrd rule which says anything that doesn`t score for budget purposes has to be eliminated. That would eliminate all the delivery system reform, all the insurance market reform, all of those things the experts tell us are really the most important parts of this bill.

The only possible role that I can see for reconciliation would be make modest changes in the major package to improve affordability, to deal with what share of Medicaid expansion the federal government pays, those kinds of issues, which is the traditional role for reconciliation in health care.

And here’s Politico reporting on this exchange:

Sen. Kent Conrad (D-N.D.) threw cold water on the idea of using the reconciliation process Sunday during an appearance on CBS' "Face the Nation."



"Reconciliation cannot be used to pass comprehensive health care reform," said Conrad, chairman of the Senate Budget Committee. "The major package would not be done through reconciliation."



Asked by CBS host Bob Schieffer to elaborate, given that the White House suggested earlier Sunday that they could pass the main bill with a simple majority of 51 votes, Conrad said that reconciliation was not, in fact, an option