At yesterday’s bi-partisan health summit, Republicans repeatedly called on the Democrats not to use budget reconciliation to finalize the bill. John McCain said that doing so would have “cataclysmic effects“.
Jonathan Cohn at TNR makes an important point:
If the House votes for health care reform, it will do so by passing the “Patient Protection and Affordable Care Act.” That is the bill that will build the infrastructure of reform–including the new insurance exchanges–and provide the vast majority of the funding. In other words, that is the bill that will do most of what reform critics find so objectionable. And it has already passed the Senate with sixty votes.
The two chambers are using reconciliation only for the purpose of enacting changes to the Senate bill–adding a little more money for subsidies, transforming a giveway to Nebraska to funding that helps all states, and so on. Both structurally and financially, it’s a tiny fraction of reform. And, as Brookings economist Henry Aaron has pointed out, these are precisely the sorts of changes reconciliation was designed to enact.
Republicans have used budget reconciliation more than the Democrats including a $2.5 trillion tax cut, which the Democrats decried at the time. In the case of health reform budget reconciliation would not being used to “re-shape 17 percent of the nations economy,” but to make minor changes in a bill that was passed by the U.S. Senate.