A new phrase has entered the health care debate in Washington: ping-ponging. Rather than a table game, this version of ping-pong involved dispensing with the usual conference committee that reconciles the differences between a bill passed by the House and the version approved by the Senate. Instead, Democratic leaders said this week that they will negotiate a final version of health care overhaul legislation among themselves and the White House.
This is unfortunate, but likely necessary.
Republican leaders in Congress have made it clear they will do everything possible to stymie passage of the bill. Senate rules would require at minimum three separate votes on legislation from a conference committee. Because Republicans could filibuster each vote, 60 affirmative votes would be needed at each step. So, instead, Democratic leaders plan to ping-pong the bill between the House and Senate until a compromise is reached.
There are many differences between the bill that passed the House in November and the one approved by the Senate on Christmas Eve. The House-approved bill includes a public option, a plan in which a government-run insurance plan would be offered as a means to lower private insurance plan costs. The Senate bill has no such provision, but does include a provision to have the federal personnel office negotiate a plan, to be offered by insurance companies, that could be purchased by those without insurance.
The House bill also includes much stricter limits on abortion than the Senate version. These are difficult issues to square that could benefit from Republican involvement, if they were committed to improving the final legislation. Sen. Olympia Snowe appears to be one of a few Republican lawmak-ers who wants a health care reform bill. Many of her colleagues hope to kill the bill to weaken President Barack Obama and Democratic lawmakers in hopes of picking up seats in Congress in this fall’s election.
Keeping the health care reform debate moving forward is important, which is why ping-ponging, which has been used to pass several large bills in recent years, may be necessary.
There are also big downsides to this approach. To a public already skeptical of the legislative process, this looks like more hurried, backroom dealing. However, since lawmakers have debated health care reform for more than six decades, the basics of what needs to be done are well understood. Further, the current bills are the result of months of negotiations — and some last-minute dealings to keep enough Democratic support for passage of the bill.
There are troubling aspects of both the House and Senate bills. The Senate bill includes special Medicaid exemptions for Nebraska to win the support of that state’s senator, Ben Nelson. It also includes extra Medicare hospital payments for several states with Democratic senators whose votes were needed for passage. The House bill’s strict abortion limits will punish low-income women and should be removed.
A test of whether the Democratic leadership is serious about reform and not just scoring political points by passing a bill, no matter how flawed, is whether such troublesome provisions are changed.