Obama takes hands-on role in advancing healthcare reform

Obama has gathered congressional leaders to push through a healthcare reform bill. Democrats look for an end-run around the GOP by avoiding a House-Senate conference committee.

House Speaker Nancy Pelosi of Calif., gestures during a news conference on Capitol Hill Tuesday to discuss healthcare legislation. She says President Obama's leadership is essential to passing a bill.

Pablo Martinez Monsivais/AP

January 6, 2010

The White House finally may be getting involved in the hard, gritty work of forging healthcare reform legislation, provision by provision.

To this point, the Obama administration has left much of the drafting-of-bill details to Congress, with officials setting broad goals for the effort while trying to avoid discussion about specific policies.

But for President Obama the new healthcare reform watchword appears to be “hands-on.” On Wednesday, he was set to convene a second day of meetings with Democratic congressional leaders as part of the effort to resolve differences between House and Senate versions of health reform legislation.

“Without [Mr. Obama’s] leadership, without his vision, without his encouragement, we would not be right on the verge right now of passing this historic legislation,” said House Speaker Nancy Pelosi at a Tuesday press conference.

The White House meetings appear central to the Democrats’ strategy of bypassing the usual negotiations between the two chambers, in the interests of speed and avoiding Republican influence.

Civics textbooks say this reconciliation of different bill versions should be done via a formal conference committee between the chambers, with members appointed by House and Senate leaders.

Can lawmakers just, well, sort of clap their hands and ignore this requirement, which is written in chamber rules?

“They sure can,” says Ross Baker, a political scientist and expert on congressional procedures at Rutgers University in New Jersey.

There is nothing in the Constitution about conference committees. They have been handled very differently down the years, with some formal processes, and others informal in a manner similar to the way in which the Democrats are currently proceeding.

“There’s very little that’s written in stone about conference committees,” says Professor Baker.

Given the Senate’s tenuous 60-vote coalition in favor of the bill, it’s likely that the House will have to give up more in the final agreement than the Senate will.

The House included a government-run insurance program in its bill, but that “public option” is certain to be struck from the final bill. Speaker Pelosi said Tuesday she would not insist on the government-run plan as long as the final legislation includes more subsides to help the middle class purchase insurance, among other things.

House leaders also want the Senate to agree to House language that would revoke antitrust protection for insurers.

House and Senate are also divided on a main method of financing the health reform overhaul. The House wants to raise income taxes on individuals making more than $500,000 and on couples making more than $1 million. The Senate, by contrast, proposes taxing high-cost health insurance plans.

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