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Senate Maneuvering Begins on Health Care Reform Bill

Senate Maneuvering Begins on Health Care Reform Bill

Last Updated on Monday, November 16, 2009 at 8:30 am EST

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Despite the Senate Democratic Leadership's Protestations to the Contrary, Senate Seems
Unlikely to Begin Formal Consideration of Care Reform Bill This Week

By Micheal E. Hill
Monday, November 16, 2009 -- 8:30 am EST

Senate Majority Leader Harry Reid (D-NV) last week put the Senate into position to take up a health care reform bill as soon as Tuesday, November 17. However, as the week begins, it appears highly unlikely that the full Senate will take up the yet-to-be-unveiled measure this week.

As a technical matter, the Majority Leader last week placed the House-passed version of H.R. 3962, the "Affordable Health Care for America Act", on the Senate legislative calendar. That move started a three-day clock ticking that, once the three days have elapsed, would enable him to move as soon as Tuesday, November 17, to bring the bill before the full Senate.

Under the most optimistic scenario, the Majority Leader would move that the Senate proceed to consideration of the health care reform bill on Tuesday, November 17, simultaneously filing a "cloture petition" to shut off debate on the "motion to proceed" to consideration of the measure.

Under this optimistic scenario, the Senate would vote on invoking cloture on that motion on Thursday, November 19. If the Majority Leader secured the requisite 60 votes needed to invoke cloture on the "motion to proceed" to consideration of the health care reform bill, the Senate could vote as soon as Friday, November 20, or Saturday, November 21,on whether to proceed to consideration of the bill, a vote that would require only 51 votes in order for the Majority Leader to prevail. If he prevailed, the Senate would then begin to formally debate the health care reform measure.

Despite the Senate Democratic Leadership's assertions of optimism, however, as a practical matter, it seems highly unlikely at the time of this writing that the Senate will consider a health care bill this week. This is, in part, because it appears unlikely at the time of this writing that the Majority Leader has secured the commitment of all 60 of the Senate Democrats to vote to invoke cloture on his "motion to proceed" and not a single Republican has indicated his or her support for invoking cloture on the "motion to proceed." Moreover, as the week begins, the Majority Leader has not yet revealed the contents of his bill; he is waiting for the Congressional Budget Office (CBO) to "score" the bill's costs, and a number of moderate Democrats have said that they will not support moving forward in considering the bill until its cost has been determined and its text has been available for at least 72 hours for inspection.

Thus, given that the Senate is scheduled to be in recess next week in celebration of Thanksgiving Day, it appears at the time of this writing that, despite the parliamentary maneuvering that could begin as soon as this week, the Senate will not likely formally take up the health care reform bill until the first week of December, or later.

Few Details Available
Few details about the Senate's health care reform bill were available at the time of this writing. Four big issues loom over the debate, any one of which could scuttle consideration of the measure. The first of these issues is the bill's costs. The second issues is the question of whether or not the bill should contain a "public option" or government-run plan. The third issue in contention is the degree to which the bill should bar federal funding for abortion. And the fourth big political issue in contention is how both legal and illegal immigrants should be treated under the measure.

With regard to immigration, it is anticipated that the bill's immigration-related provisions will be closely (if not identically) patterned after the immigration-related provisions that are contained in S. 1796, the "America's Healthy Future Act of 2009", which the Senate Committee on Finance approved in October. That measure contains a number of provisions that are strongly opposed by the pro-immigrant advocacy community.

The "America's Healthy Future Act of 2009" contains a number of immigration-related provisions and impacts. More specifically, it would:

Health Insurance Mandate. mandate that legal immigrants (along with U.S. citizens) either purchase health insurance or be subject to a tax penalty;

Treatment of Illegal Immigrants Under Mandate. exempt illegal immigrants from the mandate to purchase health insurance;

Illegal Immigrants and Health Insurance Exchanges. bar illegal immigrants from purchasing health insurance in state or federal health insurance exchanges;

Health Insurance Exchanges and Mixed Families. permit illegal immigrants to purchase health insurance in the exchanges for their U.S. citizen or LPR children;
Legal Immigrants and Affordability Credits. permit legal immigrants to receive affordability tax credits to help them pay for health insurance without regard to the five-year waiting period under the law for Medicaid and the Children's Health Insurance Program (CHIP);

Illegal Immigrants and Affordability Credits. bar illegal immigrants from receiving affordability tax credits to help them purchase health insurance;

Legal Immigrants with Expiring Immigration Status. bar legal residents from receiving affordability tax credits to help them purchase health insurance if their legal status will expire within a year;

Calculation of the Federal Poverty Level. exempt illegal immigrants from the calculation of the Federal Poverty Level for the purposes of the bill; and

Citizenship and Immigration Status Verification. impose an immigration status verification regime on all persons --- citizens and noncitizens, alike -- seeking to purchase health insurance.

Once the Senate begins to debate the substance of its health care reform bill, debate on the measure is expected to continue well into December, right up to Christmas, and perhaps beyond.