Flipping the Byrd on Healthcare Reform

This week, the healthcare reform debate churned on behind the scenes as the economic crisis and treasury secretary Geithner’s latest bank rescue plan dominated the news cycle. Meanwhile Democrats weighed various strategies to advance healthcare reform even without a filibuster-proof majority in the senate. Drug policy made headlines this week. Attorney General Eric Holder expanded upon the administration’s new found tolerance towards states that permit medical marijuana. The morning after pill will soon be available over-the-counter, thanks to a ruling by a New York Federal judge. “Could an obscure Senate rule free Barack Obama from the filibuster and enable health-care reform?” asks Ezra Klein in the American Prospect. Democrats are eager to maintain momentum for their ambitious healthcare reform agenda, but the potential of a filibuster could derail the plan. It all comes down to numbers: If a healthcare reform bill were introduced in the Senate, the Democrats would not have the 60 votes they need to block a Republican filibuster. However, as Klein explains, it’s possible to pass a healthcare bill with a simple majority in the Senate: Imagine you want to run health reform through the reconciliation process. Here’s how it works: Congress includes reconciliation instructions in the budget. Those instructions direct certain committees — say, the Finance Committee and the Health, Energy, Labor, and Pensions Committee — to produce health-reform legislation hitting certain spending targets by a certain deadline. Once finished, the legislation is tossed back to the Budget Committee, which staples it together into an omnibus bill and sends it to the floor of the Senate for 20 hours of debate followed by an up-or-down vote. There’s always a catch. In this case, Klein explains, the catch is a provision known as the Byrd Rule, which states that only provisions directly related to spending or deficit reduction can be inserted during budget reconciliation. Everyone seems to agree that healthcare reform will have a profound impact, for good or ill, on the nation’s bottom line–but would healthcare legislation “count” under the Byrd test? Klein says that nobody knows because the final decision would rest with the inscrutable Senate parliamentarian, Alan Frumin . George W. Bush used the reconciliation process to pass everything from oil drilling to trade policy, but there’s simply no way to know whether the parliamentarian would indulge the Democrats on healthcare. Klein writes, “It’s the legislative equivalent of deciding a bill on penalty kicks.” Even so, the Republicans aren’t taking any chances. The Washington Monthly’s Steve Benen recently chided Sen. Judd Gregg (R-NH) for saying that using the reconciliation process to pass healthcare reform would be a step towards “mob rule”. Public interest lawyer Roy Ulrich argues in AlterNet that we may not see healthcare reform until we see campaign finance reform. Ulrich notes that most liberals, President Obama included, want healthcare reform to included a publicly-financed health insurance option. However, even some of the Democrats in the Senate are hostile to that idea, notably Sen. Max Baucus (D-MT), who has received more than $413,000 over the past four years from drug companies and health insurance carriers. Drug policy continues to make headlines this week. Steve Benen of the Washington Monthly follows up on Attorney General Eric Holder’s announcement that he will no longer raid medical marijuana facilities in California, where the drug is legal with a doctor’s prescription: Holder stated that on his watch, federal authorities would only target traffickers posing as legitimate dispensaries, bona fide purveyors of medical marijuana. Benen notes that Sen. Chuck Grassley (R-IA) is giving an unpredictable justification for his entirely predictable outrage: “This Attorney General is not doing healthcare reform any good,” said Grassley. “The first rule of medicine — ‘do no harm’ — is being violated by the Attorney General with this decision.” Yes, that’s the same Chuck Grassley who cheers on Rush Limbaugh for telling lies about comparative efficacy research (CER) and healthcare reform. I’m not making this up. Chris Hayes of the Nation has the details. Limbaugh, Fox News and other right wing media outlets have been deliberately circulating misinformation about the president’s comparative effectiveness research program. In reality, CER is a tool for doctors to make better treatment deisions. Limbaugh and his cronies are claiming that it has something to do with healthcare rationing and Grassley is cheering them on. Despite some deescalation on the medical marijuana front, President Obama has shown a troubling willingness to further militarize other aspects of the drug war, Democracy Now reports. And finally, a big step forward for birth control, thanks to a federal judge in New York. Thanks to the judge’s ruling, Plan B, also known as the morning after pill, will be available over-the-counter to women over the age of 17 within the next 30 days, Dana Goldstein notes in the American Prospect. The judge found the FDA erred in restricting access to Plan B during the Bush era.