State
Should Congress approve health care reform legislation? No.
As Democrats consider shoving health care reform through the House with a process known as "deem and pass," it is helpful to return to square one and ask: What, again, is the rush?
A year ago, when reform work got under way, Democrats were hell-bent on passing legislation before year's end. There was no way, Democrats believed, that they could accomplish such sweeping reform in an election year.
The Senate bill, which still doesn't have enough votes in the House to pass, barely met the do-or-die deadline, squeaking through on Christmas Eve.
Now the new deadline for a final package is Easter break. This time the thinking goes: If Congress doesn't get a bill to the president before politicians head home, there will be no health care reform for 10 more years.
Meanwhile, the zoo in the living room demands attention. If the bill is so unpopular that it must be passed long before Election Day, could there be a problem with the legislation? If you can't run on the strength of the laws you pass, then either you shouldn't be running or you shouldn't be passing.
Yet, now House Speaker Nancy Pelosi is considering new ways to allow House members to pass the Senate bill without actually voting for it so that vulnerable Democrats can deny responsibility for a bill they don't like and don't support. Is this sane? More to the point, is it constitutional?
A thorough vetting would consume this space, but basically, the "deem and pass" maneuver accomplishes the same thing as if the House approved the Senate bill with tweaks through the reconciliation process. Rather than voting on the Senate bill, the House passes a package of changes to the bill. Thus the bill is "deemed" to have passed.
House members who don't want to vote for the bill are granted plausible deniability. Come election time, they can say, "Hey, don't look at me, I didn't vote for it." And voters, whom lawmakers apparently deem mentally challenged, will give legislators a pass. This is called implausible optimism.
Deem and pass — or sneak and sprint — is right only if your goal is to beat a deadline and pass something — anything — regardless of how imperfect the result. Even the majority of Americans who oppose the bill don't know the half of it, because almost no one does.
What they do know is that this reform reeks of maneuvering and the kind of compromises that involve sacks of cash.
Even recent attention to "sweetheart deals" has failed to improve the product. Obama initially said he wanted state-specific deals removed, but now the White House has backed off, saying that if more than one state theoretically could benefit from a deal, then the program is OK.
Theoretically, that could cover just about anything — and everything. Certainly, such an approach helps justify sweeteners such as the so-called "Frontier States" amendment that raises Medicare reimbursements for some rural states at a cost of $2 billion over 10 years.
The deal was added to the Senate bill between its exit from the Finance Committee and the Christmas Eve vote. Coincidentally, it just happens to benefit two powerful Democratic committee chairmen — North Dakota's Kent Conrad (budget) and Montana's Max Baucus (finance).
Other states deemed worthy of special treatment according to what is essentially an artificial creation — half of each state's counties must have six or fewer persons per square mile (and bite their fingernails?) — are Wyoming, South Dakota and Utah. Just 51 hospitals will receive the entire $2 billion, according to Centers for Medicare and Medicaid Services data.
Given the procedural complications, the clear lack of House support, and a raft of dubious deal-making, slowing down wouldn't be the worst thing to happen to health care reform.
There's no dishonor in admitting that one was in too big a hurry.
But rushing to do the wrong thing is, in a word, idiotic.
Parker's e-mail address is kathleenparker@washpost.com.
THE WASHINGTON POST WRITERS GROUP
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