View Full Version : Mark Schmitt on health care

07-29-2009, 09:11 PM
I learn more from Mark Schmitt than anybody else writing about politics.

Some have suggested using reconciliation to install the rough skeleton of reform, and then fixing it later, but the act of using reconciliation in the first place is such a nuclear option that it is likely to poison the waters not just with the four semi-reasonable Republicans but also with the Democrats who are left out of the deal, and will be needed on subsequent legislation.

But what if Congress did it in reverse? Use the 60-vote Senate to pass whatever they can pass now -- we liberals will grumble but live with it -- and then use reconciliation next year to fix it. With the exchange structure and subsidies established, it wouldn't be hard to add an employer mandate, which would save money. With the rudiments of even a weak public plan in place, it wouldn't be complicated to expand it and modify its eligibility rules, in ways that might save or cost money but in either event, involve budget changes to an existing program rather than creating something new. Aggregating small changes over the next few years (on the model of the steady expansion of Medicaid engineered by Henry Waxman and others over the 1980s and 1990s) could non-controversially build the kind of robust and equitable system we dream of.