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Health overhaul may ride on tactic

Seldom-used rule could thwart GOP Democrats would need only 51 votes

By Lisa Wangsness and Sasha Issenberg
Globe Staff | Globe Correspondent / September 2, 2009

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With bipartisan efforts to pass a health care bill sputtering, Democrats are increasingly looking at Plan B: a politically risky, last-ditch “nuclear option’’ designed to ram their proposals through over the objections of the other party.

Senate Democrats are still hoping they can forge a compromise with moderate Republicans and avoid a dramatic showdown after Congress ends its summer recess and resumes its work. But that appears to be less likely. Key GOP negotiators in the Senate are rapidly distancing themselves from Democratic proposals, and the GOP this week renewed its push to convince Americans that sweeping change is not needed.

That means Democrats may soon decide to go it alone, employing a somewhat rare parliamentary tactic called “reconciliation.’’

Typically, the majority party in the Senate needs 60 votes to end debate and block a minority filibus ter. But in the current debate, Democrats have only 59 members because of the death last week of Massachusetts Senator Edward M. Kennedy; moreover, a handful of moderate Democrats might not support health care legislation without at least some Republicans on board.

So Democratic leaders are discussing the possibility of passing a Senate bill with a simple majority, or 51 votes, under the reconciliation rule.

Meant to allow important budget bills to move through the chamber more easily, the procedure has been invoked only occasionally - by Republicans to pass tax cuts in 2003, for example, and by Democrats to pass President Clinton’s budget in 1993.

Under reconciliation, each provision must be directly related to the budget, greatly complicating the task of passing health care overhaul rules, while opening up debate to intense procedural wrangling. Still, for Democrats, it might be better than risking a crippling defeat for Obama on a signature issue.

“I think the Democrats are willing to risk it,’’ said Ross Baker, a political scientist at Rutgers University. “The stakes are just too high. The idea of ending the 111th Congress without any result on health care at all is unthinkable for the Democrats.’’

A senior Democratic aide who spoke anonymously to offer a candid assessment of the strategy said: “The goal is not to have to do reconciliation - the goal is to garner 60 votes, hopefully in a bipartisan fashion. But the reality is you may have to.’’

Senate Finance Committee chairman Max Baucus, a key Democratic negotiator on health care, told the Associated Press this week in Montana that chances for bipartisan reform remain good. But he said of his GOP colleagues, “Politics have crept in. They are being told by the Republican Party not to participate.’’

If negotiations fall apart, added Baucus, Democrats will resort to the “nuclear option’’ of trying to pass legislation without Republicans, using the special rules.

Passing a partisan health care bill is unappealing for Democrats because it promises to be politically dangerous and procedurally messy. After a furious conservative backlash against a health overhaul this summer, moderate Democrats are desperate for even a few Republicans to lend their support.

Republicans would consider the use of reconciliation a declaration of war, and they’re warning that any attempt to do so would mean political devastation for the majority party. “I think that would wreck our health care system and wreck the Democratic Party if they did that,’’ said Senator Lamar Alexander, a Republican from Tennessee, in a conference call with reporters yesterday.

Alexander said that Democrats have been going about solving major problems such as health care, climate change, and economic reforms all wrong by attempting comprehensive rather than gradual change and that the White House has not engaged in a credible attempt to reach across the aisle.

“Either the White House doesn’t know how to do it, or they don’t want to do it,’’ he said.

As they warn against Democrats trying to push health care without getting 60 votes, they also are working to turn public opinion against change.

The Republican Party is airing a new TV spot, featuring party chairman Michael Steele calling for a “seniors’ bill of rights,’’ a call designed to warn the elderly about Obama’s health care overhaul proposals. In the ad, he calls for “no cuts to Medicare to pay for another program. Zero.’’ He also declares that the government should “make it illegal to ration health care based on age’’ and “prevent any government role in end-of-life care.’’

The White House, afraid of repeating the mistakes that Clinton made 16 years ago, has left the bill-writing to Congress. Three House committees and one Senate committee have passed bills, based on Democratic majorities. But only one committee - the Senate Finance Committee - has seriously attempted a bipartisan discussion.

In the last several months, Baucus has worked assiduously to reach consensus with what’s become known as the “Gang of Six’’ - two other Democrats, Senators Kent Conrad of North Dakota and Jeff Bingaman of New Mexico, and Republicans Mike Enzi of Wyoming, Chuck Grassley of Iowa, and Olympia Snowe of Maine.

Over the course of the negotiations, Baucus has repeatedly moved deadlines at the Republicans’ request, and at their urging he has embraced increasingly moderate positions on key issues, such as the creation of private nonprofit cooperative insurance plans instead of a government-run option.

But during the August recess, as grass-roots anger fueled by conservative groups and the GOP has grown, Enzi and Grassley have appeared to waver. Enzi, in delivering the Republican radio address last weekend, criticized Democratic health care plans without uttering a word about the bipartisan talks.

On Monday, White House spokesman Robert Gibbs said that Enzi “has clearly turned over his cards on bipartisanship.’’ If the partisan fights continue to escalate next week, Obama and Senate majority leader Harry Reid will come under greater pressure from liberal Democrats to dispense with their effort to forge a filibuster-proof Senate deal and push through a bill using the special rules.

“I think that every effort will be made to get to 60, and if it appears that it’s going to be difficult, or the leadership can’t get to 60, then they will focus on a reconciliation strategy,’’ said Ron Pollack, director of Families USA, a Washington healthcare advocacy group.

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