"It's this bill, or everybody dies"

That's what Ezra Klein said Saturday at a forum sponsored by Families USA.  He was referring to the fact that for Democrats, there is no way to move backwards on this.  There is no going back on this.  There is no smaller piecemeal legislation.  Democrats can run on this bill and the success of it having passed, or they can run on a caricature of this bill and the failure of it.  Either way, Democrats are tied to it.  If we let health reform fail now - if we don't pass it quickly now - the failure will doom the Democratic party.  It's this bill, or everybody dies.  Not having health care reform will spell political and policy disaster for the Democratic party.  Not to mention, Ezra reminded the audience, this bill will save real lives.  Failing on this means more real people will continue to die.

Click here to see Ezra Klein make this point succinctly.

There are plenty of people running around in the Democratic party saying that health care reform has to be put on a back burner while Congress works on a jobs bill and so on and so forth.  There are two problems with that.  As I have pointed out before, the House is already ahead of the game, having passed its massive jobs bill back in December.  And secondly, Congress can do more than one thing at a time.  We cannot let health care reform lose steam just as the President is picking up steam and exposing the Congressional Republicans for the phonies that they are.

And "this bill" has to start with the House passing the Senate bill first.  If for no other reason, because the House can move faster than the Senate - even when the Senate is operating under reconciliation rules.  As Jonathan Cohn, Senior Editor of the New Republic points out in the same forum, even while a bill is moving through the reconciliation process, the Republicans can still obstruct and take up time, even though they won't be able to stop it ultimately.  Passage of the Senate bill through the House while reconciliation starts in the Senate (but is not completed) and the current Senate bill is signed into law will create momentum.

So, it's time again.  You need to call your member of the House and your Senators - even if you have already called.  First, call the Capitol switchboard and ask for your member of the House.  Tell them politely but firmly that you expect your member to vote for the Senate health care bill as is so that it can be signed by the President.  Then urge them to follow up with a reconciliation bill to fix it (or find your member at House.gov).  Call the Capitol switchboard back and ask to speak to your Senators (you can also find your Senators on Senate.gov).  Tell them you expect them to follow through on the House's reconciliation bill.  Call Harry Reid also if you like, as well as Speaker Pelosi.  Here are the toll-free numbers:
  • 1-866-338-1015
  • 1-866-220-0044
  • 1-866-311-3405
There is absolutely no excuse why we shouldn't be able to get this done.  In fact, we are incredibly close, if Robert Gibbs is to be believed.
"We’re one vote in the House of Representatives from making health care reform a reality," the White House press secretary said, positing a scenario where the House passed the version of the bill already passed by the Senate which President Obama would then sign into law.

We are one vote shy.  One vote that millions of lives depend on, and that means that it's time to set aside the detractors, the endless back-and-forth, and get it done. If at this point you are unconvinced that this bill will worth passing, I will ask you one more time, can your conscience live with killing the bill?
It's this bill, or everybody dies.

Let's also talk about what this reconciliation everyone is demanding might include.  It would be great if a  public option can get in, and I'm still going to push for it.  A reconciliation bill is only being talked about because Democrats no longer have the 60 votes in the Senate, but the overall parameters of the House-Senate negotiations may not have changed.  Recall that prior to the election of Scott Brown to the Senate, the House was demanding fixes to the Senate bill - and those fixes did not include the public option.  Those negotiations were directing to these possible demands from the House: a national exchange (instead of state based ones), a supposed fix/temporary exemption for unions of the Cadillac tax and combining it with a millionaire's tax as a revenue mechanism, increasing the subsidies for low-income Americans in the exchange, fixing the Nebraska compromise to give all states the same treatment as Ben Nelson got for Nebraska in terms of Medicaid payments (having the federal government take over 100% of payments rather than sharing it with the states) and ending the anti-trust exemption for health insurance companies.  Whatever the Senate was unlikely to give the House before January 19, it is probably not likely to give it now, at least not right away.  The reconciliation bill is still taking shape, and this one will likely skip the public option.  So the basic question for those of us pushing for a public option in reconciliation is this: are we willing to kill health reform if - as is likely - a reconciliation bill does not include a public option?  I am certainly not willing to do that.  I am willing to get whatever we can of the rest of the fixes in reconciliation.  And once again, I believe that the House should not wait until the reconciliation process is complete to pass the Senate bill - it will only delay the bill without any sense of success or accomplishment to fuel the rest of the path.

Sen. Al Franken has begged the House to pass the Senate bill if the Senate will promise to fix it through reconciliation.  I think he put it best:
"I know that there are elements of the Senate bill that are distasteful to many members of the House of Representatives," Franken said.  "Believe me, there are a few elements in our bill that I’d like to see improved.

"But If we in the Senate pledge to fix those elements through reconciliation — a budget process that requires only 51 votes,  the House of Representatives should pass the Senate bill," he said. "Big pieces of legislation often need to be fixed and improved after passage.  Health care would be no different.  But we have to stop letting the perfect — and everyone has different definitions of perfect — be the enemy of the very good."
I am with those who believe the Senate bill should be fixed through a reconciliation process, and I will continue to push my Senators for it.  But this cannot be an excuse for letting the underlying Senate bill wither on the vine or die.  Insisting that the reconciliation bill must not just begin but pass the Senate before the House can act is delaying health care reform, and potentially derailing it.  Besides, if anyone believes that whatever can be pushed into a reconciliation package are the only fixes this bill is ever going to need, I have a very nice bridge in Brooklyn that I would like to sell you.  The process of improving this law will begin the moment the President signs the legislation, and will most definitely not end once a reconciliation bill is also signed into law.  It is going to take much longer term commitment both for us advocates and for Congress.  So let's pass the damn bill, and commit to seeing it improve not just in reconciliation but by any means necessary in the coming years.