Congress,Health Care Reform,and Reconciliation

This article explores the role of reconciliation in the passage of health care reform in the 111th Congress. Although counterintuitive, the analysis suggests that the loss of a filibuster-proof super-majority with the election of Senator Scott Brown (R-MA) aided Democrats in clearing the overhaul package by facilitating the use of reconciliation. Reconciliation provided the critical procedural mechanism enabling health care reform to be enacted into law. Despite reconciliation's importance, substantively the reconciliation “fixes” were relatively modest amendments. Moreover, notwithstanding the use of reconciliation, Congress passed the health care legislation with largely conventional means—separate health care reform measures cleared the House and Senate in 2009, in 2010 the House approved the Senate bill, and then both chambers quickly passed the reconciliation addendum. This research draws on discussions I had with over a dozen key actors after health care reform passed.