The Perils of Pelosi's 'Deem and Pass' Healthcare Strategy

Once the healthcare bill is ‘deemed’ passed, there’s no guarantee it’ll be fixed.

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By Peter Roff, Thomas Jefferson Street blog

After almost 18 months of phony deadlines, it appears the congressional debate over healthcare may finally be coming to an end. House Speaker Nancy Pelosi and her allies have spent much of the week trying to win the votes they need in order to get the bill out of the House and to President Barack Obama's desk. Though the various whip counts vary, most observers believe that Pelosi is still anywhere from five to a couple of dozen votes short for what she wants to do, which is to slip the bill through the House without calling it up for a recorded vote.

To understand what is going on requires some knowledge of how things work in the House, something Pelosi and her allies are no doubt counting on to disguise what really is going on.

In short, almost every piece of legislation that comes to the House floor is preceded by a "rule" that directs how the bill will proceed, how much time will be set aside for debate, what--if any--amendments might be in order, and so on.

Utilizing what some have taken to calling the "Slaughter Strategy" (after Louise M. Slaughter, the New York Democrat who chairs the House Rules Committee) the rule for the upcoming reconciliation bill--the same bill that wavering Democrats have been promised will include the "fixes" they are demanding be made to the version of the healthcare bill that passed the Senate last Christmas--will include a section that will "deem" the House to have passed the Senate healthcare bill if it votes to adopt the rule for the reconciliation.

Under the Slaughter Strategy, the key vote will not be the vote on the reconciliation package or an up or down vote on the Senate healthcare bill or even on the resolution to be offered by Democrat-turned-Republican Rep. Parker Griffith of Alabama to demand the House hold an up or down vote. The key vote will be, and is most likely to be, Capitol Hill insiders say, on the rule on reconciliation.

If successful--if the rule on the reconciliation bill passes with the deeming language included in it--then game over. The healthcare bill will be considered by the White House to have been passed by Congress and irretrievably on its way to Barack Obama's desk. Democrats who want the change the bill will have no opportunity to claw it back out of the president's hands if the fixes they were promised fail to materialize.

It is worth noting that the reconciliation has passed unamended just once in the last 20 years or so. It is almost certain that the House and Senate will--in record time--pass different versions of the bill, which may have to be settled in a conference committee or in another deeming action, where one chamber accedes to the language of the other. Which is fine as far as it goes but will have little impact, ultimately, on the healthcare legislation that had previously become law.

If the "Cadillac Tax" on health plans is left unchanged, or if other fixes are dropped out of the reconciliation package when it goes to the Senate--where all 41 Republicans have committed in writing to vote as a bloc to uphold the "Byrd Rule" intended to keep extraneous matters out of reconciliation--it will not matter. The healthcare bill that passed the Congress includes the "Cornhusker Kickback," the "Louisiana Purchase," "Gator Aid," and all the other pork-barrel buyouts that were used to get 60 senators to vote for the bill. And it does not include the ironclad prohibitions put into the House bill by Rep. Bart Stupak to prevent federal funds from being used to support abortion and abortion-related services. And it will be fair and it will be accurate to say that every Democrat who voted to adopt the Slaughter Strategy rule on reconciliation voted to make that bill law.

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