In my old Congressional office, we used to employ the phrase “let’s get to yes” as one of our intra-office expressions. It was a half joking/half serious take on the bestselling book “Getting to Yes” by Roger Fisher and William Ury. Given the events of the last week, it is no wonder that phrase has re-entered my daily vocabulary.
President Obama this week took perhaps his strongest stance to date in health reform, essentially telling Members of Congress from both parties: let’s get health reform done, period. Democratic Congressional Leaders have declared that health reform will be enacted, and they will use all of the tools at their disposal to ensure that happens. There have been suggestions this could all happen by as soon as the Easter congressional recess.
How will health reform “get to yes”?
Well, this week, talk has centered around a “two-step” process. While the order of events remains unclear at this point, the general sense is that the Senate-passed health reform legislation will be passed at some point by the House with no changes, allowing the President to sign it into law without a conference. Under the currently discussed scenario, the House would not take this step without some kind of yet to be determined commitment from at least 50 senators that they would be willing to support a budget reconciliation bill “fixing” their version.
In the meantime, the House will be developing the “budget reconciliation” bill with the fixes to some of the pieces of the Senate legislation which are objectionable to the House. To describe it in an overly simple fashion, budget reconciliation means it will be a bill that must reduce the deficit and that it will also have procedural protections which means it cannot be blocked via filibuster. Theoretically, this would give the Congressional Democratic Leadership the votes to get health reform through both the House and Senate. For health centers and our patients, that could mean a guaranteed increase in funding by $11 billion over the next 5 years as the President has proposed, as well as many other provisions, including guaranteed contracting and PPS rates under new “exchange” plans.
There are many, many complicating factors to the “process” of how this will all work, some of which we will be expanding upon in the weeks to come on the blog. The takeaway, however, is that health reform is still very much alive, and health centers and our patients, for whom health reform is so incredibly important, will surely be a part of “getting to yes” in the days to come. Stay tuned.