In the healthcare reform proposal that President Obama sent to Capitol Hill last week, a new proposed deadline went with it—the end of March.
That's when he would like Congress to approve a new health reform bill. But if the past year is any indication, this ambitious deadline will face major challenges.
The House and the Senate is expected to enter into the final legislative phase this week. First, the House, which voted for its own bill by the narrowest of margins (220-215) in November, could vote on the Senate reform bill that was approved on Christmas Eve. Then, each chamber is anticipated to consider a package of budget-related "fixes"—offered under reconciliation—that will protect it from a Republican filibuster in the Senate.
The current question, though, is whether the Democrats will be able to field enough votes in the House to move forward. The number of supportive Democrats has changed since the vote. For instance, Rep. Neil Abercrombie (D HI) and Rep. Robert Wexler (D FL) have left the House, Rep. John Murtha (D PA) died last month following gallbladder surgery; and Rep. Parker Griffith (R-AL) switched parties late last year.
And on the Senate side, Sen. Judd Gregg (R-NH), the senior minority member on the Senate Budget Committee, which holds jurisdiction over reconciliation bills, has called the reconciliation legislation "a giant asteroid headed at the Earth." He has pledged to block the legislation as it goes through the Senate.
There could be other delaying tactics too. Twenty hours of debate are permitted for each budget-related reconciliation measure that is approved and introduced. However, amendments can be offered to the measures—but there is no limit on how many can be offered (and they don't count against the 20 hours).
Other tactics that health reform opponents could use are quorum calls—meaning 51 senators would have to be present for business to continue; and parliamentary points of order that could require votes during the reconciliation process.
And then there's the history of reform legislation, which famously missed deadline after deadline throughout the summer and fall months last year.
Department of Health and Human Services Kathleen Sebelius, appearing on Meet the Press Sunday, said she thinks Congress will have the votes "to pass comprehensive health reform." But as for the urgency related to passing the bill, she remained noncommittal.
"The timetable is not about some congressional time clock; it's about what's happening across this country to Americans," she said.
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.