Numerous commentators have argued that, although the budget reconciliation procedure would allow health reform legislation to avoid filibuster and pass with a majority Democratic vote, the Byrd rule would prohibit many no cost provisions critical to such an enterprise. These no cost provisions include standards to protect consumers in marketing commercial insurance, the design of independent review of health claims denials and mechanisms to ensure universal enrollment in public and private insurance plans and subsidy programs to assist low-income families.
This week, Senate Budget Committee Chairman Kent Conrad joined those concerned about the effect of the Byrd Rule, stating that "If you try to write in reconciliation healthcare reform ... you'll be left with Swiss cheese because so much will be subjected to Byrd rule strikes."
In fact, the Byrd rule can be easily repealed or revised to accommodate health reform by a simple majority vote of Democrats in the Budget Committee. With a 12-9 majority, the aye votes of only 11 Democrats on the Committee are required to remove the Byrd rule impediment to passing substantive and well-designed health reform legislation. Indeed, the arcane Budget Rules provide that a sixty-vote super-majority is required to reverse such a vote on the Senate floor.
Marsha Simon, PhD, President, Simon & Co., LLC
