The Treatment

A Quick Reconciliation Thought

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Republicans continue to accuse Democrats of "ramming" or "jamming" health care reform through Congress by using the budget reconciliation process. Put aside all the familiar rejoinders--that Republicans used it all the time to pass their bills, that the reconciliation process merely allows a majority to pass a law, etc. The accusation is misleading in another respect.

If the House votes for health care reform, it will do so by passing the "Patient Protection and Affordable Care Act." That is the bill that will build the infrastructure of reform--including the new insurance exchanges--and provide the vast majority of the funding. In other words, that is the bill that will do most of what reform critics find so objectionable. And it has already passed the Senate with sixty votes.

The two chambers are using reconciliation only for the purpose of enacting changes to the Senate bill--adding a little more money for subsidies, transforming a giveway to Nebraska to funding that helps all states, and so on. Both structurally and financially, it's a tiny fraction of reform. And, as Brookings economist Henry Aaron has pointed out, these are precisely the sorts of changes reconciliation was designed to enact.

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