As I explained a while back, the reconciliation process can only be used to pass bills that have a direct impact on reducing the budget deficit, which is why passing a health care bill through reconciliation could prove to be difficult: some aspects, like the public option, might not have enough of an impact on the deficit to survive the process intact. This leaves Democratic legislators with two options: they could scrap the public option and include it in a later round of reform, or they could include a public option that’s far more liberal and far more reaching in its scope. TPM’s Brian Beutler gives the details:
According to Martin Paone, a legislative expert who’s helping Democrats map out legislative strategy, a more robust public option–one that sets low prices, and provides cheap, subsidized insurance to low- and middle-class consumers–would have an easier time surviving the procedural demands of the so-called reconciliation process. However, he cautions that the cost of subsidies “will have to be offset and if [the health care plan] loses money beyond 2014…it will have to be sunsetted.”
And there the irony continues: Some experts, including on Capitol Hill, believe that a more robust public option will generate crucial savings needed to keep health care reform in the black–and thus prevent it from expiring.
Naturally, there’s concern that conservative Democrats will balk at the possibility of stronger cost controls and greater long-term savings:
But though that may solve the procedural problems, conservative Democrats have balked at the idea creating such a momentous government program, and if they defected in great numbers, they could imperil the entire reform package