How Congressional Legislation Happens

From TPM:

As Senate leaders begin work on a Democrat-only health care bill, they're finding themselves confronted with an unexpected irony: Though the caucus has reached an uneasy consensus around a public option that's modeled in many ways after a private insurer, it may be necessary to make the public option more liberal, and thus, more politically radioactive, if it's to overcome a number of unique procedural hurdles.

This is the needle Democrats may have to thread if they want a public option, and at the same time, want to bypass a Republican filibuster. And the key for them will be keeping conservative Democrats on board.

"A very robust public option that scores significant savings would presumably be easy to justify doing through reconciliation," says a Senate Democratic aide. "But it is still being studied whether other, more moderate versions of a public option could pass parliamentary muster."

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. 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.

Let's see if I have this straight. If Democrats choose the more robust public option, they are more likely to be able to overcome the procedural hurdles and pass the bill on 51 votes without the threat of filibuster by the Republicans. The bill would also save money and perhaps pay for itself.

But the conservative Democrats may not stay on board, because they don't like the idea of a "momentous government program"? On what grounds? Read on. Because the Republicans in their pushback say that the public option would have to be "very aggressive in setting rates, price controls and rationing,". Ah, those are scary words to conservative Democrats.

On the other hand, those with no health insurance know rationing quite well.

So. As the author of the article, Brian Beutler says:

The path of least political resistance is beset by procedural obstacles; and the path of least procedural resistance is beset by political ones.

Got that everyone?