Congress must pass the Senate bill with a commitment to use reconciliation to modify areas to improve the bill. Remember the story of the dog with a bone looking at his shadow with a much bigger bone. He dropped the bone for the shadow and ended up with nothing. Read Nate Silver’s article below. It is an academic exercise in positive pragmatism.
I’m a little surprised that some people are still pushing a "reconciliation only" strategy on health care, particularly when passing the Senate bill with a "sidecar" of fixes through reconciliation would quite clearly be the dominant strategy. But just suppose that the only two options are "reconciliation only" and to pass the Senate’s bill as is. Let’s take another look at that Kaiser poll I cited earlier today and look at the popular elements of the health care bill — those which poll at a net favorability of +10 or better. Which could be implemented through a "reconciliation only" strategy? It’s hard to say for sure, but here is a reasonable guess given the constraints imposed by the process:
You could probably — not certainly — get a public option through reconciliation, and the public option is popular, polling at a net +22. However, there are are least five provisions which are more popular than the public option that you almost certainly couldn’t get through reconciliation only, including the insurance exchange, guaranteed issue, allowing children to stay on their parents’ plans though age 25, guarantees on the acturial value of private insurance policies, and limitations on age rating. Nor could reconciliation ban gender rating or or eliminate lifetime coverage limits, which also poll well.
"Reconciliation only" might be better than the status quo. But it’s almost certainly worse than the Senate’s bill, as is. And it’s categorically worse than the Senate’s bill with a reconciliation sidecar. But why take half a loaf when you can get a quarter?
p.s. For those who don’t catch the reference in the headline, the background is here.
FiveThirtyEight: Politics Done Right: 1. Reconciliation! 2. ??? 3. Profit!