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Congress OKs Final Changes to Healthcare Overhaul

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Congress has approved a package of final changes to the landmark healthcare overhaul. The House of Representatives put the finishing touches on the bill Thursday night after the Senate approved the package on a 56-43 vote. The reconciliation package does not include a public insurance option, though backers of the plan said they will work to see it implemented in follow-up legislation. [includes rush transcript]

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This is a rush transcript. Copy may not be in its final form.

JUAN GONZALEZ: We move now to the congressional debate over healthcare reform, which ended Thursday night with the House Democrats voting 220 to 207 to approve the Senate’s changes to the bill President Obama signed into law Tuesday. The reconciliation package includes better benefits for seniors and low-income and middle-class families and raises revenue by increasing Medicare taxes on the wealthy. It does not include a public insurance option, though. Backers of the plan said they will work to see it implemented in follow-up legislation.

Shortly after the Senate approved the reconciliation package Thursday with a vote of 56 to 43, President Obama heralded the passage of this healthcare plan during a speech at the University of Iowa.

    PRESIDENT BARACK OBAMA: What this is is a historic step to enshrine the principle that everybody gets healthcare coverage in this country. Every single person. So — but here’s what the bill does. It finally tells the insurance companies that in exchange for all the new customers they’re about to get, they’ve got to start playing by a new set of rules that treats everybody honestly and treats everybody fairly.

AMY GOODMAN: Well, for more on what happened in Congress Thursday and what we can expect in terms of follow-up legislation, we’re joined from Washington, DC by Ryan Grim. He’s the senior congressional correspondent for the Huffington Post.

Welcome to Democracy Now!, Ryan. Well, what about the latest, the latest approval by the House of, well, what the Senate sent over to it — for many, surprised that the Senate wouldn’t just approve the healthcare legislation overall?

RYAN GRIM: So, using the reconciliation — the budget reconciliation process, which only requires a majority vote in the Senate, the Senate made major changes to the earlier bill that was signed on Tuesday. The House approved those changes last night, and it became law.

As you mentioned, it raises Medicare taxes on the wealthy. It reduces the Cadillac tax that was going to hit labor unions. And it also expands a lot of benefits that weren’t in the original package.

But there are major political implications to the fact that they were able to use reconciliation here. The center hates the idea of reconciliation, because they want to carry on the fiction that you need sixty votes to get anything done in the Senate, and if you don’t have sixty votes, you know, it’s a great idea, but sorry, we just can’t do it. In fact, right after the Massachusetts special election, when Scott Brown won and reduced the Democratic majority to fifty-nine in the Senate, you had people like Chris Matthews and Lawrence O’Donnell on MSNBC saying, “Look, I’ve worked in Congress. I know for a fact you cannot use reconciliation to pass legislation. This is finished.” We saw last night that they were forced to do it, and they were able to do it. So that opens up a whole new path forward for passing legislation.

So, what Democrats are saying that they’re going to do, Bernie Sanders, for instance, the independent from , Jeff Merkley from Oregon, they’ve been promised by Harry Reid that they can get a vote on a public option this year. I talked to Jeff Merkley yesterday, and he said he has no plans to go forward with just a symbolic vote. He wants a vote that leads to it becoming implemented. Now, the way to do that is to do it through reconciliation again. That fight will go to the Budget Committee, the Senate Budget Committee, where they will write reconciliation instructions, which will say, over the course of this next year, we can do healthcare legislation through reconciliation. So, Jeff Merkley is on the Budget Committee, so that’s what progressives are going to watch next, to set up the next — the next step in reconciliation. You can do it once every year. So Democrats are going to have to start, you know, deciding what each year they want to do through reconciliation.

JUAN GONZALEZ: But what are the prospects, even if this happens in the House, for the Senate to agree to any kind of new reconciliation where the public option would be on the table?

RYAN GRIM: It depends on the amount of pressure that comes for it, because as we found in this debate, just simply having public commitments from a majority of senators and a majority of House members that they support a public option isn’t enough. There’s more to legislating than that. You also need pressure. You know, you need pressure behind it to happen.

But there is a very real possibility that this could happen. All that the Democratic senators have to do in the Budget Committee is write it into the reconciliation language. In other words, what they do is they write what are called reconciliation instructions. It’s exactly what happened last year. At the beginning of last year, they said, “We can do” — the Democrats said, “We can do a public option and we can do education reform through reconciliation.” It was that language that enabled what happened last night. So they would do that again this time. There will be reconciliation instructions written, that’s a certainty. The question is what those instructions will say.

Now, there do appear to be at least fifty, fifty-one, fifty-two, maybe fifty-three or fifty-four votes for the public option in the Senate. So if you can get it through the Budget Committee and then to a vote on the Senate floor, then you’re in a situation where a majority of senators could implement a public option. And Pelosi and Clyburn both say they have the votes over in the House if that happens. It’s really a matter of will at this point, not a matter of votes.

AMY GOODMAN: So Obama is out on the campaign trail campaigning for the plan. He was interrupted in his speech in Iowa yesterday by a member of the audience who shouted, “What about the public option?” Does he now sign what the House and Senate have just passed?

RYAN GRIM: Right, he’ll sign that into law, and that will become the law of the land. And the main argument that Democrats have been using for why they wouldn’t have a vote on the public option these last few weeks is that it could upset the applecart and the entire reform effort might be put in jeopardy by it. And there might even be something to that. But the second that he puts his signature on this reconciliation bill, then healthcare reform is law. It’s over. So any fight that you have over the public option subsequent to that isn’t going to upset what they’ve already done. So there’s really no argument that they have left for why not go forward with it.

AMY GOODMAN: Finally, the jobless bill, that they go off now into recess, but Senator Coburn has stopped, as of April 5th, a number of jobless benefits that Americans could get.

RYAN GRIM: There was an amazing scene in the Senate yesterday. After the Senate pushed through its reconciliation package, fifty-six Democrats, they held a press conference just across the hall from the Senate floor, where they were all patting each other on the back and celebrating the great achievement, as the bill was being written up and sent over to the House. At that very second, there were no Democrats on the Senate floor. Tom Coburn goes in and starts a — and asks for unanimous consent to take the floor, takes the floor, and starts into a speech about unemployment. He introduces his own legislation regarding unemployment.

Harry Reid finally comes back into the chamber and says, “Senator Coburn, how long do you plan on talking?” He said, “Oh, I’ve got another forty-five minutes left or so.” And then it just devolved into chaos. Ultimately, he was able to block the unemployment extension from going through, and now Congress has two weeks of recess. Now, Democrats are saying when they come back after this, they can do it retroactively. But as of now, there are a lot of people that are in limbo as a result of the shenanigans last night.

AMY GOODMAN: Ryan Grim, we want to thank you for being with us. We’ll continue, certainly, to follow this story. Senior congressional correspondent for the Huffington Post.

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