A Historic and Dangerous Senate Mistake

By Bill Frist
Published: February 26, 2010

Using ‘reconciliation’ to ram through health reform would only deepen partisan passions.

Senate Majority Leader Harry Reid has announced that while Democrats have a number of options to complete health-care legislation, he may use the budget reconciliation process to do so. This would be an unprecedented, dangerous and historic mistake.

Budget reconciliation is an arcane Senate procedure whereby legislation can be passed using a lowered threshold of requisite votes (a simple majority) under fast-track rules that limit debate. This process was intended for incremental changes to the budget—not sweeping social legislation.

Using the budget reconciliation procedure to pass health-care reform would be unprecedented because Congress has never used it to adopt major, substantive policy change. The Senate’s health bill is without question such a change: It would fundamentally alter one-fifth of our economy.

The first use of this special prcedure was in the fall of 1980, as the Democratic majority in Congress moved to reduce entitlement programs as a response to candidate Ronald Reagan’s focus on the growing deficit. Throughout the 1980s and ’90s, reconciliation was used to reduce deficit projections and to enact budget enforcement mechanisms. In early 2001, with projected surpluses well into the future, it was used to return a portion of that surplus to the public by changing tax rates.

Senators of both parties have assiduously avoided using budget reconciliation as a mechanism to pass expansive social legislation that lacks bipartisan support. In 1993, Democratic leaders—including the dean of Senate procedure and an author of the original Budget Act, Robert C. Byrd— appropriately prevailed on the Clinton administration not to use reconciliation to adopt its health-care agenda. It was used to pass welfare reform in 1996, an entitlement program, but the changes had substantial bipartisan support.

In 2003, while I was serving as majority leader, Republicans used the reconciliation process to enact tax cuts. I was approached by members of my own caucus to use reconciliation to extend prescription drug coverage to millions of Medicare recipients. I resisted. The Congress considered the legislation under regular order, and the Medicare Modernization Act passed through the normal legislative procedure in 2003.

The same concerns I expressed about using this procedure to fast-track prescription drug expansions with a simple majority vote were similarly expressed by Majority Leader Reid, Senate Budget Committee Chairman Kent Conrad, Finance Committee Chairman Max Baucus, and others last year when they chose not to use the procedure to enact their health-care legislation. Over the past several months, an additional 15 Democratic senators have expressed opposition to using this tool.

The concern about using reconciliation to bypass Senate rules which do not limit debate reflect the late New York Democratic Sen. Pat Moynihan’s admonishment—that significant policy changes impacting almost all Americans should be adopted with bipartisan support if the legislation is to survive and be supported in the public arena.

Applying the reconciliation process is dangerous because it would likely destroy its true purpose, which is to help enact fiscal policy consistent with an agreed-upon congressional budget blueprint. Worse, using reconciliation to amend a bill before it has become law in order to avoid the normal House and Senate conference procedure is a total affront to the legislative process.

Finally, enacting sweeping health-care reform through reconciliation is a mistake because of rapidly diminishing public support for the strictly partisan Senate and House health bills. The American people disdain the backroom deals that have been cut with the hospital and pharmaceutical industries, the unions, the public display of the “cornhusker kickback,” etc. The public will likely—and in my opinion, rightly—rebel against the use of a procedural tactic to lower the standard threshold for passage because of a lack of sufficient support in the Senate.

Americans want bipartisan solutions for major social and economic issues; they don’t want legislative gimmicks that force unpopular legislation through the Senate. Thomas Jefferson once referred to the Senate as “the cooling saucer” of the legislative process. Using budget reconciliation in this way would dramatically alter the founders’ intent for the Senate, and transform it from cooling saucer to a boiling teapot of partisanship.

Mr. Reid was right to rule out this option when this saga began last year. He would be wise to abandon it today.



Dr. Frist served as U.S. Senate majority leader from 2003–2007.