Health Reform Vote Coming Saturday?

Health reform is set to take a major step towards passage this Saturday (if they're working on Saturday, something big must be happening!).

A quick reminder on the procedural steps that have gotten us to where we are: First, each of the three committees of jurisdiction in the House has to pass a health reform bill. Then those three bills have to be merged into a single bill that the whole House can vote on. That single, merged bill was introduced last week and can be found in its entirety (all 1,990 pages!) here.

(Note that the same process has to happen on the Senate side, except they're a little behind; the Senate leadership is still working in merging the committees' separate bills. A combined version is expected some time in the next 2 weeks, which can then be voted on by the full Senate.)

What will happen on Saturday's vote? It's unlikely that House leadership would allow the bill to come to the floor without confidence that it would get the majority vote needed. But you never know for sure until the votes are tallied ...

Of course, there is still some last minute wrangling to be done. Yesterday, for example, House leaders met to ensure that the bill handled abortion in a way that was acceptable to pro-life Democrats. Fortunately, and thanks largely to the outreach that was done during the push for parity in 2007-08, addiction treatment issues have face no significant opposition. Not-being-talked-about is a great position to be in! A requirement that all health plans cover Screening, Brief Intervention, and Referral to Treatment (SBIRT) had been left out of the merged House bill (it had been included in one of the earlier committee drafts), but it has since been added back. This House bill also differs from earlier House bills in that it includes a large of number of American Indian-related health provisions--essentially, a separate Indian health bill was grafted to the end of the health reform bill. Many aspects of the Indian health bill relate to addiction and mental health treatment, including the creation of a Fetal Alcohol Disorders task force and the creation of new youth treatment sites to provide culturally competent care to Native American youth.

These people--Speaker of the House Nancy Pelosi and other Democratic House leaders--have a lot riding on health reform's passage! A vote is expected as early as this Saturday. Photo from Flickr user "Speaker Pelosi," used with a Creative Commons license.

No House Republicans have voted for health reform during the committee process, and it's not expected that any GOPers will vote for the bill on Saturday. The Dems hold a 258-177 numerical advantage, however, so they can afford to lose some of their own without jeopardizing the bill. Several Democratic legislators have expressed concern about the bill's cost, for example.

It also remains to be seen what effect this week's elections will have on legislators up for re-election in November 2010 (now less than a year away). The first congressional election after a presidential election year (as 2010 will be) is always considered an uphill battle for the president's party, since the out-of-power party is free to lay all the blame for whatever ails the country on the president and his allies. The fact that Republicans won the governorships in New Jersey and Virginia (even though the Democrats actually picked up a House seat by winning a special election in upstate New York) is likely to give extra pause to Democratic members of Congress facing competitive races next year. That's one of the main reasons that health reform advocates want reform passed well as soon as possible--controversial votes will get harder the closer they come to Election Day.

If health reform is passed by both the House and Senate, then those two versions will have to be reconciled and both chambers will have to vote--for the last time!--on that final version. Even without any major unexpected disruptions, this process could easily spill into 2010.

Once more, detailed information about the addiction-related provisions of the House health reform bill can be found here: https://www.naadac.org/advocacy.