A key approach to achieve legislative objectives would be to use budget reconciliation procedures to pass some tax and spending measures in areas, such as Affordable Care Act enhancement and pandemic relief. The process begins with a budget resolution. Next, reconciliation legislation is then considered using a fast-track process that can be passed by a simple majority without having to be filibustered in the Senate. Limitations exist since budget reconciliation cannot be used for any and all federal legislation. Instead, bills must contain provisions that affect revenue and spending, with no extraneous items allowed, according to a restriction known as the “Byrd Rule.” Named after its principal sponsor, the late Senator Robert C. Byrd, D-WV), the rule provides six definitions of what constitutes extraneous matter. The Byrd rule has been in effect during Senate consideration of 22 reconciliation measures from late 1985 through the present.
During the month of September this year, various committees of jurisdiction in the House of Representatives have been working to advance major components of a $3.5 trillion reconciliation package. Examples include the following:
Education and Labor Committee
This group has been focusing on its portion of the Build Back Better plan, tuition assistance for community college students, increased funding for the Pell Grant program, and significant new investments in historically black colleges and universities, and other minority serving institutions.
Energy and Commerce Committee
Its members seek to address the “Medicaid coverage gap” and permanently extend the Children’s Health Insurance Program; allow the Medicare program to negotiate the prices of certain medications; invest in public health infrastructure and the health workforce; and fund pandemic preparedness efforts.
Ways and Means Committee
Constituents of this legislative body are considering medical education and other workforce issues; extending the expanded Affordable Care Act Marketplace premium tax credits from this year’s COVID-19 legislation; addressing drug pricing; and expanding Medicare benefits for dental, vision, and hearing.
Budget Committee
Participants involved in the activities of this entity ultimately will combine the health care measures with various education, housing, climate, and transportation provisions.
Apart from what occurs in the House, a Senate that lacks a majority by either of the two major political parties means that Democrats must be unified in their support. Although that party enjoys a majority in the House, the margin is slim. Thus, it will take only a small handful of Democrats to prevent the bill from being passed once it arrives on the House floor. If it does make its way to President Biden for his signature into law, it will be the most significant legislation of its kind since the New Deal in the 1930s.