Editor’s note. This is taken from a Sunday posting at http://powellcenterformedicalethics.blogspot.com.

It is presently unclear whether a vote to adopt the Senate heath care restructuring bill will occur before Christmas or not.

According to InsideHealthPolicy.com, at a meeting with "key stakeholders" late last week, senior staff from the majority leadership sketched out a scenario for a vote on Tuesday, December 22 or Wednesday, December 23.
The end game would be triggered by the filing of cloture motions-- to cut off debate and proceed to a vote--on three items.

One would be the so-called "manager's amendment" [individual amendments agreed to by both sides in advance] which is expected to contain all the compromises necessary to get 60 votes. A second would be on the Reid Substitute, as amended by adoption of the manager's amendment. The third would be on the adoption of the bill itself, a House-passed revenue measure, as replaced by the amended Reid Substitute.

Once cloture is voted on each of these, there would still be 30 hours of debate permitted under the Senate rules before it could come to a vote. During that period any "germane," that is to say, related, amendments could be offered. However each could be subject to an undebatable motion to "lay on the table," which has the effect of killing it. This, for example, is the mechanism that was used to defeat the Nelson-Hatch amendment against abortion funding in the bill.

This scenario would require that the cloture motions be filed no later than Tuesday or Wednesday of this week. In order for that to occur, Majority Leader Harry Reid (D-Nv.) would presumably have to be sure of his 60 votes by then. This would mean that the Congressional Budget Office score on the "public option" compromise would have be delivered soon, and that it would have to satisfy the relevant senators--or else lead to quick "tweaks" that do.

It has been observed that while this schedule is technically possible, any complication, such as an inability to reach quick agreement yielding 60 votes, would scuttle it. In that case, the vote would have to be deferred until after Christmas.

There have been different predictions concerning what the schedule would be in that case. One possibility is that the Senate could take only what has been called a "long lunch break," recessing, for example, only for Christmas Eve through the following weekend, and returning for the week between Christmas and New Year's Day. Others have speculated that there would be so much resistance to such a schedule that if the Senate cannot get to a final vote by Christmas, it might recess until after New Year's Day.

If there is a final Senate vote on the pending health care legislation, the differences between the Senate and House versions would still have to be resolved before a bill could be sent to President Obama for signature. One option that has been discussed would be to send the Senate-passed version directly to the House for a vote. However, according to InsideHealthPolicy.com, at the stakeholders' meeting last week the senior Congressional staff suggested that would be impossible -- that there would need to be negotiations among the leaders of the two houses, even if a formal conference committee were not convened.

The White House and its allies have long sought to avoid the health care debate going over into next year, both because they want to get the public's attention focused on planned efforts to address the high unemployment rate and other effects of a poor economy and because it is widely believed that votes to adopt the measure will become more and more difficult to achieve the farther they are pushed into a Congressional election year.

December polls have consistently shown majority opposition to the health care bill: by 51 % to 41 % in a December 4/5 Rasmussen poll, by 52 % to 38 % in a December 1/6 Quinnipiac poll, by 61% to 36 % in a December 2/3 CNN/Opinion Research poll, and by 57 % to 34 % in a December 8/9 Fox News poll.

Part Three
Part One