Factcheck.org misleads on reconciliation

In a misguided attempt at evenhandedness, Factcheck.org took a shot at Democrats' claims that there is nothing unusual or inappropriate about completing health care reform legislation by passing a series of fixes to the Senate reform bill via reconciliation.  Here's how Factcheck summarized one of a series of alleged "factual missteps" in the health reform summit:

Reid said “since 1981 reconciliation has been used 21 times. Most of it has been used by Republicans.” That’s true, but scholars say using it to pass health care legislation would be the most ambitious use to date of this filibuster-avoiding maneuver.

The analysis section references an article by Thomas Mann and Molly Reynolds of Brookings that, according to Factcheck, finds "that passing health care legislation in this fashion would be the 'most ambitious' use of reconciliation to date."

But what does in this fashion mean?  The Brookings article was published on April 20, 2009.* The authors were weighing the possibility of passing the entire reform package through reconciliation. (They also concluded that "it is perfectly reasonable for Democrats to use the process for health care reform that both parties have used regularly for other major initiatives," but never mind.)

Passing a full-spectrum reform package through reconciliation is not on the table right now. The Democrats are trying to muster the will to have the House pass the Senate bill, which already passed the Senate with a 60-vote supermajority, and pass some funding-related adjustments through reconciliation.  And as Henry Aaron, also of Brookings, has written (and Jonathan Cohn highlighted), such budget-related adjustments are precisely what the reconciliation process was designed to address:

But in fact Congress created reconciliation procedures to deal with precisely this sort of situation -- its failure to implement provisions of the previous budget resolution. The 2009 budget resolution instructed both houses of Congress to enact health care reform. The House and the Senate have passed similar but not identical bills. Since both houses have acted but some work remains to be done to align the two bills, using reconciliation to implement the instructions in the budget resolution follows established congressional procedure.

So never mind that the Republicans passed two massive, budget-busting tax cuts and a massive, budget-busting deficit-funded Medicare prescription drug benefit through reconciliation, or that the authors of the study Factcheck cited concluded that passing the entirety of health care reform through reconciliation would be a better alternative than no health care reform at all. The contemplated use of reconciliation is limited, targeted, and focused on budgeting as reconciliation is supposed to be.

* Brookings added a headnote to this piece after the summit but sloppily neglected to mention that Democrats are not now contemplating passing a complete health reform package through reconciliation.  But Brookings' sloppiness does not excuse Factcheck's.

UPDATE: In the Factcheck.org mailbag, Thomas Mann of Brookings validates this criticism.

Related posts:
Reconciliation explanation fail, cont.
Chait, is the gate 'wide open'?
The earth beneath their feet: Obama recasts health care reform
Aghanistan redux: Obama's HCR surge
Obama picks "none of the above" again
A gallon of water at bedtime for bedwetters: Obama's HCR prescription
How Obama will -- and won't -- lead on health care

David Brooks "Dull as Expected" on health care reform

The headline to David Brooks' column proclaims cheerfully that the health care summit was "not as dull as expected!"  But David Brooks here is dim as expected -- as dim as ever on health care.

His signature charge, here and elsewhere, is that the Democrats are not serious about cost control because supporters of the excise tax on expensive policies have allowed that tax to be weakened:

Fifth, you got to see at least one area of bipartisan agreement. Neither side was willing to be specific about how to cut costs and raise revenue. The Republicans continued to demagogue efforts to restrain Medicare spending. The Democrats (and the Republicans) conveniently neglected to mention the fact that they had just gutted the long-term revenue source for their entire package, the excise tax on high-cost insurance plans. That tax was diluted and postponed until 2018. There is no way that members of a Congress eight years from now are going to accede to a $1 trillion tax increase to pay for a measure that the 2010 Congress wasn’t brave enough to pay for itself.

First, it is just plain slander to assert that the Democrats are unwilling to be specific about how to raise revenue.  The House bill has no excise tax, but it is deficit neutral -- it raises money from other taxes, such as a surtax on high earners, while the Obama plan published in advance of the summit adds a new Medicare surtax on capital gains for high earners.  Second, as Atul Gawande has documented in exhaustive detail and as a group of top health care economists led by Dr. Alan Garber has affirmed, the bill deploys just about every means of cost control that health care experts deem to have potential  -- coordinated care teams, incentives for results and penalties for not meeting standards on measures such as hospital readmissions, a MedPAC commission with real authority -- and yes, the excise tax, albeit delayed.

Third, it is always suspect to speak of "courage" when dealing with collective bodies.   The excise tax has not been weakened because of a lack of "courage." Indeed, Obama has gone to the mat for it as he never did for the public option -- as Ezra Klein predicted he would long ago. Unions and their closest allies in the House have had the 'courage' to risk the entire bill to weaken this tax.  Cost control hawks have had the "courage" not to let it go.  Any further "courage" on their part would doom the bill to failure.