Several U.S. senators have raised the possibility of using an expedited budget process, called reconciliation, to pass a health care reform bill with a government-run insurance option. Reconciliation would require the support of 51 U.S. senators to pass such a bill, instead of the 60 votes needed to bypass a filibuster.

Speaking at a Clean Economy Expo at the International Brotherhood of Electrical Workers hall in Concord yesterday, Democratic U.S. Rep. Paul Hodes, who is running to replace U.S. Sen. Judd Gregg, said he would support the use of reconciliation.

"Because health care reform is so important to the future in this country, because it is so necessary to cultivate a strong working economy, because we're all paying too much and we can't afford to wait, we may have to use the reconciliation process to move this bill past the Senate into a conference committee to get a bill to the president," Hodes told a friendly audience of about 80 people. "Health care reform is too important to be stopped by a minority that wants to preserve the status quo and keep on empowering the health insurance industry to get between us and our health care."

Hodes said Congressional Democrats and President Obama are trying to get bipartisan support for a health care reform bill and do not want to use reconciliation. But, he added, "If my colleagues who are Republicans simply persist in being the party of no, without any ideas but just simply trying to bring down health care reform, trying to stop the progress we know we need, we're going to use the reconciliation process, I hope, to bring this bill forward."

The idea of using reconciliation has been proposed by liberal Democrats and advocacy groups that hope to have a public option, a government-run insurance plan, included in any health care reform bill. Although a public option was included in a version of the bill passed by U.S. House committees, Senators involved in the bill's negotiations have said a public option would not have enough votes to pass in the Senate. A public option is likely to face opposition from both Republicans and conservative "blue dog" Democrats.

Independent political analyst Dean Spiliotes said the Senate has two options for health care reform to pass. "They can bring out a bill that is moderate and centrist enough to get 60 votes, or they can circumvent it by using reconciliation," Spiliotes said.

The practice of reconciliation was established for appropriations bills, where the inability to pass legislation could shut down the government's ability to spend money. But it has been used in the past by both parties on other issues. According to a memo from Senate Democrats published on the Talking Points Memo website, reconciliation has been used 19 times since 1980, including by the Bush administration to pass tax cuts in 2001 and 2003.

In this case, Spiliotes said, the idea of reconciliation grew from outrage toward comments by the Obama administration that a public option may not be essential for passing a reform bill.

"Democrats who want a public option in Congress are trying to figure out a way to get it through," Spiliotes said. "Over the weekend, Democratic Senator Charles Schumer of New York said Democrats would consider reconciliation."

Hodes is a strong supporter of the public option. In his speech, he promoted the idea of an "exchange," an open competitive marketplace where consumers can choose from a variety of health insurance plans, including one run by the government.

"I consider the public option to be a critical element to health care reform," Hodes said. "It is absolutely important to introducing competition to the health insurance companies. It is not going to drive them out of business. What it will do is lower everybody's costs."

When asked whether he could eventually support a reform bill that did not include a public option, Hodes responded that he wants to read the final bill before committing to what he would support.

"I believe a public option is the best way to increase competition, deliver better quality and put people back in control of their health care," Hodes said. "If I can see some other way to accomplish that goal, it's incumbent on me to keep an open mind because I don't want to make the perfect the enemy of the good."

Among the other health care policies that Hodes said he supports as part of the reform bill: further regulating the health insurance industry, reforming Medicare to allow the government to negotiate rates with drug companies, not slashing reimbursement rates for doctors, and ensuring doctors are paid for quality and efficiency, with a focus on primary and preventive care.

Of New Hampshire's U.S. Senate delegation, Democratic Sen. Jeanne Shaheen would not commit to a position on reconciliation. "We need to pass health care reform because millions of families and businesses simply can't afford coverage, and our economy can't continue on a path where we spend so much on health care," Shaheen said in a written statement. "I am hopeful that we'll be able to work in a bipartisan manner on this legislation because I think everyone can agree that we absolutely must fix our health care system."

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