Updated health care projections

I am lowering from 60% to 50% my projection for the success of comprehensive health care reform.

  1. Pass a partisan comprehensive bill through the House and through the regular Senate process with 60, leading to a law; (was 40% -> 30%)
  2. Pass a partisan comprehensive bill through the House and through the reconciliation process with 51 Senate Democrats, leading to a law; (steady at 20%)
  3. Fall back to a much more limited bill that becomes law; (was 20% -> 15%)
  4. No bill becomes law this Congress. (was 20% -> 35%)

I think there is zero chance a bill makes it to the President’s desk before 2010. If a bill were to become law, I would anticipate completion in late January or even February.

The next few days

Later today Senate Majority Leader Reid is expected to release his version of the health care reform bill along with a CBO score. Senate Democrats are scheduled to meet (“caucus”) late this afternoon. My sources tell me that most Senate Democrats do not know what is in the Reid amendment. Release of the Reid amendment and the caucus meeting are two pivot points that can significantly shape prospects for the bill.

Leader Reid will be asking all 58 Senate Democrats, along with Independents Lieberman and Sanders, to vote for cloture on the motion to proceed this Friday or Saturday. Here is how I would expect the process to play out:

  • Today: Leader Reid moves to proceed to an unrelated House-passed tax bill. He then files a cloture motion (signed by 16 Senators) on the motion to proceed.
  • Friday: The Senate votes on cloture on the motion to proceed. If Reid gets 60 votes to invoke cloture, then 30 hours of post-cloture debate begins. That takes us to Saturday afternoon.
  • Saturday: There’s an up-or-down (majority) vote on the motion to proceed. Assuming cloture was invoked Friday, this vote is a gimmee. It might even be a voice vote that does not require Senators to be present.
  • After the motion to proceed is adopted on Saturday, the Senate would be debating the unrelated House bill. Reid would then offer his new proposal as a complete substitute amendment for the text of that bill, sometimes colloquially referred to as the shell bill. Leader Reid’s proposal would be referred to as the Reid substitute. You can think of it as the Reid bill.
  • The amendment (probably approaching 2,000 pages) needs to be read in full. I assume Leader Reid would ask for unanimous consent to dispense with the reading of his amendment. I would then expect a Republican (McConnell? Coburn?) to object.
  • Saturday – Monday?: The Senate clerks would take turns reading the entire Reid substitute amendment aloud.
  • Monday: The amendment would have been read, and the Senate would adjourn until Monday the 30th.
  • Monday, Nov. 30: The Senate would convene and begin consideration of the Reid substitute.

Advantages for Leader Reid of starting now:

  • If he gets 60 votes on cloture on the motion to proceed, he has a win going into the Thanksgiving recess, having held his entire party together. This creates positive momentum.
  • He allows himself more time in December for debate and amendments.
  • In December he is inoculated against process arguments about having had insufficient time to read and understand his amendment. By the 30th the amendment would have been public for 12 days.

Disadvantages for Reid of starting now:

  • A Friday cloture vote would break the 72-hour transparency commitment he made to his moderates. This might cause a bump or two within his caucus, but he can solve it by delaying the cloture vote until Saturday night.
  • He may be rolling the dice on the upcoming cloture vote. I have been surprised that some of his 60 have been willing to leverage their votes on the motion to proceed to push for substantive concessions. It is highly unusual to challenge your own party leader on the motion to proceed.
    • Q: Does he already know he has 60 for a Friday (or Saturday) cloture vote, or is he betting that he can round up 60?
    • Q: Do some of those 60 votes depend on substantive policy that they have not yet seen? If so, the substantive and mechanical challenges of rounding up the votes by Friday are significant.
  • He is exposing his members to a lot of risk over the Thanksgiving recess. They will spend 9-10 days at home being hammered on a bill that many/most of them may have not yet seen. Imagine a constituent asking you, “Why did you vote for [cloture on the motion to proceed to] the Reid bill when it contains _________?” In reaction, a nervous Senate Democrat might reply, “I agree with you. I just voted to start the process, but I won’t vote for cloture in December unless that is fixed.” Winning the battle this week may make it harder for him to win the war in the third week of December.
  • Constituencies have more time to analyze the bill, organize their campaigns, and lobby Members. This makes December more difficult.

Nevertheless, the odds favor Reid invoking cloture on the motion to proceed this Friday or Saturday. If that falls apart, then Reid and the bill are in trouble, because Democrats will be going home in chaos, and could not complete Senate floor action in December.

It is also interesting that Leader Reid is using an unrelated House bill as the shell, rather than the House bill. I am fairly certain that is because some of his members don’t want to take any vote even indirectly related to the House-passed bill. This is an indication of overall strategic weakness and substantive differences between the House and Senate.

Looking forward to December

Assume that Leader Reid is successful and the Senate spends three six-day weeks in December debating and amending the Reid substitute amendment. I would expect that as the third week approaches, Reid would begin to signal that the Senate has worked hard on the bill and needs to bring debate to a close. Around the middle of week three, he would file a cloture motion on his substitute amendment, with the cloture vote happening on or near Friday, December 18th.

That vote, cloture on the Reid substitute, is the vote. If Reid can get 60, then the Senate will pass a bill and the probability of a signed law goes way up. If he cannot get 60, the path is murky, but his chances for success go down.

My projections therefore depend heavily on my guess about that vote. It is nearly impossible to predict because you can tell two equally strong stories that point to opposite results:

  • Pointing in favor of cloture on the Reid substitute: Independent of the policy substance and the home-state politics, how many Senate Democrats (and Independents) have the guts to vote no on cloture on December 18th after receiving a phone call from (or having an Oval Office visit with) the President? I can think of only one for certain. 60 votes of support for this bill could results from Democratic party loyalty to and fear of the President.
  • Pointing against cloture on the Reid substitute: Were this not the President’s top priority in year one, this bill would have died weeks ago. The politics are a sure loser for almost any moderate Democrat, and the substantive attacks are effective and brutal. Like most, I expect the Reid amendment will lean left, causing serious policy concerns about higher taxes, higher premiums, government interference, more spending and long-term deficit risk for Democrats who think of themselves as fiscally conservative. In addition, most voters are focused instead on the poor labor market picture.

I have lowered my projection of Leader Reid succeeding for three reasons:

  1. Pretty much everything has to go right for him to win on cloture in mid-December. He has no more wiggle room on the schedule, and new intra-Democrat policy fights are popping up.
  2. I think his members are going to get beat up about health care and jobs over Thanksgiving recess, then return to Washington to face another bad jobs day Friday the 4th.
  3. If moderates demand large substantive concessions for their votes, liberals like Senators Rockefeller and Boxer may refuse. They may tell Reid they will oppose cloture if the bill moves toward the center, and instead advocate abandoning regular order and starting a clean reconciliation process in January. House liberals might join this effort.


  • Does Leader Reid already know that he has 60 votes for cloture on the motion to proceed?
  • Will the substance of his amendment affect that vote count?
  • Will he include a payroll tax increase in his amendment, as is rumored?
  • How badly will his moderate members get beat up over Thanksgiving break?

And when we get to mid-December,

  • Will he have 60 votes for cloture on the Reid substitute?
  • Suppose he knows he has 57-59 votes, with 1-3 undecided. Will he gamble?
  • Suppose he knows he does not have 60, so he knows he would lose a cloture vote right before leaving town. Does he have the vote anyway?
  • If he loses a cloture vote, what happens in January, and who has the whip hand in deciding?

Thursday morning update: Leader Reid did not file cloture on the motion to proceed yesterday. Assuming he does today, slip the above schedule by one day, with the cloture vote to occur Saturday.

(photo credit: Democrats.Senate.Gov video clip)

13 thoughts on “Updated health care projections

  1. @legalmusings


    It would be very interesting to see a timeline showing how your predictions for each scenario have changed over the last 6 months, perhaps you could create a link at each change to the blog post describing the rationale. (I could see you doing a stacked bar chart or a multi-series line graph to show how the probabilities have changed over time.

    Just a thought.

  2. GAC


    How do you bake the Lieberman Factor into your cake? Seems like he has boxed himself in as much as a senator can, and may even enjoy sticking his finger into the eyes of the activists who primaried him. (Good for Joe!) But I see three possibilities: (1) Nothing passes; (2) a bill without a public plan passes; (3) Senator Joe performs the most egregious and transparent flip-flop in Senate history.

  3. Brinty

    I have a question on Senate procedure: Can Senator Reid swith to the Reconciliation path at any time? Or must he choose Regular Order or Reconciliation and stick with it? I ask because it seems to me that unless a lot of things fall into place, the Regular Order path is almost blocked (Lieberman et. al.). Always appreciate your insight.

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  5. Kevin Pond

    I want to thank you for always having the in-depth explanations and thinking the many possibilities through. As a college student, I really feel like I gain alot from reading your articles. Keep up the great work!

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  7. Batman

    The power of the Congress and the President to offer just about any conceivable bribe to wavering Senators is enormous. I frankly do not believe that a single Democrat Senator will vote against cloture in December. Since Sanders is to the left of all of them, you can add his vote too. That leaves only Lieberman. On the other side Snowe is the only Republican whom I think might vote for cloture. So it looks like 59 votes maximum at this point.

    If Reid knows he has only 59 votes, what are his options? A defeat just before the Christmas recess will look very bad for Obama. So will he postpone the vote? Or will he try some other parliamentary maneuver? I predict the latter. As Brinty wrote above, is there anything to stop him from turning to reconciliation in mid-stream?

    Here is a technical question: can Vice President Biden only vote when there is a mathematical tie — 50/50 or 49/49 — or is there any loophole that permits him to break a deadlock of any other kind? I know this sounds like a dumb question but I want to be sure that there is no previously untested mechanism that they can use.

  8. Jon Kessler

    Perfect description of the inside ball. Clearly, he does not have 60 votes right now or he would have filed this morning or this afternoon. Let's say he gets Lincoln, Nelson et al. Another senate leader would not risk beginning debate if he didn't have the votes to end it. Given Liberman's position, that's where Harry is. He will risk walking into that dead end alley 'cause he clearly doesn't care about being procedurally defeated inside the Beltway. Say what you will, he's a grinder.

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  10. Lawrence Auster

    Mr. Hennesey,

    A question about your useful article:

    If the cloture vote that took place on Saturday night, Nov. 21, was on the unrelated House bill, how then can debate proceed on the Reid substitute for the House bill? Doesn’t that substitute bill have to have its OWN procedure, consisting of (a) a motion to proceed; followed by (b) cloture on the motion to proceed; followed by (c) an up or down majority vote the he motion to proceed, before it can be debated?

    Look at it this way: if the actual bill that is going to be debated (the Reid substitute) is a completely different bill from the bill on which the motion to proceed was actually passed, what is the point of even requiring cloture on a bill to proceed with a bill? The Senate could have a cloture vote on some meaningless piece of text, and then replace it by a bill to turn America into a socialist country.

    1. Keith Hennessey Post author

      The motion to proceed applies to a bill. Senator Reid will be offering a "complete substitute" amendment to that bill. This needs no motion to proceed.

      His amendment will be subject to many amendments of its own. Both the Reid amendment and any amendment to it could be filibustered and require its own cloture vote.

      I suggest avoiding the "what is the point" questions when focusing on Senate procedure. The rules exist so that they work in a wide range of cases. There are points in the process of implementing those rules, like cloture on the motion to proceed to a substantively unrelated bill, which may seem to not substantively "make sense." In my view, as long as those rules are consistently implemented over time and everyone can understand them, that's acceptable.

      As for "replacing it by [an amendment] to turn America into a socialist country," Leader Reid would need just as many votes (60) to do that as to adopt a freestanding bill that achieves the same goal.

  11. Lawrence Auster

    Thanks for the reply. But it amounts to saying that the rule is this way because it is this way. The rule continues to defy common sense, or, at least, the common sense of reasonable persons not conversant with the rules. .

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