House Starts Health Reform Reconciliation Process

Janice Simmons, for HealthLeaders Media , January 6, 2010

The wheels of healthcare reform reconciliation began to turn this week with closed-door discussions among House leadership.

House Speaker Nancy Pelosi (D-CA), appearing with House Democratic healthcare leaders during a briefing break on Tuesday afternoon, was upbeat about the process.

"We are optimistic that there's much that we have in common with both of our bills and that we will reconcile the legislation in a way that [has] a 'triple A' rating: affordability for the middle class, accountability for the insurance companies, and accessibility to many more people in the country to quality, affordable healthcare," Pelosi said.

However, Pelosi appeared to indicate that the House would not automatically roll over and just approve what the Senate advocates in its bill. One of the areas where both bills differ is the inclusion of the controversial public option—or what Pelosi views it as "the public's option"—where insurance companies would be held accountable for their actions, she said.

"There are other ways to do it, and we look forward to those discussions. But unless we hold the insurance companies accountable, we will not be able to have the affordability for the middle class," she said.

The large question surrounding the reconciliation process is how much the American public will get to see. Despite a request last week from C-SPAN to broadcast the proceedings, the House and the Senate will likely be working behind closed doors or outside of the public view.

Saying she is not sure what "route they will take," Pelosi cited obstacles with outside special interests that were trying to stop the reconciliation process. "We will do what is necessary to pass the bill."

The White House is expected to take a more active role in the discussions than in the past on settling disputes. Missing from the picture, though, are Republicans from both chambers who have not been invited to ongoing discussions of the bills.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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