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How Will the Senate Combine Max Baucus's Health Care Bill With All the Others?

Max Baucus finally unveiled the Senate Finance Committee's health care bill today, meaning that all five congressional committees with jurisdiction over health care reform will soon have proposals on the table. So what happens then? Who decides how to merge Baucus's conservative plan with its more liberal counterpart, to create the official Senate bill that will receive a vote in the full chamber?

After the Finance committee votes on the plan, it's all up to the Senate leadership. According to congressional expert Norman Ornstein, Harry Reid is empowered to combine the Senate proposals using whatever method he considers most likely to attract a minimum of 51 votes and avoid a filibuster. Reid could designate a formal committee to mesh the bills, or he could assemble the final product in a closed room that includes the leadership and a few important senators.

The Senate leadership will want to maintain control, says Ornstein, so it will probably adopt a more informal process overseen by Reid. He will likely be joined by Senators Richard Durbin (the majority whip), Chris Dodd, and Max Baucus, with significant input from Kent Conrad. Although Reid is "unlikely to knock heads together and make things happen," Ornstein says, he is a former whip and knows what will work to get the necessary votes. The White House will have input as well, most likely conveyed during visits from Joe Biden or Rahm Emanuel.

Several of these meetings will probably be done in a public fashion, so as to make a big show of the statesmanlike efforts of senators involved. But there might be a few events that the leadership tries to keep out of the press, particularly when they are courting votes from more hesitant congressmen. Those could be held anywhere in the Capitol--they may be in Reid's offices or in locked backrooms. 

For its part, the House of Representatives has already worked out a draft bill using what Nancy Pelosi's office called a "Tri-Committee," including representatives from all three relevant House committees--especially the influential Henry Waxman--and members of the House leadership. Emanuel was probably present as well, Ornstein says, “just outside the room, or in the room."

One benefit of this whole procedure is that it may actually strengthen the legislation. In the Senate, the leadership will be able to take into account the actions of Republicans on the Finance committee--none of whom ultimately supported the bill. By asking for concessions and then refusing to back the final product, they may be perceived as having pulled a "bait and switch"; the leadership could rescind their concessions during the combination process.

Correction: This article originally stated that, after the combination process, the Senate Rules Committee could restrict the number of amendments to the Senate health care bill. In fact, this only occurs in the House. We regret the error.