In their search for an endgame to the health reform debate, the Obama administration is examining new ways to at least get a comprehensive bill through the Senate. Media reports indicate that one strategy on the table is to split reform initiatives into two bills —one containing the least-contentious provisions that would pass the chamber with a standard 60-vote majority, and another full of hot-button issues, such as a government-run option, that would move through a filibuster-proof “reconciliation” process.

It’s a “risky political proposition,” says employee benefits law firm Groom Law Group’s Bill Sweetnam, and may not even be possible, as measures passed through reconciliation must relate to mandatory spending or revenue programs. Additionally, such an action would put moderate Democrats between a rock and a hard place.

“Since the well has been poisoned by splitting the bill, no Republicans will vote for either bill, so all Democrats will have to vote for the second bill or at least vote for cloture to allow there to be a vote on the second bill,” says Sweetnam. “These moderate Democrats will have a recorded vote for health care reform, and their Republican opponents will use that against them -- regardless of whether they voted for the bill with the hot-button issues.”

Cyndy Nayer, president of the Center for Health Value Innovation, a non-profit 501(c)3 educational organization, offers another perspective. “This may be the most efficient way to get some sort of health care change moving,” she says. “Sometimes, even if the job is big, you have to start with small shovels.”

However, appearing on CBS’s “Face the Nation” over the weekend, Sen. Kent Conrad (D-N.D.) expressed doubt that splitting the legislation would be feasible. “I think it's very unlikely for that to work,” he said. “When you look at the legislative agenda, it's very difficult to see how you put two packages through and coordinate them well.”

Although he now thinks that “anything is possible” with the 111th Congress, it’s the larger issue of abandoning a bipartisan approach that has Tom Schuetz, co-president of Iowa’s Group Services concerned.

“Don’t you think the American public is asking for bipartisan support and a more detailed explanation of exactly what issues the health reform legislation is supposed to address? I think that’s the crux of all of the unrest,” he says. “A perception that Congress is not willing to share details and rushing to a conclusion for political reasons has always created problems.”

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