Reconciliation can sound like a dirty word, depending upon who is doing the speaking, but the process is nothing new and is certainly not out of the bounds of normal politics.

Introduced in 1974, the process of reconciliation is used when Congress issues directives to legislate policy changes in mandatory spending (entitlements) or revenue programs (tax laws) to achieve the goals in spending and revenue contemplated by the budget resolution.

Reconciliation was first used in 1980 and at least 22 times since then on a variety of policies including overhauling the welfare system, and passing several huge tax cuts under George W. Bush. Of the 22 times reconciliation has been used, 16 were approved by a Republican-controlled Senate.

Reconciliation and health care have a strong history together. The Consolidated Omnibus Budget Reconciliation Act (COBRA), Children’s Health Insurance Program (CHIP), added Medicare benefits for HMOs, added protections for patients in nursing homes, and changes in the way Medicare pays doctors and other health professionals all passed through the reconciliation process.

The great health care debate of 2009-2010 encountered many sticking points, with reconciliation being used as part of reform opponents’ scare tactics. Republicans who previously supported the process of reconciliation, but now cry foul, say that health care reform is too big of an issue to be passed through reconciliation and is a threat to the Senate and the American way of life.

One must keep in mind, however, that a health care reform bill has already passed through the House, and a separate health care reform bill passed the Senate through the normal channels with a super majority. All that remains is to merge the two bills, or to have the House vote to pass the Senate bill.

Despite what opponents of reform would have us believe, what would be passed through the reconciliation process is a budget fix on legislation that has already been approved. Congress created reconciliation in the first place in order to deal with exactly this type of situation.

The Budget Reconciliation Process: Reconciliation is not a required action, but an optional procedure, beginning with the inclusion of reconciliation instructions in the budget resolution.

The process begins with a bill containing changes in law recommended pursuant to reconciliation instructions in a budget resolution. If the instructions pertain to only one committee in a chamber, that committee reports the reconciliation bill. If the instructions pertain to more than one committee, the Budget Committee reports an omnibus reconciliation bill, but it may not make substantive changes in the recommendations of the other committees.

Under reconciliation, the legislative process is speeded up, putting a limit of 20 hours on floor debate with no opportunity for a filibuster. Only a simple majority of 51 votes is needed to pass.

Motions and amendments may be offered and considered without debate, but unrelated amendments are prohibited (The Byrd Rule), as are amendments that would cause the deficit levels to increase.

The Senate Parliamentarian decides any technical disputes over the complex procedure.

Once a reconciliation bill is passed in the House and Senate, members of each body meet to work out their differences. A majority of the conferees on each panel must agree on a single version of the bill before it can be brought back to the full House and Senate for a vote on final passage. Approval of the conference agreement on the reconciliation legislation must be by a majority vote of both Houses. In the House, the conference report is usually given a special rule from the Rules Committee to govern floor consideration. In the Senate, the floor debate is governed by Senate rules and specific provisions of the Budget Act.

Simple Majority/Super Majority: Simple majority refers to the majority of all senators in attendance and voting. A bill can pass with 51 votes if all 100 senators are present. The Vice President, as President of the Senate, can vote to break a tie. A super majority is 60 votes — the number of votes needed in the Senate to avoid a filibuster.

Filibuster: When a bill comes up on the Senate floor, debate can go on indefinitely. A filibuster is when a Senator refuses to yield and prevents a roll call vote from taking place. The filibuster gives individual senators a lot of power to delay or block legislation.

Cloture: The only procedure by which the Senate can vote to place a time limit on consideration of a bill or other matter, and thereby overcome a filibuster. Under the cloture rule, the Senate may limit consideration of a pending matter to 30 additional hours, but only by vote of three-fifths of the full Senate, normally 60 votes.

You can read the complete rules of reconciliation HERE.

More Information on Reconciliation:

U.S. House of Representatives Committee on Rules

U.S. Senate

Related Reading on Care2

• How to Keep Track of Health Care Policy and Reform
• The GOP Shame Deficit: Republicans blatantly mislead public on Reconciliation