Whoever said “nothing worthwhile comes easily” might as well have been talking about health care reform.

After losing their filibuster-proof majority in the Senate by one vote, congressional Democrats in January all but abandoned efforts to forge a final health care reform bill by merging versions previously passed in the House and Senate, H.R. 3962 and H.R. 3590 respectively.

Now that they are down to 59 votes in the Senate (two Independents — Vermont Sen. Bernie Sanders and Connecticut Sen. Joe Lieberman — caucus with the Democrats), Democratic congressional leaders would need to further consider means of overcoming Republican opposition to the bill.

House Speaker Nancy Pelosi, D-Calif., rebuffed suggestions to simply put the Senate’s H.R. 3590 up for a vote in the House, insisting that House Democrats would not send what they view as too weak a bill to the president.

At this story’s deadline, NASW lobbyist Jim Finley said Democrats were considering two options. One would be to break the bill into smaller versions and get less-controversial provisions with bipartisan support — such as a ban on the insurance industry practice of denying coverage over pre-existing conditions — passed and out of the way.

The other option would be for the House to pass H.R. 3590 as is and then pass a reconciliation bill to amend it and send that back to the Senate for a vote. Under reconciliation, debate and the amendment process are limited and just a simple majority of 51 votes in the Senate is required for passage.

The latter option appeared to be gaining the most traction, Finley said.

In a January 26 Action Alert, NASW reminded members that there’s still opportunity to weigh in on health care with their congressional representatives.

“For decades NASW and the social work profession have called on Congress to enact comprehensive reform through the legislative process — and we appreciate your tremendous progress this past year,” the Action Alert said. “But now Congress is moving away from pushing comprehensive reform and considering scaling back to much more limited legislation. NASW advocates that Congress stay on track and pass comprehensive health care reform legislation.”

On Feb. 1, President Barack Obama unveiled a fiscal year 2011 budget proposal that would freeze discretionary spending for three years to help rein in the deficit.

“We’re pleased the president didn’t freeze spending across the board,” said Rebecca Myers, NASW’s director of external relations, pointing out that the administration proposed increased spending on certain programs, albeit at the expense of others. “NASW understands the need to address the deficit; enacting health care reform is an essential piece of the puzzle.”

The administration proposed increased funding for a number of government programs with implications for social work, including:

• $8.2 billion for Head Start, an increase of $989 million over FY 2010 spending, and $118 million for quality enhancements;
• A six-month extension of the temporary Federal Medical Assistance Percentage increase for foster care and adoption assistance provided by the 2009 American Recovery and Reinvestment Act;
• $102.5 million in increased funding for an Administration on Aging caregiver initiative to enable families to better care for their aging relatives and support seniors trying to remain independent in their communities;
• Extending the Temporary Assistance for Needy Families (TANF) block grant and related programs, including the Contingency Fund and Supplemental Grants, through FY 2011 and increasing the TANF Emergency Fund for FY 2011 by $2.5 billion;
• $500 million for a new Fatherhood, Marriage, and Families Innovation Fund;
• A one-year, $669 million extension of the federal match to states’ reinvestment of incentive payments into Child Support Enforcement programs; and
• $32.1 billion for the National Institutes of Health, an increase of $1 billion over FY 2010 spending.