House Democrats passed their landmark health care overhaul, the “Patient Protection and Affordable Care Act,” (PPACA) on a party-line 219-212 vote late on March 21. A little more than a day following, on March 23, President Obama signed the legislation into law at a White House ceremony.
Additionally, the House passed H.R. 4872, the “Health Care and Education Affordability Reconciliation Act” (Reconciliation Bill), which is a package of amendments to the PPACA. The approved Reconciliation Bill then went back to the Senate, where it needed to be voted on – and potentially amended – before it would be ready for President Obama’s signature.
On March 25, by a vote of 56 to 43, the Senate approved the Reconciliation bill with some modifications, and sent it back to the House for yet another vote. Democrats Ben Nelson (D-NE), Mark Pryor (D-AR) and Blanche Lincoln (D-AR) joined Republicans in voting “no.” Johnny Isakson (R-GA), who is ill, did not vote.
In the final vote on current health insurance reform legislation, the House approved – by 220 to 207 – the same version of the health reconciliation bill, H.R. 4872 that was approved earlier in the day by the Senate. This bill is now ready to be signed into law by President Obama. The final version of the reconciliation bill is virtually identical to the version that the House approved on March 21. The only difference is that two student loan provisions were removed during the Senate floor debate.
The combined package costs $940 billion, and is expected to expand health insurance coverage to 32 million Americans while cutting the deficit by $143 billion over the next 10 years.
A spokesman for House Republican Whip Eric Cantor (R-VA) said Republicans are now shifting their efforts against the health legislation to a campaign aimed at repealing the law and replacing it with their own solutions. Both the Senate and the House began the two-week Easter recess on March 27.
Overview: Tax Extenders Package
Along with the Reconciliation legislation, lawmakers were also focused intensely on passing another extension of expiring provisions including the Medicare physician payment “fix”, unemployment benefits and the eligibility period for premium assistance for COBRA and state continuation coverage. Senate leaders attempted to pass by unanimous consent a 30-day extenders package, H.R. 4851, which was approved by the House on March 17. Senator Tom Coburn (R-OK) objected to the unanimous consent request because of his concern that the bill did not include budget offsets.
Senate Democrats and Republicans then reached an agreement to pass a one-week extension with budget offsets, but House leaders objected to this approach. As of this writing, it appears that efforts to pass an extenders bill have reached a stalemate. The Senate passed an adjournment resolution that day allowing the Senate to conduct legislative business through March 31 (cutting into the aforementioned Easter recess), although the “next steps” in the extenders debate are highly uncertain at this time.