Health Care and Education Reconciliation Act of 2010
Encyclopedia
The Health Care and Education Reconciliation Act of 2010 is a law that was enacted by the 111th United States Congress
, by means of the reconciliation process
, in order to amend the Patient Protection and Affordable Care Act
. It was signed into law by President Barack Obama
on March 30, 2010.
The law also includes the Student Aid and Fiscal Responsibility Act
, which was attached as a rider. However, small technical parts of the bill relating to Pell Grant
s were removed during the reconciliation process.
Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010. The Health Care and Education Reconciliation Act of 2010 was passed by the House of Representatives on March 21, 2010, by a vote of 220–211, and on March 25, after having two minor provisions stricken under the Byrd Rule
, passed the Senate by a vote of 56-43. A few hours later, the amended bill was passed by the House 220-207. President Obama signed the health care reconciliation bill into law on Tuesday, March 30, at Northern Virginia Community College
.
, became the most viable avenue to reform following the death of Democratic Senator Ted Kennedy
and his replacement by Republican Scott Brown
. Lacking a filibuster
-proof supermajority in the Senate, the Obama administration and House Speaker Nancy Pelosi
began encouraging the House to pass an amended version of the Senate bill using the reconciliation
process.
Under the Fiscal Year 2010 budget resolution
the text submitted to the Budget Committee
had to have been reported by October 15, 2009. Therefore, the Democrats combined the text of America's Affordable Health Choices Act of 2009
as reported out of the Ways and Means Committee
, and as it was reported out of the Education and Labor Committee, and the text of the Student Aid and Fiscal Responsibility Act
as reported out of the Education and Labor Committee. This version was never meant to be passed, it was only there to serve as the base for the actual 'fix' bill. The bill was automatically amended to the version that was meant to be passed per the special rule that was reported out of the Rules Committee
. The Student Aid and Fiscal Responsibility Act was added to the Reconciliation Act as only one reconciliation bill can be passed each budget year, and it also faced a tough road through the Senate due to Republican filibuster and opposition from several centrist Democratic Senators. The move was also thought to give President Obama two key victories in overhauling the health care and student loan system. It also eventually became clear that the budget savings caused by the student loan bill would become essential to the overall reconciliation bill by reducing the deficit enough for the overall bill to qualify for the reconciliation process.
Passage of the legislation in the United States House of Representatives
using the self-executing rule
method was considered but rejected by House Democrats
. Instead, on March 21, 2010, the House
held a series of votes: the first vote on ordering the previous question
on the special rule resolution
that set the terms of debate, the second on the rule itself, the third on the Senate bill, the fourth on a minority attempt to amend the reconciliation bill itself, and finally a vote on a the reconciliation bill itself. The reconciliation bill passed on a vote of 220–211, with all 178 Republicans and 33 Democrats voting against it.
In the Senate, the bill faced numerous amendments made by the Republicans, all of which failed. However, the Republicans had two provisions dealing with Pell Grant
s stricken from the bill due to violations of budget reconciliation rules, forcing the bill to return to the House. The two provisions were: The fourth paragraph of Sec. 2101(a)(2)(C) and Sec. 2101(a)(2)(D). On March 25, the bill passed the Senate by a 56–43 vote, with all Republicans and 3 Democrats voting against it. The only Democratic Senators to vote against were: Lincoln
(D-AR), Nelson
(D-NE) & Pryor
(D-AR). Later in the same day the House passed the modified bill by a 220–207 vote, sending it to President Obama for a signature.
that was signed into law on March 23, 2010. These changes include the following,
that passed the House in 2009; but with some slight variation. The reform package includes,
's last estimate predicted that if both bills were passed into law in 2010, the net reduction in federal deficits would be $143 billion over the 2010–2019 period as a result of the proposed changes in direct spending and revenues. That figure comprises $124 billion in net reductions deriving from the health care and revenue provisions and $19 billion in net reductions deriving from the education provisions. The health care and revenue provisions consist in part of several new taxes, fees on health-related industries, and cuts in government spending on healthcare programs like Medicare
Advantage.
111th United States Congress
The One Hundred Eleventh United States Congress was the meeting of the legislative branch of the United States federal government from January 3, 2009 until January 3, 2011. It began during the last two weeks of the George W. Bush administration, with the remainder spanning the first two years of...
, by means of the reconciliation process
Reconciliation (United States Congress)
Reconciliation is a legislative process of the United States Senate intended to allow consideration of a budget bill with debate limited to twenty hours under Senate Rules...
, in order to amend the Patient Protection and Affordable Care Act
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
. It was signed into law by President Barack Obama
Barack Obama
Barack Hussein Obama II is the 44th and current President of the United States. He is the first African American to hold the office. Obama previously served as a United States Senator from Illinois, from January 2005 until he resigned following his victory in the 2008 presidential election.Born in...
on March 30, 2010.
The law also includes the Student Aid and Fiscal Responsibility Act
Student Aid and Fiscal Responsibility Act
The Student Aid and Fiscal Responsibility Act of 2009 is a bill introduced in the U.S. House of Representatives of the 111th United States Congress by Congressman George Miller that would expand federal Pell Grants to a maximum of $5,500 in 2010 and tie increases in Pell Grant maximum values to...
, which was attached as a rider. However, small technical parts of the bill relating to Pell Grant
Pell Grant
A Pell Grant is money the federal government provides for students who need it to pay for college. Federal Pell Grants are limited to students with financial need, who have not earned their first bachelor's degree or who are not enrolled in certain post-baccalaureate programs, through participating...
s were removed during the reconciliation process.
Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010. The Health Care and Education Reconciliation Act of 2010 was passed by the House of Representatives on March 21, 2010, by a vote of 220–211, and on March 25, after having two minor provisions stricken under the Byrd Rule
Byrd Rule
The Byrd Rule is a Senate rule that amends the Congressional Budget Act of 1974 to allow Senators, during the Reconciliation Process, to block a piece of legislation if it purports significantly to increase the federal deficit beyond a ten-year term or is otherwise an "extraneous matter" as set...
, passed the Senate by a vote of 56-43. A few hours later, the amended bill was passed by the House 220-207. President Obama signed the health care reconciliation bill into law on Tuesday, March 30, at Northern Virginia Community College
Northern Virginia Community College
Northern Virginia Community College, often abbreviated NVCC and colloquially as NOVA, comprises several locations in the Northern Virginia suburbs of Washington, D.C., and is both the second largest multi-campus community college in the United States and the largest educational institution in the...
.
History
By the end of 2009, separate health care reform bills had been passed by both houses of Congress. The Senate bill, the Patient Protection and Affordable Care ActPatient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
, became the most viable avenue to reform following the death of Democratic Senator Ted Kennedy
Ted Kennedy
Edward Moore "Ted" Kennedy was a United States Senator from Massachusetts and a member of the Democratic Party. Serving almost 47 years, he was the second most senior member of the Senate when he died and is the fourth-longest-serving senator in United States history...
and his replacement by Republican Scott Brown
Scott Brown
Scott Brown is a United States senator.Scott Brown may also refer to:-Sportsmen:*Scott Brown , American college football coach of Kentucky State...
. Lacking a filibuster
Filibuster
A filibuster is a type of parliamentary procedure. Specifically, it is the right of an individual to extend debate, allowing a lone member to delay or entirely prevent a vote on a given proposal...
-proof supermajority in the Senate, the Obama administration and House Speaker Nancy Pelosi
Nancy Pelosi
Nancy Patricia D'Alesandro Pelosi is the Minority Leader of the United States House of Representatives and served as the 60th Speaker of the United States House of Representatives from 2007 to 2011...
began encouraging the House to pass an amended version of the Senate bill using the reconciliation
Reconciliation (United States Congress)
Reconciliation is a legislative process of the United States Senate intended to allow consideration of a budget bill with debate limited to twenty hours under Senate Rules...
process.
Under the Fiscal Year 2010 budget resolution
Budget resolution
In the United States Congress, a budget resolution is a legislation in the form of a concurrent resolution setting forth the congressional budget. The budget resolution establishes various budget totals, allocations, entitlements, and may include reconciliation instructions to designated House or...
the text submitted to the Budget Committee
United States House Committee on the Budget
The U.S. House Committee on the Budget, commonly known as the House Budget Committee, is a standing committee of the United States House of Representatives, the lower house of Congress...
had to have been reported by October 15, 2009. Therefore, the Democrats combined the text of America's Affordable Health Choices Act of 2009
America's Affordable Health Choices Act of 2009
The proposed America's Affordable Health Choices Act of 2009 was an unsuccessful bill introduced in the U.S. House of Representatives on July 14, 2009. The bill was introduced during the first session of the 111th Congress as part of an effort of the Democratic Party leadership to enact health...
as reported out of the Ways and Means Committee
United States House Committee on Ways and Means
The Committee of Ways and Means is the chief tax-writing committee of the United States House of Representatives. Members of the Ways and Means Committee are not allowed to serve on any other House Committees unless they apply for a waiver from their party's congressional leadership...
, and as it was reported out of the Education and Labor Committee, and the text of the Student Aid and Fiscal Responsibility Act
Student Aid and Fiscal Responsibility Act
The Student Aid and Fiscal Responsibility Act of 2009 is a bill introduced in the U.S. House of Representatives of the 111th United States Congress by Congressman George Miller that would expand federal Pell Grants to a maximum of $5,500 in 2010 and tie increases in Pell Grant maximum values to...
as reported out of the Education and Labor Committee. This version was never meant to be passed, it was only there to serve as the base for the actual 'fix' bill. The bill was automatically amended to the version that was meant to be passed per the special rule that was reported out of the Rules Committee
United States House Committee on Rules
The Committee on Rules, or Rules Committee, is a committee of the United States House of Representatives. Rather than being responsible for a specific area of policy, as most other committees are, it is in charge of determining under what rule other bills will come to the floor...
. The Student Aid and Fiscal Responsibility Act was added to the Reconciliation Act as only one reconciliation bill can be passed each budget year, and it also faced a tough road through the Senate due to Republican filibuster and opposition from several centrist Democratic Senators. The move was also thought to give President Obama two key victories in overhauling the health care and student loan system. It also eventually became clear that the budget savings caused by the student loan bill would become essential to the overall reconciliation bill by reducing the deficit enough for the overall bill to qualify for the reconciliation process.
Passage of the legislation in the United States House of Representatives
United States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...
using the self-executing rule
Self-executing rule
The self-executing rule, also known as "deem and pass", is procedural measure used by the U.S. House of Representatives to approve legislation. If the full House votes to approve a legislative rule that contains such a provision, the House then deems a second bill as also approved without requiring...
method was considered but rejected by House Democrats
Democratic Party (United States)
The Democratic Party is one of two major contemporary political parties in the United States, along with the Republican Party. The party's socially liberal and progressive platform is largely considered center-left in the U.S. political spectrum. The party has the lengthiest record of continuous...
. Instead, on March 21, 2010, the House
United States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...
held a series of votes: the first vote on ordering the previous question
Previous question
Previous question, in parliamentary procedure is a motion to end debate, and the moving of amendments, on any debatable or amendable motion and bring that motion to an immediate vote.-Explanation and Use:It is often invoked by a member saying, "I call [for] the...
on the special rule resolution
Resolution (law)
A resolution is a written motion adopted by a deliberative body. The substance of the resolution can be anything that can normally be proposed as a motion. For long or important motions, though, it is often better to have them written out so that discussion is easier or so that it can be...
that set the terms of debate, the second on the rule itself, the third on the Senate bill, the fourth on a minority attempt to amend the reconciliation bill itself, and finally a vote on a the reconciliation bill itself. The reconciliation bill passed on a vote of 220–211, with all 178 Republicans and 33 Democrats voting against it.
In the Senate, the bill faced numerous amendments made by the Republicans, all of which failed. However, the Republicans had two provisions dealing with Pell Grant
Pell Grant
A Pell Grant is money the federal government provides for students who need it to pay for college. Federal Pell Grants are limited to students with financial need, who have not earned their first bachelor's degree or who are not enrolled in certain post-baccalaureate programs, through participating...
s stricken from the bill due to violations of budget reconciliation rules, forcing the bill to return to the House. The two provisions were: The fourth paragraph of Sec. 2101(a)(2)(C) and Sec. 2101(a)(2)(D). On March 25, the bill passed the Senate by a 56–43 vote, with all Republicans and 3 Democrats voting against it. The only Democratic Senators to vote against were: Lincoln
Blanche Lincoln
Blanche Meyers Lambert Lincoln is a former U.S. Senator from Arkansas and a member of the Democratic Party. First elected to the Senate in 1998, she was the first woman elected to the Senate from Arkansas since Hattie Caraway in 1932 and, at age 38, was the youngest woman ever elected to the...
(D-AR), Nelson
Ben Nelson
Earl Benjamin "Ben" Nelson is the senior U.S. Senator from Nebraska. He is a member of the Democratic Party and was elected to the U.S. Senate in 2000....
(D-NE) & Pryor
Mark Pryor
Mark Lunsford Pryor is the senior United States Senator from Arkansas, serving since 2003. He is a member of the Democratic Party and former Attorney General of Arkansas....
(D-AR). Later in the same day the House passed the modified bill by a 220–207 vote, sending it to President Obama for a signature.
Provisions
The Health Care and Education Reconciliation Act is divided into two titles, one addressing health care reform and the other addressing student loan reform.Amending the Senate's Healthcare Bill
The Reconciliation bill makes several changes to the Patient Protection and Affordable Care ActPatient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
that was signed into law on March 23, 2010. These changes include the following,
- Increasing the tax credits to buy insurance
- Eliminates several of the special deals given to senators, such as Ben NelsonBen NelsonEarl Benjamin "Ben" Nelson is the senior U.S. Senator from Nebraska. He is a member of the Democratic Party and was elected to the U.S. Senate in 2000....
's "Cornhusker Kickback" - Lowers the penalty for not buying insurance from $750 to $695
- Closes the Medicare Part DMedicare Part DMedicare Part D is a federal program to subsidize the costs of prescription drugs for Medicare beneficiaries in the United States. It was enacted as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and went into effect on January 1, 2006.- Eligibility and...
"donut holeDonut Hole (Medicare)The Medicare Part D coverage gap — informally known as the Medicare donut hole — is the difference of the initial coverage limit and the catastrophic coverage threshold, as described in the Medicare Part D prescription drug program administered by the United States federal government...
" by 2020 and gives seniors a rebate of $250. - Delays the implementation on taxing "Cadillac health-care plans" until 2018
- Requires doctors who treat Medicare patients be reimbursed at the full rate
- Sets up a medicare tax on the unearned incomes of families that earn more than $250,000 annually.
- Offer more generous subsidies to lower income groups. Households below 150% of the federal poverty level would pay 2% to 4% of their income on premiums. Health plans would cover 94% of the cost of benefits. Households with incomes from 150% to 400% of the federal poverty level ($88,200 for a family of four) would pay on a sliding scale from 4% to 9.8% of their income on premiums, rest will be covered by government advanceable, refundable tax credit. Health plans would cover 70% of the cost of the benefits.
- In 2014, if a company with more than 50 workers does not offer coverage, they will be obligated to pay $2,000 for each full time worker in the company, exempting the money due for the first 30 employees. For example, an employer with 53 workers will pay the penalty for 23 workers, or $46,000.
- Would increase Medicaid payment rates to primary care doctors to match Medicare payment rates, which are higher, in 2013 and 2014.
- The federal government would pay all of the costs of expanding Medicaid under the reform until 2016, 95% in 2017, 94% in 2018, 93% in 2019, and 90% thereafter. Some states that already insure childless adults under Medicaid would receive more federal money for covering that group through 2018.
- The Medicare patients will receive 50% discount on brand-name drugs would begin in 2011. By 2020, the government would pay to provide up to 75% discount on brand-name and generic drugs, eventually closing the coverage gap.
- Would extend the ban on lifetime limits and rescission of coverage to all existing health plans within six months after signing into Law.
Student loan reform
Title II of the reconciliation bill deals with student loan reform. The language is very similar to the Student Aid and Fiscal Responsibility ActStudent Aid and Fiscal Responsibility Act
The Student Aid and Fiscal Responsibility Act of 2009 is a bill introduced in the U.S. House of Representatives of the 111th United States Congress by Congressman George Miller that would expand federal Pell Grants to a maximum of $5,500 in 2010 and tie increases in Pell Grant maximum values to...
that passed the House in 2009; but with some slight variation. The reform package includes,
- Ends the process of the federal government giving subsidies to private banks to give out federally insured loans. Instead loans will be administered directly by the Department of Education.
- Increases the Pell GrantPell GrantA Pell Grant is money the federal government provides for students who need it to pay for college. Federal Pell Grants are limited to students with financial need, who have not earned their first bachelor's degree or who are not enrolled in certain post-baccalaureate programs, through participating...
scholarship award. - For new borrowers of loans starting in 2014, those who qualify will be able to cap the amount they must spend on loan repayment each month to 10% of their discretionary income (current cap is 15%.)
- Also, for new borrowers after 2014, loans will be eligible to be forgiven to those who make timely payments after 20 years (the current time-frame being 25 years).
- Will make it easier for parents to take out federal PLUS loans for students.
- Several billion will be used to fund historically poor and minority schools, as well as increasing community college funding.
Deficit effect
The Congressional Budget OfficeCongressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....
's last estimate predicted that if both bills were passed into law in 2010, the net reduction in federal deficits would be $143 billion over the 2010–2019 period as a result of the proposed changes in direct spending and revenues. That figure comprises $124 billion in net reductions deriving from the health care and revenue provisions and $19 billion in net reductions deriving from the education provisions. The health care and revenue provisions consist in part of several new taxes, fees on health-related industries, and cuts in government spending on healthcare programs like Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
Advantage.
See also
- 111th United States Congress111th United States CongressThe One Hundred Eleventh United States Congress was the meeting of the legislative branch of the United States federal government from January 3, 2009 until January 3, 2011. It began during the last two weeks of the George W. Bush administration, with the remainder spanning the first two years of...
- Patient Protection and Affordable Care ActPatient Protection and Affordable Care ActThe Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
- Health care reform in the United StatesHealth care reform in the United StatesHealth care reform in the United States has a long history, of which the most recent results were two federal statutes enacted in 2010: the Patient Protection and Affordable Care Act , signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010 , which amended the PPACA and...
- Health care reform debate in the United StatesHealth care reform debate in the United StatesThe health care reform debate in the United States has been a political issue for many years, focusing upon increasing coverage, decreasing the cost and social burden of healthcare, insurance reform, and the philosophy of its provision, funding, and government involvement...
External links
- Text of law, (available in plain text and PDF formats).
- docs.house.gov/rules/hr4872/111_hr4872_amndsub.pdf - The actual bill being considered.
- i2.cdn.turner.com/cnn/2010/images/03/18/section.analysis.pdf - A section-by-section analysis of the bill.