Late Saturday night the House of Representatives approved its version of health care reform by the slim margin of 220 to 215 (218 was the minimum needed). The core of the approved House bill remained unchanged from the version the Speaker introduced a few weeks ago and includes: an employer mandate to provide and pay for coverage; a fairly strong individual coverage requirement; a public plan option set up by government that would pay “negotiated” rates to providers; and insurance reforms, including guaranteed issue and modified community rating. It does not include the “Cadillac” plan tax or the insurer tax provisions currently in the Senate bill. The House bill would be paid for in part with cuts to Medicare Advantage, Medicare overall and a surcharge on the “wealthy.” If you want to see how your Member of Congress voted, you can go to the Washington Post site linked here: http://projects.washingtonpost.com/congress/111/house/1/votes/887/
Some highlights from the bill include:
By a vote of 240 to 194, the House approved an amendment by Reps. Bart Stupak (D-MI) and Joseph Pitts (R-PA) addressing coverage of abortion services. This amendment would prohibit federal funds from being used to pay for abortion services under the government-run plan, and it would prohibit the affordability credits from being used to pay for plans that cover abortion services. Individuals would be permitted to use their own funds to purchase supplemental coverage for abortion services.
By a vote of 258 to 176, the House defeated the Republican substitute amendment, which included provisions addressing the following topics: federal funding for state high risk pools and reinsurance programs to cover persons with pre-existing conditions; a nationwide marketplace for individual health insurance; improvements to HSAs; association health plans; independent review and new restrictions on health plan rescissions; administrative simplifications; medical liability reforms; FDA approval of generic biologics; and repeal of the Federal Coordinating Council for Comparative Effectiveness Research.
By a vote of 247 to 187, the House defeated a motion to recommit the bill to the committees of jurisdiction with instructions to amend the bill to include medical liability reforms and to protect seniors from Medicare Advantage funding cuts. This motion was offered by House Republican Whip Eric Cantor (R-VA).
Now that the House has passed its bill, all eyes will be focused on the Senate. The schedule for the Senate floor debate is highly uncertain, as senators are still waiting for Congressional Budget Office (CBO) to complete its scoring of the bill it received from Senate Majority Leader Harry Reid (D-NV) early last week. The Senate is scheduled to be in session just two days this week, Monday and Tuesday, before leaving for the Veterans Day recess. If CBO sends a score to Leader Reid next week, the Senate floor debate potentially could begin during the week of November 16. However, there also is a possibility that the Senate debate may not begin until after Thanksgiving.
Once the Senate acts, then the House and Senate go to a Conference Committee to reconcile the two bills before each has to pass the final bill again. Then – the President gets a bill to sign. All these actions may push us into early next year given the Congressional calendar and the issues remaining to be resolved.