Heath Care Reform Bill HR 3590

Senate Approves Health Care Reform Bill; Difficult Conference Expected, (Dec. 28, 2009)
The Senate on December 24 passed its sweeping health care reform legislation, the Patient Protection and Affordable Care Bill (HR 3590) by a vote of 60 to 39. The vote set the stage for a contentious conference with the House to merge the two chambers' respective versions of the bill.
Calling Senate passage of the health care reform bill "a historic vote," President Obama said that Congress is "finally poised to deliver on the promise of real, meaningful health insurance reform that will bring additional security and stability to the American people." The president noted that, if a final bill is enacted, it will be "the most important piece of social policy since the Social Security Act in the 1930s, and the most important reform of our health care system since Medicare passed in the 1960s."
Conference Issues
Liberal House Democrats are unhappy that the Senate jettisoned a public insurance option. They are also opposed to language in the Senate bill that prohibits the use of federal funds to pay for abortions, a key concession necessary to win the vote of Sen. Ben Nelson, D-Neb. The moderate lawmaker has warned that significant changes to the Senate version could cause him to vote against the final bill, leaving Senate Democratic leaders short of the necessary 60 votes required for passing the measure.
The House and the Senate also differ on how to pay for the reform package. The Senate bill raises most of the revenue for health care reform by imposing a 40-percent surtax on high-cost employer-sponsored health plans. House members from states with strong union supporters oppose the tax on so-called "Cadillac" plans and they have threatened to withhold their support of a final bill if the provision is included.
The House bill would raise revenue through a 5.4-percent surtax on high-income earners and the Senate has openly rejected that plan. Democratic aides believe, however, that both sides will eventually compromise on revenue provisions and have suggested that conferees will likely consider raising the income threshold for high-end insurance plans.
Democratic staff members will begin laying the framework for negotiations during the week starting on December 28 and conferees are expected to return to Washington the first week of January 2010. House Speaker Nancy Pelosi, D-Calif., has indicated that she would like to complete work on the health care reform package in time for President Obama’s State of the Union address, traditionally delivered at the end of January. The White House has set no deadline for when it expects to see the final bill.