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The Human Needs Report is the Coalition on Human Needs' newsletter
on national policy issues affecting low-income and vulnerable populations.
It is published every other week while Congress is in session.
Article from the December 23, 2009 edition
of the CHN Human Needs
Report:
The final Senate vote on the health reform bill, the Patient Protection and Affordable Care Act of 2009, H.R. 3590, is scheduled for Christmas Eve at 8 a.m. The bill is expected to pass along party lines. The Senate began debating the bill after the Thanksgiving recess and since then Democratic leaders have been working hard to craft a package that would win over the 60 votes needed to overcome a filibuster. Senate Majority Leader Harry Reid (D-NV) had hoped that a compromise which a group of 10 moderate and liberal Democratic Senators had hammered out a few weeks back that offered an alternative to the public plan option and extended Medicare to individuals 55 and above would secure the 60 votes. However it did not and more concessions needed to be made. The real breakthrough came over the weekend. Democratic Leaders released a final package of changes on Saturday intended to win over moderates in their party. After Senator Bill Nelson (D-NE), (the last major hold-out in the Democratic caucus), announced he would support the bill Democratic leaders felt confident they had the 60 votes needed to proceed. Two critical procedural votes were held in the early hours of December 21 and 22. The first vote, which passed 60-40, added the manager’s amendment with the latest set of negotiated changes to the underlying bill. On Tuesday Senators voted 60-39 to replace the place-holder bill, H.R. 3590, with the full language of the Patient Protection and Affordable Care Act of 2009. The last hurdle for passage of health reform in the Senate is the early Christmas Eve vote.
The changes to H.R. 3590 included in the manager’s amendment boosted the cost of the bill to $871 billion over 10 years from the original $848 billion. Instead of offering a public insurance option the bill would now create a new system of national private insurance plans to be supervised by the federal Office of Personnel Management (OPM). The Medicare expansion that was negotiated earlier was dropped. To appease Senator Nelson, who sought greater abortion restrictions, the manager’s amendment requires that one of the national plans OPM manages not cover most abortions. Nelson also managed to win full federal financing for the Medicaid expansions in Nebraska in perpetuity. Two other states, Vermont and Massachusetts, will also receive additional Medicaid payments. All other states will be required after 2016 to cover 10 percent of the Medicaid expansion in their states. Other changes included in the manager’s amendment are higher penalties for higher income people who do not purchase insurance and requirements that insurers covering employees in large and small businesses spend at least 85 and 80 percent, respectively, of their revenue from premiums on medical claims beginning in 2011.
Democratic leaders hope to have a bill on the President’s desk before the State of the Union address in late January.
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