Senate passes corrected reconciliation bill, sends it back to the Housel/Final Votes in Congress Cap Battle on Health Bill

Senate passes corrected reconciliation bill, sends it back to the House
By Lori Montgomery, Shailagh Murray and William Branigin
Copyright by The Washington Post
Thursday, March 25, 2010; 3:25 PM
http://www.washingtonpost.com/wp-dyn/content/article/2010/03/25/AR2010032500006.html?hpid=topnews


The Senate passed the final piece of President Obama's landmark health-care package Thursday and sent it back to the House after Republicans identified two minor violations of reconciliation rules that forced changes to a provision on student loans.

House Democratic leaders, who had labored to pass the package Sunday by a narrow margin, said they did not expect the changes to be a significant problem and vowed to approve the bill in question later in the day.

The Senate passed the House's package of revisions to the health-care legislation --with the two small changes -- by a vote of 56 to 43.

Democratic leaders said the provisions that were struck -- from the part of the bill dealing with Pell Grants for college students -- do not significantly affect the student loan program or the overall health-care bill.

Senators stood and voted from their desks as the roll was called, a tradition reserved for high-profile bills. Before the vote, the Senate observed a moment of silence for the late senator Edward M. Kennedy (D-Mass.), the Democratic champion of health-care reform, who died last year midway through the debate.
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Three Democrats voted against the bill: Sens. Blanche Lincoln and Mark Pryor, both of Arkansas, and Sen. Ben Nelson of Nebraska. All three lawmakers supported the legislation that was signed into law on Tuesday but objected to particular provisions in the reconciliation bill.

The bill now heads to the House, where the Rules Committee could begin action within hours. Democratic aides said a final vote on the package could come in early evening, although if Republicans throw up procedural barriers, the vote could be delayed until later Thursday night.

In Iowa, Obama dared Republicans to make good on their pledge to run in November's midterm elections on a platform of repealing the health-care overhaul, telling them to "go for it" if they want to campaign on rolling back benefits he said would start taking effect this year.

House Speaker Nancy Pelosi (D-Calif.) said Thursday she was confident that Democrats would have the votes to pass the reconciliation bill again, just as they did on the first tally late Sunday. She said the tweaks mandated by the Senate's parliamentarianwould not substantially alter the bill's impact.

"Of all the things they could have sent back, this is probably the most benign [and] easily fixed," Pelosi told reporters. After the House voted 219 to 212 to pass the main health-care overhaul Sunday night and sent it to Obama for signature, a separate vote was held on the reconciliation bill containing fixes demanded by the House. That bill passed 220 to 211.

The corrected legislation most likely will not be subjected to additional challenges when it is sent back to the House, Democratic staffers said. House Majority Leader Steny H. Hoyer (Md.) said in a statement that the House would take up the corrected bill Thursday evening.

Jim Manley, spokesman for Senate Majority Leader Harry M. Reid (D-Nev.), told reporters shortly after 3 a.m. that Senate parliamentarian Alan Frumin "struck two minor provisions tonight from the Health Care and Education Reconciliation Act."

Manley said the deletions would allow the bill to be passed by the Senate, delivering "a big win for the American people."

For much of Wednesday and into Thursday morning, Senate Republicans offered dozens of amendments to the bill that Obama signed into law Tuesday. Their goal was to force the legislation that will launch an overhaul of the nation's health-care system back to the House for another vote. But when the Senate began voting shortly after 5 p.m., all 29 amendments were easily rejected.

That means the health-care package survived essentially intact, save for the deletion of the two clauses in the reconciliation bill that were found to violate reconciliation rules, the complicated set of procedures that protected the bill from filibuster.

Senate Budget Committee Chairman Kent Conrad (D-N.D.) said one of the deleted provisions was a technical item that he considered "as close to a 'nothing' as you can come around here." The second, more substantive provision would have set a formula for establishing maximum Pell Grant awards. But Conrad said the formula would not have taken effect for two years, giving Congress time to restore it in another bill.

Frumin deemed both measures to be out of order because they had no budget implications, Conrad said Thursday. The senator said no other Republican challenges to the legislation were still pending before Frumin, raising Democratic hopes that the Senate would take a final vote within hours.

The Senate adjourned shortly after 3 a.m., with an agreement to reconvene at 9:45 a.m. and hold its final vote on the corrected bill by early afternoon.

The defeated amendments would have altered central elements of the health-care law. One would have rescinded more than $500 billion in Medicare cuts, a key source of funding to make health insurance affordable to an estimated 32 million additional people over the next decade.

"Today, Republicans will give Democrats one last chance to reject the horrible impact the underlying bill and this last-minute add-on will have on our country," Senate Minority Leader Mitch McConnell (R-Ky.) said Wednesday. "Unfortunately, we already know that they plan to turn the other way."

Another proposal would have eliminated an array of smaller provisions that benefit particular states or regions, provisions Republicans derided as "sweetheart deals" whose only purpose was to win the support of specific Democratic lawmakers.

Other amendments would have stripped the bill of tax increases that will affect individuals who make less than $200,000 a year -- upholding Obama's campaign pledge not to raise taxes on the middle class, Republicans said -- and erased a requirement that employers offer affordable coverage to their workers or face penalties.

Under another proposal, offered by Sen. Charles E. Grassley (R-Iowa), Obama and members of Congress would have been required to buy insurance through state-run exchanges that were created by the legislation and that will start in 2014. The amendment failed, but the White House announced that Obama would use the exchanges anyway, apparently assuming he will win reelection in 2012. That prompted Grassley to quip: "This is a little presumptuous."

As the Senate staged a series of rapid-fire votes, only a handful of Democrats defected, suggesting that the package of changes would easily be approved in the final vote. The package was written under special budget rules, known as reconciliation, that protect it from a Republican filibuster. Just 50 of the 59 Democratic senators need to vote "yes" in order to send the bill to Obama for his signature, completing the most significant social legislation in nearly a half-century.

Although much smaller than the bill Obama has signed, the measure would make major changes to that legislation to bring the final package in line with a compromise worked out between House and Senate leaders. Federal subsidies would be expanded slightly for people who need help buying insurance, and the coverage gap known as the doughnut hole in the Medicare prescription drug program would be closed by 2020. Seniors who fall into the doughnut hole this year would be eligible for a $250 rebate.

The measure would also change the annual penalty on individuals who do not purchase insurance to at least $695 a year or as much as 2.5 percent of annual income. And it would dramatically increase the penalty facing employers who do not offer affordable coverage, to as much as $2,000 per worker.

The most significant change, however, would be the method of financing the overhaul. A new 40 percent excise tax on high-cost insurance policies would be delayed until 2018 and replaced by a new tax on the nation's highest earners. Families earning more than $250,000 a year would for the first time have to pay a 3.8 percent Medicare payroll tax on capital gains, dividends and other investment income.

Staff writer Ben Pershing contributed to this report.






Final Votes in Congress Cap Battle on Health Bill
By DAVID M. HERSZENHORN and ROBERT PEAR
Copyright by The New York Times
Published: March 25, 2010
http://www.nytimes.com/2010/03/26/health/policy/26health.html?hpw



WASHINGTON — Congress on Thursday gave final approval to a package of changes to the Democrats’ sweeping health care overhaul, capping a bitter partisan battle over the most far-reaching social legislation in nearly half a century.

The bill, which Democratic leaders hailed as a landmark achievement, now goes to President Obama for his signature.

“The American people have waited for this moment for a century,” the Senate majority leader, Harry Reid of Nevada, said at a news conference. “This, of course, was a health bill. But it is also a jobs bill, an economic recovery bill, was a deficit-reduction bill, was an antidiscrimination bill. It was truly a bill of rights. And now it is the law of the land.”

In a fitting finale to the yearlong health care saga, the budget reconciliation measure that included the final changes was approved first by the Senate and then by the House on a tumultuous day at the Capitol, as lawmakers raced to complete their work ahead of a two-week recess.

The final House vote was 220 to 207, and the Senate vote was 56 to 43, with the Republicans unanimously opposed in both chambers.

The reconciliation bill makes numerous revisions to many of the central provisions in the measure adopted by the Senate on Dec. 24, including changes in the levels of subsidies that will help moderate-income Americans afford private insurance, as well as changes to the increase in the Medicare payroll tax that will take effect in 2013 and help pay for the legislation.

The bill also delays the start of a new tax on high-cost employer-sponsored insurance policies to 2018 and raises the thresholds at which policies are hit by the tax, reflecting a deal struck by the White House and organized labor leaders. It also includes changes to close the gap in Medicare prescription drug coverage known as the doughnut hole, and to clarify a provision requiring insurers to allow adult children to remain on their parents’ insurance policies until their 26th birthday.

Many of the changes were intended to address the concerns of House Democrats, as well as to bridge differences between the original House and Senate bills and to incorporate additional provisions sought by Mr. Obama.

The bill also included a broad restructuring of federal student loan programs, a centerpiece of Mr. Obama’s education agenda.

As the Senate voted, Mr. Obama was in Iowa City where he opened an aggressive public relations blitz to sell the health care overhaul with a campaign-style rally at the University of Iowa Field House.

Speaking to a crowd of about 3,000 Mr. Obama dared Republicans to follow through on their efforts to repeal the legislation, which would require them to win back big enough majorities in Congress to override his veto.

“My attitude is, go for it!” Mr. Obama declared, warning Republicans that he is eager to take them on this fall. “If these congressmen in Washington want to come here to Iowa and tell small-business owners that they plan to take away their tax credits and essentially raise their taxes, be my guest.”

It was in Iowa City that Mr. Obama first laid out detailed plans for “affordable, universal health care in America” as a presidential candidate in May 2007. When he delivered that speech, he was facing criticism for lacking substance; his proposal made policy analysts sit up and take notice.

“Because of you,” Mr. Obama told the crowd, “this is the place where change began.”

The Senate voted after running through an obstacle course of Republican amendments and procedural objections, which kept lawmakers working through Wednesday night until 3:30 a.m. Thursday.

Republicans, raising procedural challenges, identified small flaws that struck out two minor provisions. Those changes forced the bill to be sent back to the House one more time.

The Senate approved the measure shortly after 2 p.m. Senators cast their votes standing individually at their desks, a ceremonial gesture reserved for historic occasions.

Three Democrats opposed the measure, Senators Blanche Lincoln and Mark Pryor of Arkansas and Ben Nelson of Nebraska. Senator Johnny Isakson, Republican of Georgia, was ill and did not vote.

With both sides girding for a last round of parliamentary challenges, Vice President Joseph R. Biden Jr. arrived in the chamber to preside over the session in his role as president of the Senate. Mr. Biden served for 36 years as a senator from Delaware, making him intimately familiar with the chamber, its rules and precedents, and the main combatants on the floor.

As Senator Judd Gregg, Republican of New Hampshire, formally made the procedural challenges, Mr. Biden twice replied, “The point of order is sustained.” Then he added, “Both provisions are stricken.”

Once the roll call was completed, Mr. Biden declared, “The bill as amended is passed.”

The vote came after Senate Democrats defeated more than 40 Republican amendments intended to delay or derail the legislation, including proposals related to insurance coverage of erectile dysfunction drugs for convicted sex offenders, the legality of same-sex marriage in the District of Columbia, and gun rights.

The provisions struck out were minor. One sought to prevent any annual decrease in the maximum amount of Pell grants for students from low-income families; the other was technical.

Exuberant Democrats celebrated the vote in the corridors of the Capitol. Republicans, reacting somberly, said they would carry their opposition to the bill into the fall campaign, in an effort to win back majorities in Congress and repeal the measure.

In a floor speech, the House Republican leader, Representative John A. Boehner of Ohio, derided the legislation as “a sloppy mess that the majority of the American people believe should be repealed and replaced.” He added, “We’re going to have to come back and fix this bill time and time again.”

Although the bulk of the Democrats’ overhaul was already the law of the land, the passage of the final revisions fulfilled a promise that Mr. Reid made to rank-and-file House Democrats before they took up the Senate version of the health care legislation and approved it Sunday night, 219 to 212.

Carl Hulse contributed reporting from Washington, and Sheryl Gay Stolberg from Iowa City.