Not quite. In his remarks during the signing, Obama referenced, “a last round of improvements to make on this historic legislation,” which he was confident the Senate would pass quickly. So what exactly are those changes?
There were some major differences between the original Senate bill, which is now law, and the bill the House past last November. The House passed the Senate bill exactly as written, but immediately afterwards, it also passed a second, brand-new bill making some changes to the Senate bill (changes that were negotiated in advance by the White House and leaders from the House and Senate). That’s the bill that the Senate now has to vote on.The final modifications would:
- Eliminate the so-called “cornhusker kickback” deal, which was made to earn the support of Sen. Ben Nelson’s (D-Neb.) Now, all states, not just Nebraska, will get federal aid to expand Medicaid.
- Increase payments made to doctors who treat Medicaid recipients, which should expand the number of doctors available to treat the increased number of Americans who will be covered by Medicaid after reform.
- Eventually close the Medicare “doughnut hole” that currently leaves many seniors on the hook for much of their drug costs.
- Increase tax credits to make insurance more affordable for low- and moderate- income Americans, and increase the value of coverage for low-income Americans.
- Reduce the penalty for not buying insurance for low-income Americans, and raise it for higher income earners.
- Raise the penalty on large employers whose employees earn public subsidies because the company fails to offer health insurance.
- Delay the excise tax on high-cost (aka “Cadillac”) health plans, and reduce the number of plans affected.
- Add several new tools to curb fraud, waste, and abuse in Medicare and Medicaid. ..
The Senate is considering this additional bill under a process known as “reconciliation,” which can’t be filibustered and therefore needs only 51 votes to pass, instead of 60. It’s a tricky procedure, which we won’t go into here, but you can read more about it at Roll Call, and you can read a summary of the reconciliation bill here.
—Kevin McCarthy, associate editor
Got questions about how the health reform bill will affect you? Ask them here.












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