US Senate Passes Health Care Reform Bill

The U.S. Senate's Christmas Eve vote on health care reform to expand insurance coverage to about 30 million Americans went as expected, passing by a 60-39 party-line split.

The health care bill is now subject to a negotiation session between the House and Senate to establish a final version. In the opening weeks of 2010 the negotiation will take place in a conference committee assigned to reconcile differences in the House and Senate versions of the bill, including how to handle payment for abortions and how the massive reforms should be paid for (BestWire, Dec. 23, 2009).

"This is a victory for the American people," said Senate Majority Leader Harry Reid, who put the final bill together. The bill, he said at a short press conference after the vote, "affirms the ability to lead a healthy life is a right, not a privilege for a select few."

The Patient Protection and Affordable Care Act requires all Americans to obtain health insurance but no longer includes a government-run insurer known as the "public option." That element is a central point in the House version, and the two versions also differ in the types of taxes and fees that would pay for the new laws. Instead of a public option, this bill establishes a federal exchange of nonprofit insurance plans run by private insurers. The bill also caps administrative costs for health insurers at 15% -- requiring the rest go toward medical costs. The Congressional Budget Office released a cost estimate for the final Senate bill, estimating its spending at $871 billion to expand insurance coverage to about 30 million more Americans in its first decade (BestWire, Dec. 21, 2009).

In a statement, Karen Ignagni, president and chief executive officer of America's Health Insurance Plans, expressed concern over some provisions in the bill, stating they will "increase, rather than decrease, heath care costs; reduce coverage options; and disrupt existing coverage for families, seniors and small businesses -- particularly between now and when the legislation is fully implemented in 2014."

Still, Ignagni said AHIP is supportive of "legislative changes that would provide guaranteed access to all Americans, with no preexisting condition limitations and no health status-based premiums."

A statement days before the vote from the National Association of Health Underwriters said it too believed many provisions would increase private health insurance costs. Janet Trautwein, the association's CEO, said the NAHU has "grave concerns" that the bill "will do much more to harm American health care consumers than help them as it is currently structured."

Sen. Chris Dodd, D-Conn., said, "I can't think of a better gift to give the American people than to lift the burden of fear off their shoulders." For senators, Dodd said, the vote could be the most important one cast in their tenure. At the press conference, Sen. Max Baucus, D-Mont., chairman of the Finance Committee, added he was "very happy to see people getting health care they could not get."

Senate Minority Leader Mitch McConnell, R-Ky., said the fight over health care reform "is long from over." McConnell went on to tell the chamber before the vote that he and fellow Republicans would fight to prevent the Senate bill from becoming law.

Reid said that for the first time in American history "a political party has chosen to stand on the sidelines rather than participate in great and greatly needed health care reform."

Sen. Chuck Schumer, D-N.Y., commended his party for passing a bill that he said cut costs and covers 31 million more people "without a single Republican vote" and that he did not believe Republicans would launch a great attack against the bill, saying that the party's "negativity has peaked." The senator went on to add that the legislation is "good for the American people and a true symbol of what we can do if we all pull together."

President Barack Obama said passage of bills in the House and Senate means government is "now finally poised to deliver on the promise of real, meaningful health insurance reform." He said the bills include "the toughest measures ever taken to hold the insurance industry accountable."

(By Chad Hemenway, associate editor, BestWeek: [email protected])