Resources on the House and Senate bills
Update: Week of November 30-December 4
Upon returning from the Thanksgiving recess, the Senate rolled up its sleeves and started getting right to work. The Senate has officially started floor debate on its legislation to overhaul the nation’s health care system, the Patient Protection and Affordable Care Act.
As this historic week began, we received encouraging news from the nonpartisan Congressional Budget Office (CBO). An analysis released by CBO indicated that millions of Americans would pay lower premiums under the Senate bill. Employees of large businesses could see up to a 3 percent reduction in health insurance premiums compared to what they would pay if Congress does not act. Americans who are employed by small businesses would pay as much as 11 percent less in premiums, thanks to tax credits offered to small businesses to help employers provide affordable coverage. The legislation would also provide tax credits to individuals who purchase coverage in the individual market. As a result, these Americans would see their premiums cut by up to 59 percent.
Process
This floor debate has started and has taken on a partisan tone. Democrats continue to highlight how this bill will help give millions of Americans access to quality, affordable health coverage, while Republicans attack this bill at every opportunity. In particular, seniors’ and women’s issues were at the forefront this week. We expect different themes to arise as the debate proceeds (public option, abortion, cost-containment, etc.). Many of the same attacks we heard during the August recess resurfaced. It is imperative to continue to reach out to your Senators through calls, e-mails, and letters to the editor. Families USA will continue to provide you with talking points to help equip you to push back against attacks on the bill as you reach out to your Senators. (Reminder, you can call your Senators by using our toll-free number at 1-800-828-0498.)
Timing
Majority Leader Reid continues give the Senate a Christmas deadline to finish debate and vote on a final bill on the floor. The Senate will reconvene at noon on Sunday, and we expect additional amendments to be offered and voted on.
Amendments
The Senate took its first vote on the floor on Thursday and agreed to an amendment that would allow women to receive preventive care and screenings without copayments. The amendment, introduced by Senator Barbara Mikulski (D-MD), was approved by 61-39, with Senator Olympia Snowe (R-ME) the sole Republican crossing the aisle to support it. The Senate unanimously approved an amendment introduced by Senator Michael Bennet (D-CO) that states that nothing in the Patient Protection and Affordability Act will result in a reduction of guaranteed Medicare benefits.
It is important to note that both sides will file numerous amendments, but only a handful of amendments will go to the floor and be voted on. The amendments that will go to a vote will likely be bigger picture, “message” amendments. Both sides have procedural “tricks” to slow down the debate or move it along. The Republicans, in particular, are using every procedural tactic possible to hold up debate in an effort to kill the bill.
The Senate still has a couple of major hurdles to overcome. Majority Leader Reid is working behind the scenes with Senators to come to a consensus on the public option and abortion provisions. Once they reach a compromise, Senator Reid will file cloture to end debate and move to a final vote. Meanwhile, Senator Ben Nelson has announced that he will be introducing an amendment to further restrict federal funding of abortion, and debate on this amendment could begin as soon as Saturday. Senator Tom Carper (D-DE) is working with his Democratic colleagues to forge a compromise on a public option.
Update: November 24, 2009
The Senate has voted (60-39) to bring its health reform bill to the floor for debate and amendments. And while a "vote to move the debate forward" may seem trivial, it was a huge step forward for proponents of health reform and an indication of what's to come.
Update: November 19, 2009
This week moved us another step closer to the finish line as Senate Majority Leader Harry Reid (D-NV) unveiled the Senate's health reform legislation, the Patient Protection and Affordable Care Act. We've all worked hard to get to this point, but the closer we get to making history, the more important it becomes to ramp up our energy and efforts.
The legislation would significantly improve health coverage for America's families. It would:
- Provide coverage to 31 million currently uninsured Americans,
- Make health care more affordable for families with incomes below 400 percent of the federal poverty level by providing tax credits to help them purchase health coverage in an Exchange, and
- Prohibit insurers from denying coverage based on pre-existing conditions and from charging higher premiums based on gender or health status.
The other piece of good news: According to the nonpartisan Congressional Budget Office, the bill is fully paid for, and it would reduce the nation's deficit by $130 billion over the first 10 years and by a whopping $650 billion over the following decade.
Next Steps
Motion to proceed: Now that Senator Reid has officially introduced a health reform bill, the Senate needs to take a formal vote on a motion to proceed. This simply means that 60 senators must agree that floor debate should begin on this bill. We will likely see this vote occur late Saturday or sometime on Sunday.
Amendments: The Senate will be on recess during the week of Thanksgiving, but as soon as Senators return, they will start to introduce amendments on the floor. Senator Reid has indicated that he wants to give the Senate ample time to discuss the bill and make changes to it. The debate in the Senate will therefore last much longer than it did in the House. Not only will the Senate spend more time discussing different aspects of the bill, the process will also be punctuated by procedural votes to move on from one amendment to another.
Senator Reid has set a goal for the Senate to vote on final passage of this health reform legislation by Christmas.
In the meantime, it is vital that you continue contacting your Senators to let them know how important it is that health reform becomes a reality this year. Call your Senators at 1-888-876-6242.
Update: October 2
Quick Overview
After eight days and hours upon hours of discussion that sometimes stretched into the morning, the Senate Finance Committee has finally finished its markup. This is the fifth and final Congressional Committee to complete a markup on a comprehensive bill to overhaul the health nation’s health care system.
Over the past week, the Committee considered 145 amendments (although not all amendments were voted on). Republican and Democratic amendments focused on issues spanning the spectrum – Medicare Advantage, drug price negotiation, the public option, immigration, abortion, affordability provisions and the excise tax on insurance companies – to name a few. Overall, while the Committee adopted a number of Democratic-sponsored amendments, it also accepted more than a handful of Republican-sponsored amendments. In addition, there were changes that Chairman Baucus accepted before the markup and included in the Manager’s amendment.
Recent Action
The Committee concluded its mark at 2:30 a.m. on October 2 and adopted more amendments aimed at ensuring that this bill makes health care more affordable for Americans. Senator Cantwell introduced an amendment to provide a federally funded, non-Medicaid, state plan that would be available to people with incomes between 133-200 percent of the federal poverty level. The amendment directs tax subsidies to the states and gives them the option of using their purchasing power to negotiate with private insurance carriers. While this program would be voluntary, the thought is that states would pay providers more than Medicaid – and that low-income people would have another option for health care coverage in addition to the health plans offered through the Exchange. The amendment passed 12-11. Senator Lincoln was the only Democrat to vote against it.
The Committee also adopted an amendment introduced by Senators Snowe and Schumer that would lower the income threshold for the affordability exemption. Under the original Baucus bill, an individual who cannot find a health plan that costs no more than 10 percent of his or her adjusted gross income could opt out of purchasing coverage. This amendment lowers the “hardship waiver” to eight percent of a person’s adjusted gross income. In addition, the amendment decreases and phases in the penalty for individuals who do not purchase coverage. The penalty phases in through 2017, when it would hit a ceiling of $750 for an individual or $1500 for a family. This amendment passed on a 22-1 vote. Under the original Finance Committee bill, the tax penalty could have gone as high as $3,800 for a family. Chairman Baucus dropped it down to $1,900 last week, but that was still too high for some senators.
What’s Ahead
CBO now needs to score this final amended bill. The Finance Committee will reconvene at 10:00 a.m. on Tuesday, October 6. Chairman Baucus said he will give senators some time to examine the bill but we expect to see a final vote by mid to late next week.
Democratic leaders in the Finance and HELP Committees will need to merge the parts of the two bills where the committees have overlapping jurisdiction. Senate Majority Leader Reid intends to bring the bill to the Senate floor during the week of Oct. 12. Floor debate could last a number of weeks.
Plans are less certain in the House, though the chamber is likely to wait to continue to wait for the Senate to act before it brings a bill to the floor.
House
Senate
Past Activity on the Hill
July 27- August 7
Significant progress has been made in the past two weeks leading up to the August recess. Four out of five Congressional committees with jurisdiction over health reform have passed bills out of their committees. But to be certain: August is the month during which the fate of comprehensive health insurance reform will be determined. Members of Congress need to hear from Americans that health reform cannot wait. Whether it's attending town halls, writing letters to the editor or attending visits with Members, this will be a critical month to showcase what's really in the health reform bills and to distinguish the myths from the facts. Health insurance reform will bring Americans stable, affordable, quality health care and coverage no matter how their life circumstances might change.
The Energy and Commerce Committee worked through the night up until the final hours before the House adjourned on July 31 to pass an amended bill through the Committee. After taking a few days off from the mark-up, Chairman Henry Waxman (D-CA) secured a deal with the House Blue Dogs who had expressed concerns about the cost of the bill. The concerns were addressed in the form of one amendment which helped paved the path for the bill's passage out of Committee. The final vote was 31-28. The Committee has prepared a district-level analysis of the impact of the legislation. For more information, go to http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1717&catid=156&Itemid=55
It is vital that all Members hear from their constituents – whether it is thanking them for supporting the bill or thanking them for their hard work and encouraging them to vote yes when the final bill reaches the House floor. When the House reconvenes after Labor Day, Members will need to blend the three versions of the bill as passed in the Education and Labor, Ways and Means and Energy and Commerce Committees. We expect to see a final version of the bill voted on the House floor by mid- to late September.
In the Senate, Chairman Baucus continued to lead bipartisan conversations with a group of Senators dubbed “The Coalition of the Willing” in an effort to come to a final agreement on a bill that can garner bipartisan support. President Obama held a meeting with the group on Thursday to discuss insurance affordability, and he urged the senators to continue to work hard to find a consensus. The senators will have telephone meetings during August while they are home on recess. Senator Baucus has set a tentative deadline of September 15 to complete the bipartisan negotiations.
[Return to top]
