On Thursday, December 24, 2009, in another key step toward the enactment of comprehensive health reform, the U.S. Senate passed its bill, the Patient Protection and Affordable Care Act (H.R. 3590), on a party-line vote, with all 60 Democrats voting for the bill and 39 Republicans voting against it.
The Senate health reform bill has much in common with the House version that passed in November. For example, both would expand coverage to millions of uninsured Americans, through subsidies to purchase insurance and expansions of eligibility for Medicaid. Both bills would require individuals to purchase health insurance; those who do not will be subject to a tax. The bills also implement several insurance market reforms that will be particularly beneficial to people with chronic health conditions. For more information on the content of the two health reform bills, click here.
However, there are also several key differences in the House and Senate legislation, which will need to be reconciled in a conference committee in January 2010. The House bill includes a version of the controversial "public option" government-run health insurance plan, while the Senate bill does not. Further, the bills differ substantially in how they are financed.
There are also some differences between the two bills on issues of particular importance to the bleeding disorders community. For example, in the Senate bill, lifetime caps are eliminated six months after enactment for new plans, but existing, grandfathered plans can continue to have lifetime caps indefinitely. In the House bill, lifetime caps are eliminated in all plans immediately. Annual limits are eliminated in 2014 for new plans in the Senate bill; in the House bill, annual caps are prohibited in 2013 for new plans and 2018 for existing plans.
As health reform moves into a conference between the House and the Senate, NHF will continue to actively advocate for the best possible outcomes to benefit our community. More information about the status of NHF's priority issues in each bill will be available in the January 2010 eNotes.
One final bill will be voted on by each chamber and then sent to President Obama for his signature or veto. It is anticipated that the legislation will be completed around the time of the president's State of the Union Address at the end of January or early February 2010.
For more information on the policy and politics of health reform, please visit NHF's healthcare reform page.