The House of Representatives passed the Patient Protection and Affordable Care Act (H.R. 3590) – the underlying Senate bill – by a vote of 219-210 and the Health Care and Education Reconciliation Act of 2010 (H.R. 4872) by a vote of 220-209 on March 21. H.R. 4872 includes the changes negotiated by the administration and House Democrats.
The Senate is tasks with passing H.R. 4872 under budget reconciliation rules this week. Senate Democrats assert they will finish the bill this Friday or Saturday in order to finalize the measure before the Easter recess. However, Senate Republicans plan to challenge the Senate Parliamentarian in hopes of derailing the measure, or at least sending an amended H.R. 4872 back to the House of Representatives.
The budget reconciliation process allows for 20 hours of floor debate and unlimited amendments, but requires only 51 votes for passage rather than the 60 traditionally needed to overcome a filibuster. Each provision of H.R. 4872 must satisfy specific budget reconciliation rules, specifically the Byrd rule, which requires that all provisions in a reconciliation bill deal with revenues or spending. While most experts predict that there will likely be at least one parliamentarian ruling in favor of Republicans, the overall bill is unlikely to be entirely derailed.
President Obama’s Tuesday morning signing ceremony of sweeping health care reform legislation marked the end of a year-long battle to reform the nation’s health care system. Although health care reform legislation was passed and signed into law this week, its subsequent implementation will span for more than ten years.
Click here to read NSBA’s report and stated opposition to the legislation’s passing.
Meanwhile, small-business owners, their employees and families should prepare for the bill’s implementation. While the most significant provisions of the bill are not implemented until 2013-2014 and beyond, the bill does implement several changes this year that could have a direct impact on small businesses.
In 90 days, the bill will enact a temporary reinsurance program that allows employers to provide coverage for employees over the age of 55 who are not eligible for Medicare. Concurrently, the bill enacts a temporary high-risk insurance pool for individuals with pre-existing conditions that have not had insurance for at least six months.
After six months, the bill implements several insurance market reforms, including barring rescissions and insurers from denying coverage to children with pre-existing conditions, as well as the elimination of lifetime caps on coverage. In addition, the bill would require insurers to accept dependents up to the age of 26.
For tax years 2010-2013, the bill provides businesses with 10 or fewer employees earning less than $25,000 a year on average a tax credit of 35 percent of health insurance costs. The tax credit phases out for businesses with 11-25 employees earning up to average wages of $50,000. The business must pay at least 50 percent of the total cost of premiums to qualify for the credit.
Additional changes will come in 2011 and beyond. Stay tuned to the NSBA Web site for additional details and resources to prepare for the bill’s implementation. Also, continue to watch NSBA’s Health Reform Today Web site for more information on health care reform.
