Passed the Senate on March 25, 2010 (56-43) with amendment
House agreed to Senate amendment on March 25, 2010 (220–207)
Signed into law by President Barack Obama on March 30, 2010
House votes by congressional district.
Democratic yea on both votes
Democratic nay on both votes
Democratic nay on first vote, not voting on second
Republican nay on both votes
Republican nay on first vote, not voting on second
Republican nay on first vote, no representative seated on second
No representative seated
Senate vote by state.
Democratic yea
Democratic nay
Independent yea
Republican nay
Republican not voting
It was passed by the U.S. House of Representatives on March 21, 2010, by a vote of 220–211, and passed the Senate by a vote of 56–43 on March 25, after having two minor provisions relating to Pell Grants stricken under the Byrd Rule. A few hours later, the amended bill was passed by the House with the vote of 220–207. The Act was signed into law by President Barack Obama on March 30, 2010, at Northern Virginia Community College.
At the end of 2009, each house of Congress passed its own health care reform bill, but neither house passed the other bill. The Senate bill, the Patient Protection and Affordable Care Act, became the most viable avenue to reform following the death of Democratic Senator Ted Kennedy and his replacement by Republican Scott Brown. Lacking a filibuster-proof super-majority in the Senate, the Obama administration and House Speaker Nancy Pelosi encouraged the House to pass the Senate bill and then pass a new bill to amend it using the reconciliation process.[1]
Under the Fiscal Year 2010 budget resolution,[2] the text of the reconciliation bill submitted to the Budget Committee had to have been reported by the relevant Committees by October 15, 2009.[3] Therefore, the Democrats combined the text of America's Affordable Health Choices Act of 2009 as reported out of the Ways and Means Committee, and as it was reported out of the Education and Labor Committee, and the text of the Student Aid and Fiscal Responsibility Act as reported out of the Education and Labor Committee.[4][5] This version was never meant to be passed; it was only created so that the reconciliation bill would comply with the Budget resolution.[3] The bill was automatically amended to the version that was meant to be passed per the special rule that was reported out of the Rules Committee.[6] The Student Aid and Fiscal Responsibility Act was added to the Reconciliation Act as only one reconciliation bill can be passed each budget year, and it also faced a tough road through the Senate due to Republican filibuster and opposition from several centrist Democratic Senators.[7] The move was also thought to give President Obama two key victories in overhauling the health care and student loan system. It also eventually became clear that the budget savings caused by the student loan bill would become essential to the overall reconciliation bill by reducing the deficit enough for the overall bill to qualify for the reconciliation process.[7]
Passage of the legislation in the United States House of Representatives using the self-executing rule method was considered, but rejected by House Democrats. Instead, on March 21, 2010, the House held a series of votes: the first vote on ordering the previous question on the special rule resolution that set the terms of debate, the second on the rule itself, the third on the Senate bill, the fourth on a minority attempt to amend the reconciliation bill itself, and finally a vote on the reconciliation bill itself.[8] The reconciliation bill passed on a vote of 220–211, with all 178 Republicans and 33 Democrats voting against it.[9]
In the Senate, the bill faced numerous amendments made by the Republicans, which failed. Republicans struck two provisions dealing with Pell Grants from the bill due to violations of budget reconciliation rules, forcing the bill to return to the House.[10] The two provisions were the fourth paragraph of Sec. 2101(a)(2)(C) and Sec. 2101(a)(2)(D).[11][12] On March 25, the bill passed the Senate by a 56–43 vote, with all Republicans and three Democrats (Blanche Lincoln (D-AR), Ben Nelson (D-NE) and Mark Pryor (D-AR)) voting against it.[13] Later that same day, the House passed the amended bill by a 220–207 vote, sending it to President Obama for a signature.[14] On March 30, 2010 Obama signed the Health Care and Education Reconciliation Act of 2010,[15] 7 days after he had signed the Patient Protection and Affordable Care Act into law.[16][17]
The Health Care and Education Reconciliation Act is divided into two titles, one addressing health care reform and the other addressing student loan reform.
Amending the Senate's Healthcare Bill
Speaker of the House Nancy Pelosi signing the bill after it passed in the House of Representatives on March 26, 2010
The Reconciliation bill made several changes to the Patient Protection and Affordable Care Act that was signed into law seven days earlier on March 23, 2010. These changes include the following:[18]
Delaying the implementation on taxing "Cadillac health-care plans" until 2018
Requiring doctors treating Medicare patients to be reimbursed at the full rate
Setting up a Medicare tax on the unearned incomes of families that earn more than $250,000 annually.
Offering more generous subsidies to lower income groups. Households below 150% of the federal poverty level would pay 2-4% of their income on premiums. Health plans would cover 94% of the cost of benefits.[19] Households with incomes from 150-400% of the federal poverty level ($88,200 for a family of four) would pay on a sliding scale from 4-9.8% of their income on premiums, rest will be covered by government advanceable, refundable tax credit. Health plans would cover 70% of the cost of the benefits.[19][20]
Setting a penalty for a company with more than 50 workers not offering health care coverage after 2014, of $2,000 for each full-time worker above 30 employees. For example, an employer with 53 workers will pay the penalty for 23 workers, or $46,000.[19]
Increasing Medicaid payment rates to primary care doctors to match Medicare payment rates, which are higher, in 2013 and 2014.[19]
Having the federal government pay all costs of expanding Medicaid under the reform until 2016, 95% in 2017, 94% in 2018, 93% in 2019, and 90% thereafter. Some states that already insure childless adults under Medicaid would receive more federal money for covering that group through 2018.
Providing a 50% discount on brand-name drugs for Medicare patients starting in 2011. By 2020, the government would pay to provide up to 75% discount on brand-name and generic drugs, eventually closing the coverage gap.[19]
Extending the ban on lifetime limits and rescission of coverage to all existing health plans within six months after signing into Law.[19]
Student loan reform
Title II of the reconciliation bill deals with student loan reform. The language is very similar to the Student Aid and Fiscal Responsibility Act that passed the House in 2009; but with some slight variation.[21] The reform package included,[22]
Ending the process of the federal government giving subsidies to private banks to give out federally insured loans. Instead loans will be administered directly by the Department of Education.[23]
For new borrowers of loans starting in 2014, those who qualify would be able to cap the amount they must spend on loan repayment each month to 10% of their discretionary income, down from 15%.[22]
For new borrowers after 2014, loans would be eligible to be forgiven to those who make timely payments after 20 years, down from 25 years previously.[22]
making it easier for parents to take out federal loans for students.[24]
using several billion dollars to fund schools that predominantly serve poor and minority students, as well as increasing community college funding.[23]
Tax avoidance
The law codified the "economic substance" rule of Gregory v. Helvering from 1935, which allows the IRS to invalidate tax avoidance transactions in certain situations.[25]
Deficit effect
The Congressional Budget Office's last estimate predicted that if both bills were passed into law in 2010, the net reduction in federal deficits would be $143 billion over the 2010–2019 period as a result of the proposed changes in direct spending and revenues. That figure comprises $124 billion in net reductions deriving from the health care and revenue provisions and $19 billion in net reductions deriving from the education provisions.[26] The health care and revenue provisions consist in part of several new taxes, fees on health-related industries, and cuts in government spending on healthcare programs like Medicare Advantage.[27]
^(PDF). Archived from the original (PDF) on April 7, 2010. Retrieved April 7, 2010.{{cite web}}: CS1 maint: archived copy as title (link)
^ abBrown, Carrie Budoff. "Loan bill could give Obama twin win". Fredericksburg.com. Archived from the original on January 23, 2013. Retrieved January 21, 2011.
^. Rules.house.gov. Archived from the original on March 24, 2010. Retrieved March 21, 2010.
^Pub. L. 111–152 (text) (PDF), 124 Stat. 1029, codified as amended at scattered sections of the Internal Revenue Code and in 42 U.S.C., 19 U.S.C., and 20 U.S.C.
^Obama signs higher-education measure into law William Branigin The Washington Post March 30, 2010.
^. tpmlivewire.talkingpointsmemo.com. March 2010. Archived from the original on March 29, 2010.
^"BREAKING -- Reconciliation bill posted - Live Pulse - POLITICO.com". www.politico.com.
^ abcdefHossain, Farhana (March 19, 2010). "Proposed Changes in the Final Health Care Bill". The New York Times.
^"Policies to Improve Affordability and Accountability". whitehouse.gov. February 22, 2010. from the original on February 8, 2017 – via National Archives.
^"Registrant WHOIS contact information verification | Namecheap.com". www.opencongress.org.
^ abc. Archived from the original on December 5, 2010. Retrieved March 26, 2010.
^ ab"What would change if student lending legislation passes". The Washington Post. March 26, 2010.
^ Clark, Kim. (24 March 2010). Big Changes Coming to Student Loans Washington DC U.S. News & World Report Internet archive Retrieved 25 December 2011. ISSN 0041-5537 eISSN 2169-9283
^Rose CA. Tax Lawyer’s Dilemma: Recent Developments Heighten Tax Lawyer Responsibilities and Liabilities December 20, 2012, at the Wayback Machine. Columbia Business Law Review. Volume 2011, Issue 1.
^. CBO Director's Blog. n.d. Archived from the original on March 25, 2010. Retrieved March 21, 2010.
^Grier, Peter (March 22, 2010). . Christian Science Monitor. Boston. ISSN 0882-7729. Archived from the original on April 10, 2010. Retrieved March 22, 2010.
External links
Health Care and Education Reconciliation Act of 2010 (PDF/details) as amended in the GPO Statute Compilations collection
Text of law, (available in plain text and PDF formats).
HCERA at Congress.gov
Section-by-section analysis of the bill
March 10, 2023
health, care, education, reconciliation, 2010, text, stat, 1029, that, enacted, 111th, united, states, congress, means, reconciliation, process, order, amend, affordable, care, text, includes, student, fiscal, responsibility, which, attached, rider, long, titl. The Health Care and Education Reconciliation Act of 2010 Pub L 111 152 text PDF 124 Stat 1029 is a law that was enacted by the 111th United States Congress by means of the reconciliation process in order to amend the Affordable Care Act ACA Pub L 111 148 text PDF The law includes the Student Aid and Fiscal Responsibility Act which was attached as a rider Health Care and Education Reconciliation Act of 2010Long titleAn Act to provide for reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010 S Con Res 13 Enacted bythe 111th United States CongressCitationsPublic law111 152Statutes at Large124 Stat 1029 thru 124 Stat 1084 55 pages CodificationActs amendedAffordable Care ActLegislative historyIntroduced in the House as H R 4872 by John Spratt D SC on March 17 2010Committee consideration by BudgetPassed the House on March 21 2010 220 211 Passed the Senate on March 25 2010 56 43 with amendmentHouse agreed to Senate amendment on March 25 2010 220 207 Signed into law by President Barack Obama on March 30 2010House votes by congressional district Democratic yea on both votes Democratic nay on both votes Democratic nay on first vote not voting on second Republican nay on both votes Republican nay on first vote not voting on second Republican nay on first vote no representative seated on second No representative seated Senate vote by state Democratic yea Democratic nay Independent yea Republican nay Republican not voting It was passed by the U S House of Representatives on March 21 2010 by a vote of 220 211 and passed the Senate by a vote of 56 43 on March 25 after having two minor provisions relating to Pell Grants stricken under the Byrd Rule A few hours later the amended bill was passed by the House with the vote of 220 207 The Act was signed into law by President Barack Obama on March 30 2010 at Northern Virginia Community College Contents 1 Legislative history 2 Provisions 2 1 Amending the Senate s Healthcare Bill 2 2 Student loan reform 2 3 Tax avoidance 3 Deficit effect 4 See also 5 References 6 External linksLegislative history EditAt the end of 2009 each house of Congress passed its own health care reform bill but neither house passed the other bill The Senate bill the Patient Protection and Affordable Care Act became the most viable avenue to reform following the death of Democratic Senator Ted Kennedy and his replacement by Republican Scott Brown Lacking a filibuster proof super majority in the Senate the Obama administration and House Speaker Nancy Pelosi encouraged the House to pass the Senate bill and then pass a new bill to amend it using the reconciliation process 1 Under the Fiscal Year 2010 budget resolution 2 the text of the reconciliation bill submitted to the Budget Committee had to have been reported by the relevant Committees by October 15 2009 3 Therefore the Democrats combined the text of America s Affordable Health Choices Act of 2009 as reported out of the Ways and Means Committee and as it was reported out of the Education and Labor Committee and the text of the Student Aid and Fiscal Responsibility Act as reported out of the Education and Labor Committee 4 5 This version was never meant to be passed it was only created so that the reconciliation bill would comply with the Budget resolution 3 The bill was automatically amended to the version that was meant to be passed per the special rule that was reported out of the Rules Committee 6 The Student Aid and Fiscal Responsibility Act was added to the Reconciliation Act as only one reconciliation bill can be passed each budget year and it also faced a tough road through the Senate due to Republican filibuster and opposition from several centrist Democratic Senators 7 The move was also thought to give President Obama two key victories in overhauling the health care and student loan system It also eventually became clear that the budget savings caused by the student loan bill would become essential to the overall reconciliation bill by reducing the deficit enough for the overall bill to qualify for the reconciliation process 7 Passage of the legislation in the United States House of Representatives using the self executing rule method was considered but rejected by House Democrats Instead on March 21 2010 the House held a series of votes the first vote on ordering the previous question on the special rule resolution that set the terms of debate the second on the rule itself the third on the Senate bill the fourth on a minority attempt to amend the reconciliation bill itself and finally a vote on the reconciliation bill itself 8 The reconciliation bill passed on a vote of 220 211 with all 178 Republicans and 33 Democrats voting against it 9 In the Senate the bill faced numerous amendments made by the Republicans which failed Republicans struck two provisions dealing with Pell Grants from the bill due to violations of budget reconciliation rules forcing the bill to return to the House 10 The two provisions were the fourth paragraph of Sec 2101 a 2 C and Sec 2101 a 2 D 11 12 On March 25 the bill passed the Senate by a 56 43 vote with all Republicans and three Democrats Blanche Lincoln D AR Ben Nelson D NE and Mark Pryor D AR voting against it 13 Later that same day the House passed the amended bill by a 220 207 vote sending it to President Obama for a signature 14 On March 30 2010 Obama signed the Health Care and Education Reconciliation Act of 2010 15 7 days after he had signed the Patient Protection and Affordable Care Act into law 16 17 Provisions EditSee also Provisions of the Patient Protection and Affordable Care Act The Health Care and Education Reconciliation Act is divided into two titles one addressing health care reform and the other addressing student loan reform Amending the Senate s Healthcare Bill Edit Speaker of the House Nancy Pelosi signing the bill after it passed in the House of Representatives on March 26 2010 The Reconciliation bill made several changes to the Patient Protection and Affordable Care Act that was signed into law seven days earlier on March 23 2010 These changes include the following 18 Increasing tax credits to buy insurance Eliminating several of the special deals given to senators such as Ben Nelson s Cornhusker Kickback Lowering the penalty for not buying insurance from 750 to 695 Closing the Medicare Part D donut hole by 2020 giving seniors a rebate of 250 Delaying the implementation on taxing Cadillac health care plans until 2018 Requiring doctors treating Medicare patients to be reimbursed at the full rate Setting up a Medicare tax on the unearned incomes of families that earn more than 250 000 annually Offering more generous subsidies to lower income groups Households below 150 of the federal poverty level would pay 2 4 of their income on premiums Health plans would cover 94 of the cost of benefits 19 Households with incomes from 150 400 of the federal poverty level 88 200 for a family of four would pay on a sliding scale from 4 9 8 of their income on premiums rest will be covered by government advanceable refundable tax credit Health plans would cover 70 of the cost of the benefits 19 20 Setting a penalty for a company with more than 50 workers not offering health care coverage after 2014 of 2 000 for each full time worker above 30 employees For example an employer with 53 workers will pay the penalty for 23 workers or 46 000 19 Increasing Medicaid payment rates to primary care doctors to match Medicare payment rates which are higher in 2013 and 2014 19 Having the federal government pay all costs of expanding Medicaid under the reform until 2016 95 in 2017 94 in 2018 93 in 2019 and 90 thereafter Some states that already insure childless adults under Medicaid would receive more federal money for covering that group through 2018 Providing a 50 discount on brand name drugs for Medicare patients starting in 2011 By 2020 the government would pay to provide up to 75 discount on brand name and generic drugs eventually closing the coverage gap 19 Extending the ban on lifetime limits and rescission of coverage to all existing health plans within six months after signing into Law 19 Student loan reform Edit Title II of the reconciliation bill deals with student loan reform The language is very similar to the Student Aid and Fiscal Responsibility Act that passed the House in 2009 but with some slight variation 21 The reform package included 22 Ending the process of the federal government giving subsidies to private banks to give out federally insured loans Instead loans will be administered directly by the Department of Education 23 Increasing the Pell Grant scholarship award For new borrowers of loans starting in 2014 those who qualify would be able to cap the amount they must spend on loan repayment each month to 10 of their discretionary income down from 15 22 For new borrowers after 2014 loans would be eligible to be forgiven to those who make timely payments after 20 years down from 25 years previously 22 making it easier for parents to take out federal loans for students 24 using several billion dollars to fund schools that predominantly serve poor and minority students as well as increasing community college funding 23 Tax avoidance Edit The law codified the economic substance rule of Gregory v Helvering from 1935 which allows the IRS to invalidate tax avoidance transactions in certain situations 25 Deficit effect EditThe Congressional Budget Office s last estimate predicted that if both bills were passed into law in 2010 the net reduction in federal deficits would be 143 billion over the 2010 2019 period as a result of the proposed changes in direct spending and revenues That figure comprises 124 billion in net reductions deriving from the health care and revenue provisions and 19 billion in net reductions deriving from the education provisions 26 The health care and revenue provisions consist in part of several new taxes fees on health related industries and cuts in government spending on healthcare programs like Medicare Advantage 27 See also Edit111th United States Congress Patient Protection and Affordable Care Act Health care reform in the United States Health care reform debate in the United StatesReferences Edit Gay Sheryl March 17 2010 Health Vote Caps a Journey Back From the Brink The New York Times Retrieved March 21 2010 Congress gov Library of Congress www congress gov a b Klein Philip March 15 2010 The Health Care Shell Game Begins The American Spectator Archived from the original on March 22 2010 Retrieved April 7 2010 HR443P1 PS HR443P2 PS Archived copy PDF Archived from the original PDF on April 7 2010 Retrieved April 7 2010 a href Template Cite web html title Template Cite web cite web a CS1 maint archived copy as title link a b Brown Carrie Budoff Loan bill could give Obama twin win Fredericksburg com Archived from the original on January 23 2013 Retrieved January 21 2011 COMMITTEE ON RULES Senate Amendments to H R 3590 Patient Protection and Affordable Care Act H R 4872 Reconciliation Act of 2010 Rules house gov Archived from the original on March 24 2010 Retrieved March 21 2010 Roll call vote 167 via Clerk House gov Health Care Fix It Bill Headed for Revote 25 March 2010 Amendment to H R 4872 entitled An Act to provide for reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010 PDF Archived from the original PDF on November 3 2010 Retrieved April 6 2010 An act to provide for reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010 PDF Archived from the original PDF on November 3 2010 Retrieved April 6 2010 Roll call vote 105 via Senate gov Roll call vote 194 via Clerk House gov Pub L 111 152 text PDF 124 Stat 1029 codified as amended at scattered sections of the Internal Revenue Code and in 42 U S C 19 U S C and 20 U S C Obama signs higher education measure into law William Branigin The Washington Post March 30 2010 Obama To Sign Health Care Reconciliation Bill tpmlivewire talkingpointsmemo com March 2010 Archived from the original on March 29 2010 BREAKING Reconciliation bill posted Live Pulse POLITICO com www politico com a b c d e f Hossain Farhana March 19 2010 Proposed Changes in the Final Health Care Bill The New York Times Policies to Improve Affordability and Accountability whitehouse gov February 22 2010 Archived from the original on February 8 2017 via National Archives Registrant WHOIS contact information verification Namecheap com www opencongress org a b c Student Loan Reform What s in It for You EdLabor Journal Committee on Education and Labor Archived from the original on December 5 2010 Retrieved March 26 2010 a b What would change if student lending legislation passes The Washington Post March 26 2010 Clark Kim 24 March 2010 Big Changes Coming to Student Loans Washington DC U S News amp World Report Internet archive Retrieved 25 December 2011 ISSN 0041 5537 eISSN 2169 9283 Rose CA Tax Lawyer s Dilemma Recent Developments Heighten Tax Lawyer Responsibilities and Liabilities Archived December 20 2012 at the Wayback Machine Columbia Business Law Review Volume 2011 Issue 1 Cost Estimate for Pending Health Care Legislation CBO Director s Blog n d Archived from the original on March 25 2010 Retrieved March 21 2010 Grier Peter March 22 2010 Health care reform bill 101 Who will pay for reform Christian Science Monitor Boston ISSN 0882 7729 Archived from the original on April 10 2010 Retrieved March 22 2010 External links EditHealth Care and Education Reconciliation Act of 2010 PDF details as amended in the GPO Statute Compilations collection Text of law available in plain text and PDF formats HCERA at Congress gov Section by section analysis of the bill Retrieved from https en wikipedia org w index php title Health Care and Education Reconciliation Act of 2010 amp oldid 1116063550, wikipedia, wiki, book, books, library,
