Pink Fire Pointer March 2010

Healthcare Reform Update - 31March2010

American Benefits Council Pressures Congress to Repeal Part of Health Reform Law
  • The American Benefits Council, which represents 300 companies, is asking Congress and Obama to consider repealing a provision of the healthcare reform law.
  • The provision under scrutiny reduces the tax deductions for companies that provide prescription drug coverage for their retired employees.
    • Since 2006, companies have received a 28-percent federal subsidy (up to $1,330 per retiree) on a tax-free basis to help pay for prescription drug coverage for retirees.
    • Until now, companies could deduct the subsidy from their taxes, essentially receiving a second benefit from the money. (If a company pays $100 in coverage, they would receive a $28 subsidy, yet still deduct $100 in expenses from income for tax purposes.)
    • Now, companies will no longer be able to deduct the coverage amount, but it remains tax-free.
  • This provision doesn’t go into effect until 2013, but companies are bracing for the change now.
    • AT&T announced last week that it was taking a $1 billion charge because of the provision;
    • Deere & Company announced a $150 million charge.
    • Boeing expects a $150 million charge.
  • Many companies say they are taking these charges before the current quarter ends to comply with accounting rules. However, some critics believe the companies’ quick response to the provision is aimed at pressing the administration to repeal it.Find all the info that you need about " good research essay topics orderessay " at
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Healthcare Reform Update - 30March2010

President Obama Signs Reconciliation Bill Into Law
  • At 11:30 this morning, President Obama signed into law the Healthcare and Education Reconciliation Act of 2010.
  • The Reconciliation Act will merge with the legislation Obama signed last week to create one final law.
  • The Reconciliation Act changes many of the finer details of the existing health reform law.
  • For example, it increases the penalties for employers and individuals who do not purchase insurance, as well as increases the federal subsidies provided to help people comply.
  • The law also includes a large provision aimed at overhauling the student loan system, through which private lenders will be cut out from originating federal student loans. This provision is estimated to save the federal government as much as $7 billion per year.

Healthcare Reform Update - 26March2010

Congress approves reconciliation healthcare bill
  • The House approved it late Thursday 220-207 ending a historic week for healthcare reform.
  • The bill now goes to President Obama for his signature. He is expected to sign it into law early next week.
  • Obama welcomed debate from Republicans who vowed to campaign for repeal in the fall election season.

Healthcare Reform Update - 25March2010

Reconciliation bill returns to House
  • Working until 3 a.m. this morning to review the Reconciliation Bill and a stack of GOP amendments, the Senate parliamentarian found two minor provisions that violate Congress’ budget rules.
  • This sends the Reconciliation bill back to the House for another vote.
  • The problematic provisions deal with protecting students from future cuts in their grants if Congress does not provide enough money for them. They violate budget rules because they do not produce savings.
  • The development came as the Senate completed nine hours of uninterrupted voting on 29 GOP amendments to the legislation. Majority Democrats defeated every amendment.
  • The Republican amendments were meant to force Democrats to cast difficult political votes before November's congressional elections.
  • Democrats also deflected GOP amendments:
    • Rolling back the health law's Medicare cuts;
    • Killing extra Medicaid funds for Tennessee and other state-specific spending;
    • Barring tax increases for families earning under $250,000; and
    • Requiring the president and other administration officials to purchase health care from exchanges the statute creates.

Healthcare Reform Update - 23March2010

Obama Signs Healthcare Reform Bill into Law; Senate Begins Consideration of Reconciliation Bill
  • At 11:15 a.m. today, President Obama signed into law H.R. 3950, the approved by the Senate on Dec. 24, 2009 and by the House on Sunday evening. healthcare reform bill
  • The Senate will convene today at 2:15 p.m. to begin consideration of the reconciliation bill, H.R. 4872.
  • Obama will now take his health reform campaign to the road to inform Americans of how the legislation will benefit them. He plans to travel around the country in the coming weeks, starting Thursday in Iowa.

Healthcare Reform Update #2 - 22March2010

Legal and Constitutional Challenges Loom on Healthcare Bill
  • Republican attorneys general in at least 12 states announced today that lawsuits will be filed to stop the federal government from overstepping its constitutional powers.
  • States also oppose the expansion of Medicaid that they say infringes on their ability to provide other services.
  • Attorneys general in Alabama, Florida, Michigan, Nebraska, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington plan to band together in a collective lawsuit.
  • Virginia Attorney General Kenneth Cuccinelli also announced plans to file a lawsuit in federal court.
  • At least 36 state legislatures are weighing legislation to limit, alter or oppose the federal healthcare reform, and 27 of those are considering amending their state constitutions by ballot.
Obama Will Sign Senate Bill Tuesday
  • It was announced late today that President Obama will sign into law the Senate legislation on Tuesday.
  • Shortly after the event, the Senate will begin considering the reconciliation bill, which it hopes to approve before Congress’ spring break beginning March 26.
The personal impact of the healthcare bill

Healthcare Reform Update - 22March2010

Sunday, March 21 – House Approves Senate and Reconciliation Bills
  • The House of Representatives met from 1 p.m. through midnight to consider final health reform legislation.
  • In an effort to secure last-minute votes in favor, President Obama announced he would issue an executive order after passage attesting that the bill is consistent with long-standing restrictions on the use of federal funds for abortions.
  • After hours of debate and procedural votes, the House took two main votes on the health legislation:
    1. The House voted on the bill passed by the Senate on Dec. 24, 2009. Members approved this legislation 219 to 212. The bill will now go to Obama to be signed into law.
    2. The House voted on the passage of the reconciliation bill that applies ‘fixes’ to the Senate bill. This legislation passed 220 to 211 and now goes to the Senate for consideration this week.

Next Steps:
  • Obama is expected to sign the Senate bill into law no later than Tuesday. According to constitutional law, he must sign it before the Senate can take up the reconciliation bill.
    • The Senate bill will remain law regardless of what happens to the reconciliation bill.
  • The reconciliation bill will be considered in the Senate beginning on or after the day that Obama signs the Senate bill into law.
  • Although Senate leaders have promised not to change the legislation, there are a number of anticipated holdups in the Senate that could drag out the process:
    • All provisions must have a direct budgetary impact or can be removed by any Senator.
    • The 20-hour limit on debate doesn’t apply to amendments and Republicans have promised a blizzard of them to slow down the process.
    • The legislation may be subject to committee markups. This would require individual committees to amend and approve the package before a vote in the full Senate could occur.
    • If the Senate modifies the bill, it will have to go back to the House for another vote.

The following provisions have an impact on Benefitfocus and/or our clients and go into effect within the first year after enactment of the Senate bill:
  • Creates a temporary reinsurance pool for eligible individuals to provide access to coverage that does not impose any coverage exclusions for pre-existing health conditions. (This provision ends when the Exchanges are operational.)
  • Initiates the first phase of the small business tax credit for qualified small employers for contributions to purchase health insurance for employees. The credit is up to 35 percent of the employer’s contribution to their employees’ health coverage. There is also up to a 25 percent credit for small nonprofit organizations.
  • Bars health insurance companies from imposing pre-existing condition exclusions on children’s coverage.
  • Prohibits insurance companies from rescinding existing health insurance policies except in cases of fraud. (Effective for plan years beginning on or after six months following enactment.)
  • Prohibits lifetime limits on benefits in all group health plans and in the individual market and restricts the use of annual limits. (Effective for plan years beginning on or after six months following enactment.)
  • All group health plans and plans in the individual market must provide first-dollar coverage for preventive services. (Effective for plan years beginning on or after the date that is six months after enactment.)
  • Extends dependent coverage until the child turns 26 years of age. (Effective for plan years beginning on or after six months following enactment.)
  • Creates a new temporary reinsurance program to help companies that provide early retiree health benefits for those ages 55-64 offset the expensive cost of that coverage.
  • Requires that any group health plan or plan in the individual market implement an effective appeals process for coverage determinations and claims. (Effective for plan years beginning six months after enactment.)
  • Requires the Secretary of Health and Human Services to award grants to states to establish health insurance consumer assistance or ombudsman programs to receive and respond to inquiries and complaints concerning health insurance coverage.
  • Requires the Secretary of HHS to establish an Internet Web site through which residents of any State may identify affordable health insurance coverage options in that state. The Web site will also include information for small businesses about available coverage options, reinsurance for early retirees, small business tax credits and other information of interest to small businesses. So-called “mini-med” or limited-benefit plans will be precluded from listing their policies on this Web site.
  • Requires enhanced screening procedures for healthcare providers to eliminate fraud and waste in the healthcare system.
  • Requires that non-profit BCBS organizations have a medical loss ratio of 85 percent or higher in order to take advantage of special tax benefits, including the deduction for 25 percent of claims and expenses and the 100 percent deduction for unearned premium reserves.

Healthcare Reform Update #2 - 21March2010

History was made tonight as the U.S. House voted to pass the bill that the Senate passed on December 24, 2009. The vote was 219-212.

Immediately following this vote the president will address the nation from the East Room of The White House, where he is expected to sign the bill on the spot.

Next steps include:
  • The House will now move on to consideration of the reconciliation bill.
  • The first vote will be on whether or not to recommit (amend) the reconciliation bill. It is expected to fail.
  • If the motion to recommit fails, the second vote will be on passage of the reconciliation bill.
  • Assuming the reconciliation bill is approved, it will be sent to the Senate for consideration beginning Monday, March 22.

Healthcare Reform Update – 21March2010

Agreement with anti-abortion lawmakers appears to give Democrats the votes needed to pass the Senate bill

  • Rep. Stupak (D-Mich), who led a group of anti-abortion lawmakers in opposing the bill, announced his deal with the White House for his group to vote for healthcare reform.

  • The agreement Stupak made with the President was announced at a press conference, during which Stupak stated that the agreement “protects the sanctity of life and insures that no public funding for abortion will appear in the healthcare reform legislation.”

  • The President will sign into a law an executive order after the Senate bill passes to reinforce that there will be no public funding for elective abortions. The anti-abortion lawmakers were satisfied with additional components of this agreement that include a pregnancy assistance fund for indigent mothers.

As of this writing, all news reports continue to indicate that voting on the Senate bill will begin around 8 p.m. tonight with a possibility that it will not be finalized until after midnight.

Healthcare Reform Update #2 - 20March2010

Breaking News - Pelosi believes she has enough votes to pass the bill in Sunday's vote
The number of Democrats who will vote yes for the bill continues to grow.
  • As of this writing, Reps. Baron Hill of Indiana, John Boccieri of Ohio, Scott Murphy of New York and Allen Boyd and Suzanne Kosmas of Florida became the latest Democrats to say they would vote "yes" after voting against an earlier version that passed last year. 
  • Many fence-sitting Democrats have reported intense pressure both in favor of and against the bill.
  • This afternoon, the President took his campaign tour for the bill to the Capitol, urging lawmakers to approve the bill for the good of the millions of Americans who lack health insurance.
Today Democrats dropped plans for an indirect vote that would have relied on a legislative maneuver to give their OK to the Senate's version of health care legislation.

Pelosi is so certain she has the votes she needs that today the following activity for Sunday's session was announced:
  • First, a vote on bringing the reconciliation bill to the floor and setting terms of debate on the bills;
  • Second, a vote on the reconciliation bill itself;
  • Third, a vote on the Senate version of the legislation.
  • This three step process was set in place to make it clear that the House intends for the Senate bill to be fixed rather than become law as is.
  • Before reconciliation of the House and Senate bills can occur, however, the President must receive and approve the Senate bill.

Heathcare Reform Update - 20March2010

Here are the next steps for Healthcare Reform:
Sunday afternoon (this weekend)
  • It is anticipated that the House will vote on the Senate bill. 
  • Once this occurs, Obama will sign the Senate bill into law.
  • The House will then vote on the Reconciliation Act and send it to the Senate for debating and an eventual vote.
Week of March 22
  • The Senate will begin debating on the Reconciliation Act.
  • This debate could take up to two weeks or more.
  • If, and when, the Reconciliation Act gets passed by the Senate – unchanged – it will go to Obama to be signed into law.
  • Note that the Reconciliation Act would lie on top of the Senate bill creating one final law.

We are continuing to monitor healthcare reform news throughout the weekend and will post relevant updates as they occur.

Healthcare Reform Update - 18March2010

As of 2:26 p.m., the U.S. House of Representatives released the H.R. 4872 - Reconciliation Act of 2010. Included in the release is a Section-by-Section analysis of the Amendment, the text of the Senate Health Bill and the bill as reported by the House Budget Committee.
  • It is reported that the House will convene on Sunday at 1 p.m. with a vote beginning no sooner than 2 p.m.
  • We are in the process of reviewing the information to provide you with an update about the sections that will impact Benefitfocus and our clients.
  • In the interim, here is the link if you’d like to peruse the proposed amendment

CBO releases health bill cost estimate; legislative language anticipated to be released later today
  • The Congressional Budget Office sent House leaders a cost estimate today on their proposed healthcare legislation.
  • The estimate states that the bill would cost $940 billion over 10 years and expand coverage to 95 percent of Americans. (This would leave 21 million without insurance coverage, many of whom are illegal immigrants.)
  • The federal deficit would decrease by approximately $130 billion in the first 10 years and by $1.2 trillion over the following 10 years.
  • The bill costs more than the original draft bills passed by the Senate and the House last fall. However, Democrats were able to keep the deficit reduction figures at the same levels.
  • Pelosi (D-Calif.) continues to search for the 216 votes needed for passage. It is anticipated that these figures will ease the concerns of fiscal conservatives who have been reluctant vote for the bill.
  • Legislative language is expected to be posted to the Web site of the House Rules Committee sometime Thursday morning.
  • The latest changes to the bill would:
  • Close the donut hole in the Medicare prescription drug program,
  • Boost subsidies for lower-income individuals to buy insurance, and
  • Push back the implementation date of the tax on Cadillac insurance plans until 2018.
  • Read more:

Healthcare Reform Update - 17March2010

As of 5 p.m. Eastern time today, there are no significant updates to report. In monitoring news coverage, we have seen the following:

  • Two key House members, Kildee (D-MI) and Kucinich (D-OH), announced their support for the final vote of the healthcare bill, bringing the House closer to the 216 votes needed to pass reform.
  • The CBO still has not released the final score for the reconciliation bill; reports state they are crumbling under a firestorm of requests from members tweaking the bill.
  • Constitutional questions are being raised about the so-called “Slaughter Rule,” which would allow the House to deem the Senate bill cleared without taking a direct vote.
  • Mudslinging between the two parties continues, as national news outlets are still reporting news with mostly speculation and hype.

Healthcare Reform Update - 16March2010

Two summary statements from today’s news: Pelosi could proceed with plan to pass Senate bill without House vote and Still no final reconciliation bill or CBO score.
  • The House Budget Committee voted Monday to advance the legislation toward a floor vote later this week.
    • The panel approved a package of fixes to the overhaul by a vote of 21 to 16.
    • Two Democrats sided with all 14 Republicans in voting against the plan.
    • 37 Democrats remain opposed to the bill, albeit with varying degrees of commitment.
  • The House Rules Committee can now take up the shell bill after a 48-hour layover.
  • If the House completes a final vote this weekend, the Senate would take next steps with the bill as early as next week.
    • Note that debate on reconciliation is limited to 20 hours.
    • However, amendments do not count toward the 20 hours, so the Republicans could tie this up for some time.
  • Some speculate that the delay in releasing the bill and CBO score (which was initially supposed to come out as early as last week) suggests that early estimates from the CBO were inaccurate, and they're making changes to get the score that they want.
  • Democrats need a CBO score that's positive enough to help give fiscal conservatives an excuse to vote for the bill.
  • Having promised to post the bill online for 72 hours before they vote, the Democrats now have about a day to get a good score if they want to vote by Saturday.