- 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:
- 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.
- 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.