This was a vote on passage of a bill making changes to major health care legislation signed into law by President Obama.
In order to pass comprehensive health care reform legislation, Democratic leaders devised a plan in which the House would pass the Senate health care bill (H.R. 3590), thereby enabling the president to sign it into law. The House would then pass a separate companion bill (H.R. 4872) to make changes to the Senate health measure. Assuming the Senate passed the companion bill, that measure would then go to the president for signature as well. This process allowed the House to make changes to Senate-passed health care legislation without sending the entire health bill back to the Senate, where it could be filibustered indefinitely.
This was the vote on passage of the companion bill making changes to the Senate health care legislation. Those changes included delaying the implementation of the tax on high-cost insurance plans until 2018. Democratic leaders brought up H.R. 4872 under a process known as budget reconciliation. This process shielded the bill from a filibuster in the Senate. If a bill is filibustered, it must have the support of 60 senators in order to end debate and vote on the legislation. Under budget reconciliation, bills can pass the Senate with a simple 51-vote majority.
Republicans had sought offer a number of amendments to the companion bill in order to send it back the House, where it had passed by a narrow margin. CNN reported that Republicans had chosen to offer a slew of amendments in order to “undermine the measure,” while the Associated Press characterized the amendments as “a final drive to thwart President Barack Obama's health care remake.”
H.R. 4872 would increase the number of uninsured Americans that would be covered under the health care bill by 1 million -- resulting in an expansion of coverage to 32 million individuals, as opposed to 31 million. An estimated 95% of Americans would be covered under the legislation.
H.R. 3590 placed 40% tax on high-cost insurance plans -- or those plans that are worth more than $27,500 for families, and $10,200 for individuals. Under the reconciliation bill (H.R. 4872), the tax would not take effect until 2018.
H.R. 4782 also contained a major provision -- unrelated to health care -- that would phase out a program in which the federal government guaranteed loans made to students by private lenders. Under the bill, students would instead receive loans directly from the federal government.
Democrats praised the legislation as a landmark victory for average Americans. Sen. Pat Leahy (D-VT) said: “…Today's final passage of this Health Care and Education Reconciliation Act marks the culmination of a decades-long struggle to make health insurance affordable to hard working Americans. This has been an arduous process, but it has proven that change truly is possible. America again has risen to meet one of its foremost challenges.”
Sen. Kay Hagan (D-NC) also praised the bill: “The new and historic law, combined with the bill we are now considering in the Senate, is going to reform our health care system to reduce costs and improve patient care for those families in North Carolina and in Virginia and families across America.”
Sen. Tom Udall (D-NM) argued passage of the bill would be historic: “This moment has been a long time coming. Teddy Roosevelt first called for health care reform nearly a century ago….No longer will insurance companies be able to discriminate based on preexisting conditions. No longer will they be able to dramatically increase rates without public scrutiny. No longer will 32 million Americans worry every day about what would happen to their families if they get sick or are in an accident. I am proud to have fought for and voted in favor of this historic legislation.”
Republicans denounced the bill as a costly mistake for the nation. Sen. Judd Gregg, a leading opponent of the measure, said: “Then you look at this in that context, what this bill is about--and the President has been very forthright about this--it is a massive explosion in the size of the government, growing the government for one fundamental purpose: because this administration believes a bigger government creates prosperity.”
Sen. John McCain (R-AZ) argued the bill was written in secret, behind closed doors: “…Eight times the President of the United States said in the campaign that all negotiations on health care reform would be conducted with C-SPAN cameras in the room. He said: We will find out who is on the side of pharmaceutical companies, who is on the side of the voters. Unfortunately, these deals were made out of the view of the C-SPAN cameras--in fact, behind closed doors.”
Sen. John Barrasso (R-WY) said: “We are looking at a bill, in my opinion, having practiced medicine for 25 years, taking care of families all across the State of Wyoming, that is fundamentally going to be bad for patients, bad for providers, our nurses and our doctors, and bad for payers, the people who are going to pay the bill, the American taxpayers.”
After the House and Senate both passed their respective health care reform bills, the two chambers had intended to reconcile those two bills into a final package. After the House and Senate passed that final package, it would have been sent to President Obama, who would have signed it into law. Sen. Scott Brown (R-MA), however, won a special election to replace the late Sen. Ted Kennedy (D-MA) before the final health care bill could be brought up for a vote. Brown's victory gave Republicans 41 votes in the Senate, leaving Democrats with 59 members – one vote short of the 60 votes they needed to defeat a unanimous Republican filibuster against the final health care bill.
In order to pass comprehensive health care legislation without a 60-vote majority in the Senate, Democratic leaders devised a plan in which the House would pass the Senate health care bill (H.R. 3590), thereby enabling the president to sign it into law. The House would then pass a separate companion bill (H.R. 4872) to make changes to the Senate health measure under a process known as "budget reconciliation." Bills considered under budget reconciliation cannot be filibustered under Senate rules. This process allowed the House to make changes to Senate-passed health care legislation without sending the entire health bill back to the Senate, where it could have been filibustered indefinitely. The companion bill incorporated changes to the Senate health care legislation desired by House Democrats. The House passed the companion measure, and sent it to the Senate, where Democratic leaders hoped to defeat all amendments -- thereby avoiding a second vote in the House on a substantively changed bill; a vote that Democrats might have lost given the already tight margin when it was voted on the previous week.
The Senate passed the reconciliation bill by a vote of 56-43. 56 Democrats voted “yea.” All 40 Republicans present and 3 Democrats voted “nay.” As a result, the Senate passed legislation -- thus enabling the president to sign it into law -- giving 32 million uninsured Americans access to heath insurance, delaying a tax on high-cost health insurance plans until 2018, and phasing out a program in which the federal government guaranteed loans made to students by private lenders (Under the bill, students would instead receive loans directly from the federal government.).