President Obama Signs Health Reform Bill

At a ceremony in the White House this morning, President Obama signed into law the Senate health reform bill that was passed by the House of Representatives late Sunday night by a vote of 219-212. The bill is expected to cost $940 billion over the next ten years and is estimated to cover 32 million additional Americans by 2019.

The reconciliation bill that was passed by the House following the passage of the Senate reform bill is now headed to the Senate for debate. Because the measure is a reconciliation bill, special Senate debate rules apply. First, debate is limited to only 20 hours and filibusters are prohibited. Second, the Byrd Rule applies, which states that any provision that does not relate directly to the federal budget must be stricken from the bill. If Republicans are successful in challenging the bill through either a point of order or with an amendment, the bill will be sent back to the House for a final vote.

To read more about today's White House signing ceremony, click here.

New CBO Score on Health Reform Bill

The non-partisan Congressional Budget Office (CBO) this morning released a cost analysis of Democrats' recently revised health reform package. Keeping in step with President Obama's commitment to keep the price of reform below $1 trillion, this package, set to be advanced through Congress using the budget reconciliation process, is estimated to cost $940 billion over 10 years and reduce the federal deficit by $130 billion.

House Democrats are expected to use a "deem and pass" parliamentary tactic that would allow House members to avoid giving an "up or down vote" on the reform bill. By using this maneuver, the original Senate-passed health reform bill would automatically be considered passed if the reconciliation bill is passed. A memo released by the Senate parliamentarian earlier this week indicated that this tactic is indeed valid in this particular case, angering Republicans who have characterized this strategy as unrepresentative of fair and proper parliamentary procedure. The next step in enacting the health reform package would be to introduce the reconciliation bill in the Senate where only a simple majority of 51 votes would be needed to approve it. Senate Republicans are expected to delay the momentum of the bill by introducing numerous amendments and having the Senate clerk read each one.

Click here for more from the New York Times.
Additional coverage is provided by The Hill and can be accessed by clicking here.

Senate Democrats Cut a Deal; Reach 60 Votes

Early Saturday morning, Senate majority leader Harry Reid (D-NV) released a 383-page manager's amendment to the Senate health insurance reform proposal, indicating that he has secured the 60 votes needed to pass the legislation by Christmas. Senate Republicans immediately invoked the first of many delay tactics by requiring the Senate Clerk to read the entire bill aloud. Appeasing the last Democratic holdout, Sen. Ben Nelson (D-NE), Mr. Reid modified language that does not require or forbid health insurance plans from covering abortion services, but does include an exemption that allows states to prohibit abortion coverage in the insurance markets or the exchanges, where most plans would be sold. Nebraska will also receive, under the amendment, a substantial increase in federal matching dollars that support the state's Medicaid program - the federal-state entitlement program that provides coverage to the poor.

This version of the Senate bill will cost, according to an analysis by the nonpartisan Congressional Budget Office, $871 billion and reduce the federal deficit by $132 billion over ten years, The Hill reports. Costing $22 billion more than its original version, the bill is predicted to cover an additional 31 million Americans.

The complete manager's amendment can be found on the Senate Democrats' website or by clicking here.

Coming only a day after a public opinion poll released by the Kaiser Family Foundation indicated that public support for reform is weakening, Mr. Reid has scheduled six votes to pass the legislation by Christmas. The first one, the next move in the process, is a 1:00am vote early Monday morning to end debate on the manager's amendment. All six procedural moves can be found at a post to the New York Times Prescriptions Blog or by clicking here.

A New York Times article discussing the changes made to key components of the legislation can be found by clicking here.

Reid Unveils Senate Health Bill

Yesterday evening, Senate majority leader Harry Reid (D-NV) released the Senate's version of a health reform bill, the "Patient Protection and Affordable Care Act". A cost analysis from the Congressional Budget Office (CBO) puts the price tag of the bill at $848 billion over 10 years while expanding coverage to an additional 31 million Americans and is expected to reduce projected federal budget deficits by $130 billion over a decade.

Now, Senator Reid is faced with the task of moving the bill to debate on the full Senate floor through a procedural move called a "motion to proceed", which is expected to happen on Saturday. This motion, along with passage of the bill itself, requires 60 votes. Senators Joseph Lieberman (I-CT) and Bernard Sanders (I-VT) are two Independents who caucus with the Democrats, but have not yet confirmed their support of the bill. If Lieberman and Sanders do not vote for the bill, Democrats will fall short of the required 60 votes by 2.

Full articles on the bill are available by clicking on the following links:

• New York Times
• Wall Street Journal
• The Hill

The full bill text can be found by clicking here. And, a searchable version of the bill, courtesy of the New York Times, is available here.

A talking points look at the Joint Committee on Taxation's revenue analysis can be accesses by clicking here.

The CBO score is available here.

CMS Actuary Releases Cost Analysis of House Health Bill

The health reform bill recently approved by the House will cost $289 billion over the next ten years, according to the chief actuary at the Centers for Medicare and Medicaid Services (CMS). This analysis, however, is not an apple-to-apples comparison of the Congressional Budget Office and Joint Committee on Taxation's cost analyses because CMS doesn't take into account the various tax provisions baked into the legislation.

Additionally, the report claims that the bill falls short of house Democrats' reform goals:

"With the exception of the proposed reduction in Medicare... the provisions of H.R. 3962 would not have a significant impact on future healthcare cost growth rates."

Read the complete story at The Hill by clicking here.

The report from CMS's Chief Actuary can be found by clicking here.

Financing Health Reform - CBO Style

In a post to the New York Times' Economix blog, Princeton economist Uwe Reinhardt writes on how the Congressional Budget Office (CBO) calculates the cost of financing the various health reform bills floating around Congress.

Find the article at http://economix.blogs.nytimes.com/2009/10/30/the-magic-of-financing-health-care-reform/

Health Care Reform - Five Key Numbers from CBO Score

A posting on the Wall Street Journal Health blog highlights five key numbers from the CBO scoring of the Senate Finance Committee health bill.

CBO estimates the cost to be $829 billion over 10 years while shaving off over $80 billion from the federal deficit over ten years as well.

Find the article at http://blogs.wsj.com/health/2009/10/07/five-key-numbers-in-cbos-score-of-the-senate-finance-bill/

Health Care Reform - CBO Scores Baucus/Senate Finance Bill

The cost analysis is in! Sen. Max Baucus' Finance Committee bill will cost $829 billion over ten years, up from an initial estimate of $774 billion, according to the Congressional Budget Office. The Finance Committee is now expected to move forward with voting on the bill, which will then get moved to the full Senate floor to be merged with the Senate HELP committee bill that was finalized in July.

The NYT story: http://www.nytimes.com/2009/10/08/health/policy/08health.html?_r=1&hp

The WSJ reports: http://online.wsj.com/article/SB125494356104171425.html

WSJ's Health Blog's take on the five important numbers in the CBO score: http://blogs.wsj.com/health/2009/10/07/five-key-numbers-in-cbos-score-of-the-senate-finance-bill/

CBO - Effect of Health Insurance on Labor Markets

The Congressional Budget Office (CBO) recently released an issue brief on the effect of changes to the health insurance system on labor markets. The brief reports that:

"Changes to the health insurance system could affect labor markets by changing the cost of insurance offered through the workplace and by providing new options for obtaining coverage outside the workplace. For example:

• Requiring employers to offer health insurance—or pay a fee if they do not—is likely to reduce employment, although the effect would probably be small.
  

• Providing new subsidies for health insurance that decline in value as a person’s income rises could discourage some people from working more hours.
  

• Increasing the availability of health insurance that is not related to employment could lead more people to retire before age 65 or choose not to work at younger ages. But it might also encourage other workers to take jobs that better match their skills, because they would not have to stay in less desirable jobs solely to maintain their health insurance."

The brief can be found at http://www.cbo.gov/ftpdocs/104xx/doc10435/07-13-HealthCareAndLaborMarkets.pdf