Summary 

Together with the Patient Protection and Affordable Care Act (H.R. 3590), the Health Care and Education Reconciliation Act (H.R. 4872) will ensure that all Americans have access to quality, affordable health insurance and will put middle class families ahead of private banks. The Congressional Budget Office has determined that these two bills will reduce health care costs and give 95 percent of non-elderly Americans access to affordable health insurance. In addition, by eliminating wasteful subsidies to banks and reducing the cost of student loans, the bill will make college more affordable and invest in our nation’s future. Together, the bills will reduce the deficit by $143 billion over the next ten years and roughly $1.3 trillion in the second decade. The Health Care and Education Reconciliation Act meets the reconciliation instructions included in the Fiscal Year 2010 Budget Resolution (S. Con. Res. 13) for both the Senate Finance Committee and the Health, Education, Labor and Pensions (HELP) Committee.

 

Major Provisions 

By making targeted improvements to the Patient Protection and Affordable Care Act, the Health Care and Education Reconciliation Act makes a good bill even better.

 

Coverage, Medicare, Medicaid and Revenues 

Title I includes provisions under the jurisdiction of the Finance Committee.

 

Coverage 

oRaises large employer penalty cap from $750 per worker to $2,000 per worker;

oStrikes the penalty for waiting periods between 60 and 90 days;

oCounts full-time equivalents toward the threshold for triggering a penalty, but does NOT impose any penalties for part-time workers;

oPhases in the penalties as employers become larger by discounting 30 full-time workers from the per-worker penalty, eliminating a disincentive to creating new jobs; and

oEliminates the special rule for construction industry employers.

 

Medicare 

 

Medicaid 

 

Fraud, Waste, and Abuse 

 

Revenue 

 

Higher Education Provisions Under the Finance Title 

 

Education and Health 

Title II includes provisions under the jurisdiction of the HELP Committee.

 

Higher Education Provisions

 

Health Provisions

Legislative History 

The Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872), makes targeted improvements to H.R. 3590,the legislative vehicle for the Patient Protect and Affordable Care Act of 2009. H.R. 3590 was presented to President Obama and signed into law on March 23, 2010. 

On March 17, 2010, Rep. Spratt introduced H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010. The bill was reported out by the House Budget Committee and, on March 21, 2010, the House passed H.R. 4872 by a vote of 220-211. [Roll Call Vote 167

On March 23, 2010, the Senate began consideration of H.R. 4872, which follows the reconciliation instructions included in the Fiscal Year 2010 Budget Resolution (S. Con. Res. 13).

 

Expected Amendments 

The DPC will distribute information on amendments as it becomes available to staff listservs.

 

Administration Position 

On March 23, 2010, the White House released its Statement of Administrative Policy on H.R. 4872: 

“The Administration strongly supports enactment of H.R. 4872, the Health Care and Education Reconciliation Act. Combined with the Patient Protection and Affordable Care Act, this legislation makes significant improvements that will help to give American families and small business owners more control of their own health care. Together, they make important changes – ending the worst practices of insurance companies; giving uninsured individuals and small business owners the same kind of choice of private health insurance that Members of Congress have; and bringing down the cost of health care for families and businesses while also reducing Federal budget deficits. 

“These bills provide the necessary health reforms that the Administration seeks – affordable, quality care within reach for the tens of millions of Americans who do not have it today by providing the largest middle class tax cuts for health care in history, reducing premium costs and out-of-pocket expenses, and prohibiting insurance companies from denying coverage to the millions of Americans with pre-existing medical conditions. These bills also make critical improvements for Medicare beneficiaries including closing the coverage gap in the Medicare drug benefit known as the “donut hole.” They also bring new stability and security for the hundreds of millions who already have insurance by reining in the worst insurance industry abuses and putting in place reforms that increase transparency, improve the quality of care, and contain health care costs. They contribute to transforming the health care system to make health care more accessible and affordable for the American people. H.R. 4872 also includes provisions that would eliminate wasteful subsidies for student loan lenders and invest these savings to: fortify the Pell Grant program and increase Pell Grants for millions of students; strengthen community colleges; strengthen Historically Black Colleges and Universities and other Minority-Serving Institutions; and allow students to cap student loan payments at affordable levels. The education provisions are estimated by the Congressional Budget Office to reduce the deficit. The Administration urges quick action on this landmark reform.”

 

Resources 

Information on the Patient Protection and Affordable Care Act (H.R. 3590) and the Health Care and Education Affordability Reconciliation Act of 2010 H.R. 4872 can be accessed here

Congressional Budget Office, Cost estimate for the amendment in the nature of a substitute to H.R. 3590, as proposed in the Senate on November 18, 2009 (November 18, 2009) available here

Congressional Budget Office, Cost estimate for the amendment in the nature of a substitute for H.R. 4872, as passed in the House on March 21, 2010 (March 23, 2010) available here

Congressional Research Service, “Health-Related Revenue Provisions: Changes Made by the Reconciliation Act of 2010 to H.R. 3590,”available here

Congressional Research Service, “Health Insurance Premium Credits in Senate-Passed H.R. 3590,” available here

Congressional Research Service, “Private Health Insurance: Changes Made by the Reconciliation Act of 2010 to Senate-Passed H.R. 3590,”available here