The yearlong health reform fight comes to an end
In a way, the fight over health care reform ended with a whimper, not a bang. The main reform bill had already been signed into law by the President. So the passage and signing of the fix-it piece – the reconciliation bill – felt like an afterthought.

But still, for those who thrive on the subtleties of Washington politics, the passage of the reconciliation bill was remarkable. After all:

• The House and Senate managed to agree on something big – quickly
• The Senate, which the House considers an untrustworthy partner, did what its members had promised: passed the House’s reconciliation bill without changing it
• Senate Democrats passed up the chance to vote for amendments like one that would have kept sex offenders from getting Viagra with federal subsidies, or that would have required Medicare savings to be returned to Medicare to shore up the program

Through the whole 13-hour Senate “vote-a-rama,” as it was called, Democrats managed to stick together. Then, when it came time to vote on the reconciliation bill itself, they stuck together again – or almost: three moderate Democrats, Ben Nelson of Nebraska and Blanche Lincoln and Mark Pryor of Arkansas – voted “no,” which they could afford to do. After all, the reconciliation process doesn’t call for 60 votes, just a majority. The bill passed easily, 56 to 43.

It did have to go back to the House, however. The Republicans had scored one small victory: They found two small parts of the bill that the Senate parliamentarian agreed were not appropriate for the reconciliation process. So the bill had to go back to the House one more time for one last vote.

The final piece
On Tuesday, President Obama signed the reconciliation bill. And he used the occasion to try to move past health reform and on to other topics. At the bill signing ceremony, he surrounded himself not with doctors, nurses, and people in need of health care, as he had with the first reform bill, but with Northern Virginia Community College students. In his remarks, he talked a little about health reform, but his emphasis was on the part of the bill that revamps the student loan system.

He did say, however, that the health-care reform legislation and the revisions represent “two major victories…in one week that will improve the lives of people for generations to come.”

“Today, we mark an important milestone on the road to health insurance reform and higher education reform,” he said. “But more broadly, this day affirms our ability to overcome the challenges of our politics and meet the challenges of our time.” Read his remarks here.

President Obama is now in the hard-sell phase of his campaign for heath care reform. Polls vary, but all show the country remains divided on the issue. A CNN poll released Tuesday found a majority of Americans disapproved of the new law, 56 percent to 42 percent. A Washington Post poll found that 50 percent opposed the legislation, while 46 percent supported it. A USA Today/Gallup found 50 percent supporting and 47 percent opposing.

In an interview with the Louisville Courier-Journal this week, Senate Minority Leader Mitch McConnell of Kentucky said the notion that the issue of health reform “would just somehow go quietly into the night between now and November in an election year is pretty naïve. I think it will be front and center.” He said Republican candidates will campaign against the health-care law on a “repeal and replace” slogan. Read the interview here.

Early Tuesday, House Minority Leader John Boehner said, “Today the President will sign not one, but two job-killing government takeovers that are already hurting our economy.” Sen. Lamar Alexander, R-Tenn. and a former education secretary, said. “The Obama administration’s motto is turning out to be: ‘If we can find it in the Yellow Pages, the government ought to try to do it.'”

What the second bill does
The reconciliation bill includes these adjustments to the first reform bill:

• It repeals the Cornhusker kickback and some other special deals for individual states
• It delays the implementation of the tax on high-cost “Cadillac” health plans from 2013 to 2018 and raises the threshold for when the tax kicks in
• It closes the Part D prescription drug “donut hole” coverage gap by 2020
• It speeds along some insurance reforms
• It gives moderate-income Americans more generous subsidies to buy insurance on the exchange
• It increases the Medicare payroll tax for people who make $200,000 and couples that make $250,000, and applies a 3.8 percent tax to income from dividends, rents, annuities, royalties and interest for those at that same income threshold

After the bill passed, Senate Majority Leader Harry Reid, D-Nev., said, “The American people have waited for this moment for a century.”

Sen. John McCain, R-Ariz., called the process that had been used “unsavory sausage-making, Chicago-style.” Minority Leader Boehner predicted, “We’re going to be back here fixing the flaws in this very flawed bill.”
Get involved. Contact Congress about health reform at MyHealthReform.org.