Tuesday, March 23, 2010

Federal legislation: U.S. House passes Senate health care reform bill to be signed into law; reconciliation act goes to the Senate

On Sunday, March 21, 2010 the U.S. House of Representatives passed by a vote of 219 to 212,
H.R. 3590 Patient Protection and Affordable Care Act 
which is the Senate version of health care reform that was originally passed  by the Senate on December 24, 2009.  H.R. 3590 is scheduled to be signed into law by President Obama on March 23, 2010 at 11:15 AM EDT.

Within minutes of the passage of H.R. 3590, the House also passed by a vote of 220 to 211 a reconciliation bill,
H.R. 4872, Reconciliation Act of 2010
which encompasses amendments to H.R. 3590 proposed by the House. The U.S. Senate still has to deliberate and approve H.R. 4872; it is required to commence those deliberations after H.R. 3590 is enacted into law by the President's signature, to allot at least 20 hours of debate to the matter, and due to technicalities the reconciliation bill requires only a simple majority for passage. The Senate calendar shows deliberation on H.R. 4872 commencing Tuesday, March 23, 2010 at 2:15PM EDT, although it is possible that could change.

H.R. 3590 does include a behavioral health provision for mental health and substance abuse treatment, however behavior analysts are not listed among those providers explicitly identified for reimbursement as part of a treatment team. It has also been noted by Autism Votes that the behavioral health clauses as enacted do not have sufficient reach to benefit more than a relative minority of families seeking ABA services, since this coverage is not required for all plans excepting,
(1) plans offered by state-based exchanges, through which individuals and small businesses can purchase coverage; and
(2) plans offered in the individual and small group markets outside the exchange.

The Arc struck a more optimistic note in changes that it sees as improvements in coverages, benefits and Long-Term Supports for those with developmental disabilities.

The reconciliation act, H.R. 4872 makes additional specification for covered professionals, under,
Sec. 1308. Coverage of marriage and family therapist services and mental health counselor services. 

National Public Radio has produced a report outlining what would be "immediate" impacts vs. those which would be coming online in several years time, such as the 2014 requirement for all the requirement that all Americans acquire health insurance or face a fine. Another NPR story describes potential state Attorney General challenges to the legislation on the grounds that penalties for not having individual coverage and state requirements under the mandate are unconstitutional.

News reports and analysis will undoubtedly continue over the coming days clarifying the relative strengths and weaknesses of the enacted legislation, with some dependency on the outcome of the Senate actions yet to occur on H.R. 4872.

News and reports of interest
Obama to sign health care reform into law, then promote it on the road
March 23, 2010 -- Updated 0736 GMT (1536 HKT)

After Obama signs health care reform bill, why mess with reconciliation?
The Christian Science Monitor
March 23, 2010

States Opposed To Insurance Mandate Prepare Lawsuits
Scott Hensley
National Public Radio health Blog
March 22, 2010 3:15PM

The Arc Applauds House Passage of Health Care Reform Legislation             
Washington, D.C. (March 22, 2010) - Press Release

Describes changes that The Arc sees as positive in coverages, benefits and Long-Term Services and Supports for those with developmental disabilities

U.S. House Passes Health Care Reform Bill Containing Provision For Autism Insurance Reform
Autism Votes
Autism Votes describes coverage gaps for those with autism, even given some behavioral health coverage in the legislation and the need to continue advocacy at the state and Federal level.

What Are The Immediate Effects Of Health Bill Passing?
Julie Appleby and Kate Steadman
March 21, 2010

© 2010 Regina G. Claypool-Frey
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