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111th Congress, Vote 167; House of Representatives #4872

Health Care and Education Reconciliation Act of 2010

Official Title: An Act to provide for reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010 (S. Con. Res. 13).

HR 4872: Health Care and Education Reconciliation Act of 2010
Passed House March 21, 2010, 220-211

Synopsis: The House bill made changes to the health reform legislation approved by the Senate on December 24:

  • Lifting subsidies available to moderate-income Americans, making it easier for them to afford private insurance
  • Raising the Medicare payroll tax that will take effect in 2013 for individuals with adjusted gross income of $200,000 or more ($250,000 for joint returns) by including net investment income in the Medicare taxable base and imposing a 3.8% tax on such income.
  • Revising the provisions regarding penalties to be imposed on individuals who decline to purchase health care coverage by:
    1. lowering the maximum penalty amount from $495 to $325 in 2015 and from $750 to $695 in 2016; and
    2. increasing the penalty rates based on taxpayer household income to 1 percent of taxable income in 2014, 2 percent of taxable income in 2015, and 2.5 percent of taxable income in 2016
  • Revising the provisions regarding penalties to be imposed on employers with 50 or more employees who decline to offer employees health care coverage by:
    1. allowing an exemption for the first 30 employees (including part-time employees) when calculating the penalty; and
    2. lifting the applicable penalty amount per employee to $2,000.
  • Prohibiting all individual and group health plans from placing lifetime limits on the coverage except in cases of fraud. Prohibiting pre-existing condition exclusions for children. (Effective six months following enactment) And, beginning in January 2014, prohibiting individual and group health plans from placing annual limits on the dollar value of coverage
  • Delaying the start of a new tax on high-cost employer sponsored insurance policies to 2018, raising the thresholds at which policies would be hit by the tax to $10,2000 for individual coverage and $27,500 for family plans, and increasing threshold amounts for retirees and employees and high-risk professions.
  • Making changes to close the gap in Medicare prescription drug coverage known as the doughnut hole by
    1. providing a one-time $250 rebate in 2010 to all Medicare part D enrollees who enter the Medicare part D coverage gap (also known as the Medicare donut hole,
    2. delaying until January 1, 2011, the deadline for establishment of a Medicare coverage gap discount program, as well as the effective date of the requirement that a part D drug manufacturer participate in it; and
    3. repealing the increase by $500 in the 2010 standard initial coverage limit and reducing the coinsurance percentage for covered brand-name and generic drugs to 25% by 2020 (thus closing the donut hole with 75% discounts).
  • Clarifying a provision requiring insurers to allow adult children to remain on their parents' insurance policies until their 26th birthday.

Why supporters pushed for this bill

  • Legislators who voted for the bill pointed to a Congressional Budget Office report which concluded that it would reduce the federal budget over the next ten years by $20 billion and – combined with the Senate bill – by $138 billion. The CBO concluded that the bill would also reduce the deficit further after the first ten years. The total cost of the coverage expansions in the bill are estimated at $940 billion over ten years, more than the $875 billion cost of the Senate bill, but less than the president's stated limit of $950 billion.
  • According to the CBO, this historic legislation would cover 32 million uninsured Americans by 2019, 95 percent of the population of the United States excluding unauthorized aliens, up slightly from the Senate bill.

Why opponents tried to stop the bill

On March 25, 2010, House Minority Leader John Boehner was speaking for many opponents of the Reconciliation bill when he declared that it tries to "jam more through the system than the system could handle, leaving us a sloppy mess that the majority of the American people believe should be repealed and replaced …

"And mark my word, we will be back to this bill over and over again in the next 6 months. You all know what's going to happen. We'll be back here to correct the mistakes that we didn't do right the first time because of the rush that we were in to approve this massive spending bill that was hidden from the original bill …

"We'll be back here to appropriate money for a new IRS group of individuals that we're going to need to hire to enforce [the tax hikes in] this law …

"And we'll be back to deal with the unintended, but certainly anticipated, consequences of people losing their health care because this bill makes it too expensive for employers to keep employees on their health plan.

"Several weeks ago, more than 130 economists signed a letter to President Obama warning that the health care bill that was being pushed through Congress would cost Americans jobs, and sadly, we're already seeing evidence that those economists were right

"In just the last 3 days, we've seen the stories. Major employers like Caterpillar and John Deere talking about increases of $250 million in their health care costs. Medical device companies in Massachusetts are talking about thousands of jobs being wiped out. The tourism industry in New Hampshire is facing millions of dollars of fines because it hires seasonal workers.

"We're going to have to come back and fix this bill time and time again in the coming weeks and months to correct all the flaws and all of the mistakes.

"What we should be doing is working together to create a better environment for America's small businesses to invest, to save, and to rehire American workers. But, no, instead we're going to keep coming back here fixing the flaws in this very flawed bill."

03/21/2010 Status: House passed

More: select a member to see his or her other key health care votes.

Yes (220)
Our pick
D Victor Snyder AR
D Gabrielle Giffords AZ
D Raúl Grijalva AZ
D Ann Kirkpatrick AZ
D Harry Mitchell AZ
D Ed Pastor AZ
D Joe Baca CA
D Xavier Becerra CA
D Howard Berman CA
D Lois Capps CA
D Dennis Cardoza CA
D Judy Chu CA
D Jim Costa CA
D Susan Davis CA
D Anna Eshoo CA
D Sam Farr CA
D Bob Filner CA
D John Garamendi CA
D Jane Harman CA
D Michael Honda CA
D Barbara Lee CA
D Zoe Lofgren CA
D Doris Matsui CA
D Jerry McNerney CA
D George Miller CA
D Grace Napolitano CA
D Nancy Pelosi CA
D Laura Richardson CA
D L. Roybal-Allard CA
D Linda Sánchez CA
D Loretta Sanchez CA
D Adam Schiff CA
D Brad Sherman CA
D Jackie Speier CA
D Fortney Stark CA
D Mike Thompson CA
D Maxine Waters CA
D Diane Watson CA
D Henry Waxman CA
D Lynn Woolsey CA
D Diana DeGette CO
D Betsy Markey CO
D Ed Perlmutter CO
D Jared Polis CO
D John Salazar CO
D Joe Courtney CT
D Rosa DeLauro CT
D James Himes CT
D John Larson CT
D Christopher Murphy CT
D Allen Boyd FL
D Corrine Brown FL
D Kathy Castor FL
D Alan Grayson FL
D Alcee Hastings FL
D Ron Klein FL
D Suzanne Kosmas FL
D Kendrick Meek FL
D D. Wasserman Schultz FL
D Sanford Bishop GA
D Henry Johnson GA
D John Lewis GA
D David Scott GA
D Mazie Hirono HI
D Leonard Boswell IA
D Bruce Braley IA
D David Loebsack IA
D Melissa Bean IL
D Jerry Costello IL
D Danny Davis IL
D Bill Foster IL
D Luis Gutiérrez IL
D Deborah Halvorson IL
D Phil Hare IL
D Jesse Jackson IL
D Daniel Lipinski IL
D Mike Quigley IL
D Bobby Rush IL
D Janice Schakowsky IL
D André Carson IN
D Joe Donnelly IN
D Brad Ellsworth IN
D Baron Hill IN
D Peter Visclosky IN
D Dennis Moore KS
D John Yarmuth KY
D Michael Capuano MA
D William Delahunt MA
D Barney Frank MA
D Stephen Lynch MA
D Edward Markey MA
D James McGovern MA
D Richard Neal MA
D John Olver MA
D John Tierney MA
D Niki Tsongas MA
D Elijah Cummings MD
D Donna Edwards MD
D Steny Hoyer MD
D C. Ruppersberger MD
D John Sarbanes MD
D Chris Van Hollen MD
D Michael Michaud ME
D Chellie Pingree ME
D John Conyers MI
D John Dingell MI
D Dale Kildee MI
D Carolyn Kilpatrick MI
D Sander Levin MI
D Gary Peters MI
D Mark Schauer MI
D Bart Stupak MI
D Keith Ellison MN
D Betty McCollum MN
D James Oberstar MN
D Timothy Walz MN
D Russ Carnahan MO
D Wm. Clay MO
D Emanuel Cleaver MO
D Bennie Thompson MS
D George Butterfield NC
D Bob Etheridge NC
D R. Miller NC
D David Price NC
D Melvin Watt NC
D Earl Pomeroy ND
D Paul Hodes NH
D Carol Shea-Porter NH
D Robert Andrews NJ
D Rush Holt NJ
D Frank Pallone NJ
D Bill Pascrell NJ
D Donald Payne NJ
D Steven Rothman NJ
D Albio Sires NJ
D Martin Heinrich NM
D Ben Luján NM
D Shelley Berkley NV
D Dina Titus NV
D Gary Ackerman NY
D Timothy Bishop NY
D Yvette Clarke NY
D Joseph Crowley NY
D Eliot Engel NY
D John Hall NY
D Brian Higgins NY
D Maurice Hinchey NY
D Steve Israel NY
D Nita Lowey NY
D Daniel Maffei NY
D Carolyn Maloney NY
D Carolyn McCarthy NY
D Gregory Meeks NY
D Scott Murphy NY
D Jerrold Nadler NY
D William Owens NY
D Charles Rangel NY
D José Serrano NY
D Louise Slaughter NY
D Paul Tonko NY
D Edolphus Towns NY
D Nydia Velázquez NY
D Anthony Weiner NY
D John Boccieri OH
D Steve Driehaus OH
D Marcia Fudge OH
D Marcy Kaptur OH
D Mary Jo Kilroy OH
D Dennis Kucinich OH
D Tim Ryan OH
D Betty Sutton OH
D Charles Wilson OH
D Earl Blumenauer OR
D Peter DeFazio OR
D Kurt Schrader OR
D David Wu OR
D Robert Brady PA
D Christopher Carney PA
D Kathleen Dahlkemper PA
D Michael Doyle PA
D Chaka Fattah PA
D Paul Kanjorski PA
D Patrick Murphy PA
D Allyson Schwartz PA
D Joe Sestak PA
D Patrick Kennedy RI
D James Langevin RI
D James Clyburn SC
D John Spratt SC
D Steve Cohen TN
D Barton Gordon TN
D Henry Cuellar TX
D Lloyd Doggett TX
D Charles Gonzalez TX
D Al Green TX
D Gene Green TX
D Rubén Hinojosa TX
D Sheila Jackson Lee TX
D Eddie Johnson TX
D Solomon Ortiz TX
D Silvestre Reyes TX
D Ciro Rodriguez TX
D Gerald Connolly VA
D James Moran VA
D Thomas Perriello VA
D Robert Scott VA
D Peter Welch VT
D Brian Baird WA
D Norman Dicks WA
D Jay Inslee WA
D Rick Larsen WA
D Jim McDermott WA
D Adam Smith WA
D Tammy Baldwin WI
D Steve Kagen WI
D Ron Kind WI
D Gwen Moore WI
D David Obey WI
D Alan Mollohan WV
D Nick Rahall WV
No (211)
R Don Young AK
R Robert Aderholt AL
R Spencer Bachus AL
R Jo Bonner AL
D Bobby Bright AL
D Artur Davis AL
R Parker Griffith AL
R Mike Rogers AL
D Robert Berry AR
R John Boozman AR
D Mike Ross AR
R Jeff Flake AZ
R Trent Franks AZ
R John Shadegg AZ
R Brian Bilbray CA
R Mary Bono Mack CA
R Ken Calvert CA
R John Campbell CA
R David Dreier CA
R Elton Gallegly CA
R Walter Herger CA
R Duncan Hunter CA
R Darrell Issa CA
R Jerry Lewis CA
R Daniel Lungren CA
R Kevin McCarthy CA
R Tom McClintock CA
R Howard McKeon CA
R Gary Miller CA
R Devin Nunes CA
R George Radanovich CA
R Dana Rohrabacher CA
R Edward Royce CA
R Mike Coffman CO
R Doug Lamborn CO
R Michael Castle DE
R Gus Bilirakis FL
R Virginia Brown-Waite FL
R Vern Buchanan FL
R Ander Crenshaw FL
R Lincoln Diaz-Balart FL
R Mario Diaz-Balart FL
R Connie Mack FL
R John Mica FL
R Jeff Miller FL
R Bill Posey FL
R Adam Putnam FL
R Thomas Rooney FL
R Ileana Ros-Lehtinen FL
R Clifford Stearns FL
R C. Young FL
D John Barrow GA
R Paul Broun GA
R Nathan Deal GA
R Phil Gingrey GA
R Jack Kingston GA
R John Linder GA
D James Marshall GA
R Tom Price GA
R Lynn Westmoreland GA
R Steve King IA
R Tom Latham IA
D Walter Minnick ID
R Michael Simpson ID
R Judy Biggert IL
R Timothy Johnson IL
R Mark Kirk IL
R Donald Manzullo IL
R Peter Roskam IL
R Aaron Schock IL
R John Shimkus IL
R Dan Burton IN
R Stephen Buyer IN
R Mike Pence IN
R Mark Souder IN
R Lynn Jenkins KS
R Jerry Moran KS
R Todd Tiahrt KS
D Ben Chandler KY
R Geoff Davis KY
R Brett Guthrie KY
R Harold Rogers KY
R Ed Whitfield KY
R Rodney Alexander LA
R Charles Boustany LA
R Anh Cao LA
R Bill Cassidy LA
R John Fleming LA
D Charles Melancon LA
R Steve Scalise LA
R Roscoe Bartlett MD
D Frank Kratovil MD
R Dave Camp MI
R Vernon Ehlers MI
R Peter Hoekstra MI
R Thaddeus McCotter MI
R Candice Miller MI
R Mike Rogers MI
R Fred Upton MI
R Michele Bachmann MN
R John Kline MN
R Erik Paulsen MN
D Collin Peterson MN
R W. Akin MO
R Roy Blunt MO
R Jo Ann Emerson MO
R Sam Graves MO
R Blaine Luetkemeyer MO
D Ike Skelton MO
D Travis Childers MS
R Gregg Harper MS
D Gene Taylor MS
R Dennis Rehberg MT
R Howard Coble NC
R Virginia Foxx NC
R Walter Jones NC
D Larry Kissell NC
R Patrick McHenry NC
D Mike McIntyre NC
R Sue Myrick NC
D Heath Shuler NC
R Jeff Fortenberry NE
R Adrian Smith NE
R Lee Terry NE
D John Adler NJ
R Rodney Frelinghuysen NJ
R Scott Garrett NJ
R Leonard Lance NJ
R Frank LoBiondo NJ
R Christopher Smith NJ
D Harry Teague NM
R Dean Heller NV
D Michael Arcuri NY
R Peter King NY
R Christopher Lee NY
D Michael McMahon NY
R Steve Austria OH
R John Boehner OH
R Jim Jordan OH
R Steven LaTourette OH
R Robert Latta OH
R Jean Schmidt OH
D Zachary Space OH
R Patrick Tiberi OH
R Michael Turner OH
D Dan Boren OK
R Tom Cole OK
R Mary Fallin OK
R Frank Lucas OK
R John Sullivan OK
R Greg Walden OR
D Jason Altmire PA
R Charles Dent PA
R Jim Gerlach PA
D Tim Holden PA
R Tim Murphy PA
R Joseph Pitts PA
R Todd Platts PA
R Bill Shuster PA
R Glenn Thompson PA
R James Barrett SC
R Henry Brown SC
R Bob Inglis SC
R Joe Wilson SC
D S. Herseth Sandlin SD
R Marsha Blackburn TN
D Jim Cooper TN
D Lincoln Davis TN
R John Duncan TN
R David Roe TN
D John Tanner TN
R Zach Wamp TN
R Joe Barton TX
R Kevin Brady TX
R Michael Burgess TX
R John Carter TX
R K. Conaway TX
R John Culberson TX
D Thomas Edwards TX
R Louie Gohmert TX
R Kay Granger TX
R Ralph Hall TX
R Jeb Hensarling TX
R Sam Johnson TX
R Kenny Marchant TX
R Michael McCaul TX
R Randy Neugebauer TX
R Pete Olson TX
R Ronald Paul TX
R Ted Poe TX
R Pete Sessions TX
R Lamar Smith TX
R Mac Thornberry TX
R Rob Bishop UT
R Jason Chaffetz UT
D Jim Matheson UT
D Frederick Boucher VA
R Eric Cantor VA
R J. Forbes VA
R Bob Goodlatte VA
D Glenn Nye VA
R Robert Wittman VA
R Frank Wolf VA
R Doc Hastings WA
R C. McMorris Rodgers WA
R David Reichert WA
R Thomas Petri WI
R Paul Ryan WI
R F. Sensenbrenner WI
R Shelley Capito WV
R Cynthia Lummis WY