As has been widely reported, yesterday the House of Representatives narrowly approved sweeping legislation designed to expand access to health insurance (through subsidies, Medicaid expansion mandates, and market reforms); reduce health care spending (particularly in the Medicare program); expand federal fraud and abuse authorities; and institute a variety of reforms of other federal health care policies. The House action came in two parts. First, the House voted 219 to 212 to approve H.R. 3590, the Patient Protection and Affordable Care Act, which is same legislation the Senate approved on December 24, 2009. No further legislative action is necessary; President Obama is expected to sign this into law on Tuesday, March 23.

Second, the House voted 220 to 211 to approve H.R. 4872, the Reconciliation Act of 2010, which includes a series of “fixes” to the Senate bill. Note that before the House adopted H.R. 4872, changes were made to the version of the bill released March 18. Specifically, a manager’s amendment adopted by the House Rules Committee on March 20 modified provisions impacting Part D catastrophic benefits, Medicare Advantage funding, Medicare physician and hospital payments, and medical device and pharmaceutical industry fees, among others. The Reconciliation Act still must be approved by the Senate before it can become law; Senate votes are expected on this bill later this week. The timetable and outlook for action on this component of the legislation is less certain, because a variety of parliamentary challenges are expected. If the Senate makes any changes to that legislation, it would need to be considered again by the House. With or without the adoption of these fixes, however, the Patient Protection and Affordable Care Act will become the law – ushering in dramatic policy changes for health providers, insurers, and individuals. Reed Smith is preparing a detailed analysis of the legislation; in the meantime, additional information is available on these previous posts.