The U.S. House of Representatives voted 219 to 212 last night to approve sweeping healthcare reform legislation, following more than a year of planning, debate, and a series of legislative delays and roadblocks.
In a rare late-Sunday evening vote, House Speaker Nancy Pelosi (D-Calif.) led 219 Democrats (no Republicans joined the majority) to first approve the healthcare reform plan passed on Dec. 24 by the U.S. Senate, and then voted 220-211 to approve a bill containing changes to the Senate plan. In the coming days, the Senate will need to approve the House’s second bill; Senate Democrats plan to use the budget reconciliation process to get around Senate Republicans’ threatened use of the filibuster tactic.
“We proved that we are still a people capable of doing big things and of tackling big challenges,” President Obama said in remarks shortly after the series of votes, which had followed hours of speechmaking on the House floor.
In addition to the well-known provisions related to health insurance reform contained in the bill, which will expand health insurance coverage to as many as 32 million people, forbid insurers from discriminating against people with pre-existing conditions, and ban recision (the practice of dropping insureds once they become ill), the bill contains a wide range of provisions that will impact providers. Among them are the creation of a CMS Center for Innovation, the unleashing of a variety of reimbursement innovations via demonstration projects (such as accountable care organizations and bundled payments); and the establishment of a nationwide value-based purchasing program under Medicare to pay hospitals based on performance on quality measures. The legislation would also establish a national Center for Quality Improvement and develop a national quality improvement strategy to determine nationwide quality improvement priorities; create medical home programs under Medicaid for enrollees with multiple chronic conditions; and create a Center for Comparative Effectiveness Research.
The Senate is expected to act on the “fix” legislation passed by the House within days. That action would complete the legislative process, leading to President Obama signing the final bill into law.
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