After a weekend of negotiations, the Senate voted in the early morning hours on Monday to advance the Patient Protection and Affordable Care Act.
The 60-40 procedural vote, which fell strictly along party lines, is seen as a major victory for Senate Majority Leader Reid (D-Nev.), who labored to convince recalcitrant democratic senators such Sen. Ben Nelson (D-Neb.), to support the sweeping reform passage. The bill now needs to pass two more procedural votes before it comes to a final vote, which is expected on Wednesday.
The Senate package has major implications for the insurance industry, including prohibitions on denying coverage for preexisting conditions and on rescinding coverage when policyholders fall ill. The legislation also seeks to regulate the “medical loss ratio” or percentage of premium dollars that insurance companies spend on patient services versus profits or administrative costs.
“This bill gives health care coverage to a record 31 million Americans who are currently uninsured, it provides all Americans with the access to adequate and dependable coverage when they need it most, and it reins in spiraling health care costs – and that is a very great thing,” Sen. Jay Rockefeller (D-W.V.) said in a statement prior to the vote. “It also requires greater transparency in insurance company practices and establishes a minimum medical loss ratio provision to create real reform for health insurance companies.”
One positive inclusion for insurers is a personal mandate that requires most Americans to either purchase health insurance or face fines. Notably absent from the Senate bill was a government run “public option” to compete with private insurance plans. This absence may present problems when the time comes to reconcile the Senate bill with reform legislation passed in the House. In addition to differences over a public option, the bills also diverge on how to pay for the legislation and have differing formulas on how to expand Medicaid coverage.
The reconciliation negotiations between the House and Senate could last for weeks or months.
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