Senate to Pass Health Reform “Fixes” Through Reconciliation - March 23, 2010

Following passage of the reform bill in the House, the chamber passed amendments to the bill as part of a budget reconciliation bill. House Democrats, unhappy with many of the provisions in the Senate bill, insisted on making significant changes, including reducing the size of the Medicaid and Medicare Disproportionate Share Hospital payment savings. The Senate will now take up the reconciliation bill. Under special budget reconciliation rules, debate is limited to 20 hours, equally divided between the parties. Filibusters are prohibited, but there is no limit to the number of amendments that any Senator may offer. Perhaps the greatest threat to individual provisions in the reconciliation bill is the "Byrd Rule" which requires that all provisions have a direct effect on the federal budget. Any Senator may raise a point of order against a specific provision, arguing that is violates the Byrd Rule. The ruling would be made by the Senate parliamentarian, and could only be overruled by a 60 vote majority. Should any changes to the reconciliation bill be made, either through an amendment or point of order, the legislation would have to be re-passed by the House. NAPH is urging the Senate to pass the reconciliation bill as quickly as possible, and asks hospitals to activate their grassroots networks to that effect.