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After the loss of a 60-seat Democratic supermajority in the Senate, Democratic Congressional leaders are turning to the budget reconciliation process to complete health care reform. Because it is in the form of a budget reconciliation measure, the Senate would need only a simple majority to approve it. Although the reconciliation bill currently contains many of the elements – including the public health insurance option – from the House-approved Affordable Health Care for America Act (H.R. 3962), these provisions are expected to be deleted and replaced with the agreed-upon compromise language. In a series of parliamentary maneuvers, a House vote on the Senate-passed Patient Protection and Affordable Care Act and on this reconciliation package could come by the end of the week.

It is all but assured that no House Republicans will vote in favor of the Senate health care bill, so Democrats are scrambling to shore up the minimum 216 votes needed for passage. Assuming the House has the necessary votes to pass the Senate bill and the reconciliation measure, the reconciliation measure would also have to be approved by the Senate.

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Just last week, two health care-related bills were introduced. The Healthy Americans Act (H.R. 1321) bears resemblance to the Massachusetts mandatory health insurance program, by requiring all adult Americans to enroll themselves and their dependent children in a qualifying health insurance program, which could include an employer-sponsored plan, or could be a universally-available Healthy Americans Private Insurance Plan (HAPI plan).  Employers offering employer-sponsored health coverage plans would be required to ensure compliance with the statutory coverage requirements, and also would be required to distribute to employees standardized information on HAPI plans and supplemental health insurance options provided by the state Health Help Agency (HAA) provided for under the Act. Additionally, the legislation sets forth penalties for failure to enroll, establishes standardized coverage and state options for HAPI plans, ensures portability, and requires the Secretary of Health and Human Services to promulgate guidelines concerning the benefits, items and services to be covered.  Requirements for setting premiums are also outlined in the bill. If enacted, the provisions of the bill would take effect no later than 4 years after the date of enactment. This bill was referred to the House Committees on Energy and Commerce, Ways and Means, Education and Labor, and Oversight and Government Reform.

On the same day the Healthy Americans Act was presented, a bill to amend the Employee Retirement Income Security Act (ERISA) to provide emergency protection for retiree health benefits was introduced. The Emergency Retiree Health Benefits Protection Act of 2009 (H.R. 1322) would accomplish the following:

• Bar plan sponsors from canceling or reducing health benefits after the dates participants retire;
• Require sponsors of group health plans to restore health benefits previously taken away from retired participants of such plans to the extent such benefits were canceled or altered after the dates the participants retired, and the plan sponsor would not sustain substantial business hardship by restoring such benefits; and
• Establish an Emergency Retiree Health Loan Guarantee Program that would provide retiree health loan guarantees to plan sponsors of group health plans. The credit would be used by plan sponsors to help them discharge their obligations to restore health benefits to retirees under the Act.

Violations of this Act would be subject to a civil penalty of up to $1,000 per violation. The Act would take effect on the date of enactment. This bill was referred to the House Committee on Education and Labor.