This installment of Hall Render's Health Law Broadcast series on health care reform is designed to provide you with a brief update on significant developments from the previous week.

HEALTH CARE REFORM?  NOT YET.

"The Bill is Passed"*

The House passed the Senate's health care reform proposal (H.R. 3590) late last night by a vote of 219-212.  All Republicans and 34 House Democrats voted against the bill.  Then, House Democrats followed this significant vote by passing its reconciliation package, entitled the Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872), by a vote of 220-211.  These votes followed several hours of lively debate and without use of the "self-executing" rule that was argued ad nauseam over the past week. 

Because the House reconciliation package of H.R. 4872 encompasses a number of budget-related modifications to the as-passed Senate bill, this reconciliation package must now go to the Senate for adoption.  Senate Democrats will need 51 votes to incorporate these modifications before the bills can be sent to President Obama for signature.  Senate Majority Leader Harry Reid (D-NV) has committed to House Speaker Nancy Pelosi (D-CA) that he has sufficient votes to pass the reconciliation package.

Yesterday's vote followed a deal between President Obama and several Representatives led by Bart Stupak (D-MI) that purportedly provided the Representatives the safeguards they sought regarding Federal funding for abortions.  It was this deal that likely resulted in the passing vote margin.  As part of the deal, President Obama will execute an Executive Order that outlines the safeguards to which he agreed.  The Executive Order's draft language as released yesterday provides in part:  

...it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), consistent with a longstanding Federal statutory restriction that is commonly known as the Hyde Amendment. The purpose of this Executive Order is to establish a comprehensive, government-wide set of policies and procedures to achieve this goal and to make certain that all relevant actors - Federal officials, state officials (including insurance regulators) and health care providers - are aware of their responsibilities, new and old.

But the health care reform process is not over.  In addition to the Senate needing to adopt the House's reconciliation package, Republican leadership and interested others have indicated that legal challenges should be expected.  These legal challenges will likely focus on the constitutionality of various provisions in the bills.  Legal challenges may even come from various states who believe that the individual mandate provisions are unconstitutional.  Legislation is either pending or recently passed in as many as 36 states that either declares the individual mandate provisions as illegal or requires the respective states to sue the Federal government. 

If the Senate adopts the House's reconciliation package, and once President Obama signs the legislation, there are a number of provisions that are effective immediately.  Detailed analysis of these provisions will follow in the coming days.

Visit our Health Law Broadcast at hallrender.com/reform for a comprehensive listing of health care reform resources.  Also sign up for health care reform alerts and periodic updates as we continue to monitor this important issue.

*A quote from Speaker Nancy Pelosi at the conclusion of voting.