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Health Care and Education Reconciliation Act of 2010
""Great Seal of the United States
Long title An Act to provide for reconciliation pursuant to Title II of the concurrent resolution on the budget for fiscal year 2010 (S. Con. Res. 13).
Enacted by the "111th United States Congress
Public law 111-152
"Statutes at Large 124 Stat. 1029 thru 124 Stat. 1084 (55 pages)
Acts amended "Patient Protection and Affordable Care Act
Legislative history
  • Introduced in the House as H.R. 4872 by "John Spratt ("D-"SC) on March 17, 2010
  • Committee consideration by "Budget
  • Passed the House on March 21, 2010 (220–211)
  • Passed the Senate on March 25, 2010 (56-43) with amendment
  • House agreed to Senate amendment on March 25, 2010 (220–207)
  • Signed into law by President "Barack Obama on March 30, 2010
House votes by congressional district.
  Democratic yea on both votes
  Democratic nay on both votes
  Democratic nay on first vote, not voting on second
  Republican nay on both votes
  Republican nay on first vote, not voting on second
  Republican nay on first vote, no representative seated on second
  No representative seated
Senate vote by state.
  Democratic yea
  Democratic nay
  Independent yea
  Republican nay
  Republican not voting

The Health Care and Education Reconciliation Act of 2010 (Pub.L. 111–152, 124 "Stat. 1029) is a law that was enacted by the "111th United States Congress, by means of the "reconciliation process, in order to amend the "Patient Protection and Affordable Care Act (Pub.L. 111–148). The law includes the "Student Aid and Fiscal Responsibility Act, which was attached as a "rider.

It was passed by the "House of Representatives on March 21, 2010, by a vote of 220–211, and on March 25 passed the Senate by a vote of 56-43, after having two minor provisions relating to "Pell Grants stricken under the "Byrd Rule. A few hours later, the amended bill was passed by the House with the vote of 220-207.

The Health Care and Education Reconciliation Act of 2010 was signed into law by President "Barack Obama on March 30, 2010 at "Northern Virginia Community College.



On March 30, 2010 Obama signed the Health Care and Education Reconciliation Act of 2010,[1] 7 days after he had signed the "Patient Protection and Affordable Care Act into law.[2][3] At the end of 2009, each house of Congress passed its own health care reform bill, but neither house passed the other bill. The Senate bill, the "Patient Protection and Affordable Care Act, became the most viable avenue to reform following the death of Democratic Senator "Ted Kennedy and his replacement by Republican "Scott Brown. Lacking a "filibuster-proof super-majority in the Senate, the "Obama administration and House Speaker "Nancy Pelosi began encouraging the House to pass the Senate bill, then pass a new bill to amend it using the "reconciliation process.[4]

Under the Fiscal Year 2010 "budget resolution,[5] the text of the reconciliation bill submitted to the "Budget Committee had to have been reported by the relevant Committees by October 15, 2009.[6] Therefore, the Democrats combined the text of "America's Affordable Health Choices Act of 2009 as reported out of the "Ways and Means Committee, and as it was reported out of the "Education and Labor Committee, and the text of the "Student Aid and Fiscal Responsibility Act as reported out of the Education and Labor Committee.[7][8] This version was never meant to be passed; it was only created so that the reconciliation bill would comply with the Budget resolution.[6] The bill was automatically amended to the version that was meant to be passed per the special rule that was reported out of the "Rules Committee.[9] The Student Aid and Fiscal Responsibility Act was added to the Reconciliation Act as only one reconciliation bill can be passed each budget year, and it also faced a tough road through the Senate due to Republican filibuster and opposition from several centrist Democratic Senators.[10] The move was also thought to give President Obama two key victories in overhauling the health care and student loan system. It also eventually became clear that the budget savings caused by the student loan bill would become essential to the overall reconciliation bill by reducing the deficit enough for the overall bill to qualify for the reconciliation process.[10]

Passage of the legislation in the "United States House of Representatives using the "self-executing rule method was considered, but rejected by "House Democrats. Instead, on March 21, 2010, the "House held a series of votes: the first vote on ordering the "previous question on the special rule "resolution that set the terms of debate, the second on the rule itself, the third on the Senate bill, the fourth on a minority attempt to amend the reconciliation bill itself, and finally a vote on the reconciliation bill itself.[11] The reconciliation bill passed on a vote of 220–211, with all 178 Republicans and 33 Democrats voting against it.[12]

In the Senate, the bill faced numerous amendments made by the Republicans, which failed. Republicans struck two provisions dealing with "Pell Grants from the bill due to violations of budget reconciliation rules, forcing the bill to return to the House.[13] The two provisions were the fourth paragraph of Sec. 2101(a)(2)(C) and Sec. 2101(a)(2)(D).[14][15] On March 25, the bill passed the Senate by a 56–43 vote, with all Republicans and three Democrats ("Blanche Lincoln (D-AR), "Ben Nelson (D-NE) and "Mark Pryor (D-AR)) voting against it.[16] Later that same day, the House passed the amended bill by a 220–207 vote, sending it to President Obama for a signature.[17]


The Health Care and Education Reconciliation Act is divided into two titles, one addressing health care reform and the other addressing student loan reform.

Amending the Senate's Healthcare Bill[edit]

Speaker of the House "Nancy Pelosi signing the bill after it passed in the House of Representatives on March 26, 2010

The Reconciliation bill made several changes to the "Patient Protection and Affordable Care Act that was signed into law 7 days earlier on March 23, 2010. These changes include the following,[18]

Student loan reform[edit]

"Education in the United States
""Diploma icon.png "Education portal
""Flag of the United States.svg "United States portal

Title II of the reconciliation bill deals with student loan reform. The language is very similar to the "Student Aid and Fiscal Responsibility Act that passed the House in 2009; but with some slight variation.[21] The reform package included,[22]

Tax avoidance[edit]

The law codified the "economic substance" rule of "Gregory v. Helvering from 1935, which allows the IRS to invalidate "tax avoidance transactions in certain situations.[25]

Deficit effect[edit]

The "Congressional Budget Office's last estimate predicted that if both bills were passed into law in 2010, the net reduction in "federal deficits would be $143 billion over the 2010–2019 period as a result of the proposed changes in direct spending and revenues. That figure comprises $124 billion in net reductions deriving from the health care and revenue provisions and $19 billion in net reductions deriving from the education provisions.[26] The health care and revenue provisions consist in part of several new taxes, fees on health-related industries, and cuts in government spending on healthcare programs like "Medicare Advantage.[27]

See also[edit]


  1. ^ Pub.L. 111–152, 124 "Stat. 1029, codified as amended at scattered sections of the Internal Revenue Code and in 42 U.S.C., 19 U.S.C., and 20 U.S.C.
  2. ^ Obama signs higher-education measure into law William Branigin The Washington Post March 30, 2010.
  3. ^ "Obama To Sign Health Care Reconciliation Bill". tpmlivewire.talkingpointsmemo.com. March 2010. Archived from the original on 2010-03-29. 
  4. ^ Gay, Sheryl (March 17, 2010). "Health Vote Caps a Journey Back From the Brink". The New York Times. NYTimes.com. Retrieved March 21, 2010. 
  5. ^ "Concurrent Resolution on the Budget for Fiscal Year 2010 - S.CON.RES.13". 
  6. ^ a b Klein, Philip (2010-03-15). "The Health Care "Shell" Game Begins". The American Spectator. Archived from the original on 22 March 2010. Retrieved 7 April 2010. 
  7. ^ HR443P1.PS
  8. ^ HR443P2.PS
  9. ^ http://www.rules.house.gov/111/RuleRpt/111_hr4872_rpt.pdf
  10. ^ a b Brown, Carrie Budoff. "Loan bill could give Obama twin win". Fredericksburg.com. Archived from the original on 23 January 2013. Retrieved 21 January 2011. 
  11. ^ "COMMITTEE ON RULES - Senate Amendments to H.R. 3590 Patient Protection and Affordable Care Act H.R. 4872 Reconciliation Act of 2010". Rules.house.gov. Archived from the original on March 24, 2010. Retrieved March 21, 2010. 
  12. ^ Roll call vote 167, via Clerk.House.gov
  13. ^ Health Care Fix-It Bill Headed for Revote 25 March 2010
  14. ^ http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h4872eas.txt.pdf
  15. ^ http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h4872pcs.txt.pdf
  16. ^ Roll call vote 105, via Senate.gov
  17. ^ Roll call vote 194, via Clerk.House.gov
  18. ^ Reconciliation bill posted. Live Pulse. POLITICO.com March 2010
  19. ^ a b c d e f Hossain, Farhana (March 19, 2010). "Proposed Changes in the Final Health Care Bill". The New York Times. 
  20. ^ "Policies to Improve Affordability and Accountability". The White House. February 22, 2010. Archived from the original on December 30, 2012. 
  21. ^ Text of H.R.4872 as Reported in House: Health Care and Education Affordability Reconciliation Act of 2010 - U.S OpenCongress
  22. ^ a b c http://edlabor.house.gov/blog/2010/03/student-loan-reform-whats-in-i.shtml#more
  23. ^ a b "What would change if student lending legislation passes". The Washington Post. March 26, 2010. 
  24. ^ Big Changes Coming to Student Loans - US News and World Report 24 March 2010
  25. ^ Rose CA. Tax Lawyer’s Dilemma: Recent Developments Heighten Tax Lawyer Responsibilities and Liabilities. Columbia Business Law Review. Volume 2011, Issue 1.
  26. ^ "Cost Estimate for Pending Health Care Legislation". CBO Director's Blog. n.d. Archived from the original on March 25, 2010. Retrieved March 21, 2010. 
  27. ^ "Health care reform bill 101: Who will pay for reform?". Christian Science Monitor. 22 March 2010. Retrieved 22 March 2010. 

External links[edit]

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