2010

Passage of Patient Protection and Affordable Care Act – Mechanics of Passage: In Senate, Majority Leader Harry Reid made these concessions: he killed public option and Medicare buy-in for 55–64-year-olds to retain vote of Joseph Lieberman; he gave Nelson special treatment for Nebraska on Medicaid (“Cornhusker kickback,” which never made it into law). Affordable Care Act thereby passed in Senate on straight party lines, 60-40, on 24 December 2010 (228-230). On 21 March 2011, House of Representatives passed Senate bill, 219 to 212, with no Republication support. On 25 March 2011, House and Senate enacted the follow-up reconciliation measure putting the bill into Law. The reconciliation measure (to which a majority of Senators had agreed in advance) made the Senate bill more progressive by raising affordability subsidies for low-income people buying subsidiaries through the exchanges; eliminating special provision for Nebraska; and increasing support for states’ expansion of Medicaid (233).