Late Sunday evening, the House of Representatives voted on and passed the Senate-passed "Patient Protection and Affordable Care Act" (H.R. 3590) and the "Reconciliation Act of 2010" (H.R. 4872). H.R. 3690 contains a one year extension of the 2% urban, 3% rural and super rural Medicare ambulance relief, retroactive to January 1, 2010. Although the Reconciliation Act—which contains various modifications to H.R. 3590—must now be passed by the Senate, H.R. 3590 now goes to the President for his signature. In the coming days, CMS will issue a notification as to how the Medicare ambulance relief extensions will be implemented. We will keep you posted.

The following is a description of yesterday's consideration of health reform legislation by the House.

Consideration of H Res 1203 - Rules for Debate

The House first held a vote on the House resolution setting the rules for the debate on the health reform bill. Republicans raised various objections, which were all voted down. During the floor proceedings, Rep. Stupak (D-MI) held a press conference to announce that he and President Obama reached an agreement that the President will issue an Executive Order prohibiting any federal funding from being used to pay for abortion under the health care reform legislation. Rep. Stupak had led a group of House Democrats in opposition to the Senate legislation because they did not believe it went far enough in preventing government funds from being used for abortion services. With Rep. Stupak's announcement, Democrats were virtually assured of sufficient votes to pass the health reform bill. The House approved the rules for debate by a vote of 224-202.

H.R. 3590 – Patient Protection and Affordable Care Act (Senate-passed health reform bill)

The House next voted on the Senate health reform bill, H.R. 3590. This bill includes a one-year extension of Medicare ambulance relief. The House approved the legislation 219-212. No Republicans voted for the bill, and 34 Democrats voted against it, including: Reps. Adler, Altmire, Arcuri, Barrow, Berry, Boren, Boucher, Bright, Chandler, Childers, Davis (AL), Davis (TN), Edwards (TX), Herseth Sandlin, Holden, Kissell, Kratovil, Lipinski, Lynch, Marshall, Matheson, McIntyre, McMahon, Melancon, Minnick, Nye, Peterson, Ross, Shuler, Skelton, Space, Tanner, Taylor, and Teague.

Motion to Recommit

The Republicans then made a motion to recommit the bill to Committee so that it could be amended. This motion failed, 199-232.

H.R. 4872 – Reconciliation Act of 2010

Finally, the House voted on H.R. 4872, the Reconciliation Act of 2010. This legislation contains various modifications to H.R. 3590 that the House requested before committing to hold a vote on the Senate bill. This bill was approved 220-211.

The reconciliation bill must now be passed in the Senate where it will be considered under the Senate's reconciliation process. Under this process, the Senate needs only 51 votes for final passage. Senate consideration of the Reconciliation Act could begin as early as Tuesday.