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Leslie Bonacum

CCH Special Report Details Employer, Medicare Provisions of Senate Health Care Reform Bill

(RIVERWOODS, ILL., January 4, 2010) – CCH has issued a Special Report on the Senate version of health care reform legislation, detailing the provisions of the bill which passed by a vote of 60-39 on December 24, 2009. To access the Special Report, click here.

The Patient Protection and Affordable Care Act mandates significant changes to insurance coverage, including provisions affecting employers, as well as major changes for Medicare and Medicaid, according to Wolters Kluwer Law & Business, a leading provider of research information and software solutions for legal, business compliance health care and human resources professionals (

The House passed its version, The Affordable Health Care for America Act, on November 7, 2009 . There are significant differences between the two measures and a Conference Committee will be necessary to reconcile them.

The Senate bill provides a financial penalty for employers not offering coverage, with relief and tax credits for small employers.

“If health care reform passes, all but the smallest employers will be assessed some sort of tax or penalty if they do not offer coverage to their employees,” said Stephen Huth, Managing Editor of Spencer’s Benefits Reports produced by Wolters Kluwer Law & Business.

The Senate bill, like the House measure, would prohibit taxpayers from using health flexible spending arrangement (FSA) dollars to pay for over-the-counter medications (unless prescribed by a health professional) and also cap annual contributions to a health FSA offered under an employer-sponsored cafeteria plan at $2,500, indexed for inflation.

Health Insurance Exchanges But No Public Option

The Senate bill requires that, like businesses, individuals either provide insurance for themselves or face a financial penalty. Those covered by an employer would meet this requirement.

Like the House bill, the Senate measure establishes a new Health Insurance Exchange in which consumers who are not covered by their employer can comparison shop from among health care plans. Unlike the House, the Senate did not provide for a “public option” to be offered through the exchanges. It also provides premium assistance tax credits and reduced cost sharing for lower-income individuals.

“The public option is one of the more controversial parts of the House bill, and likely will not be included as the measure moves through the Conference Committee,” Huth said.

The Senate bill raises money to finance its reforms through a new tax on high-cost group insurance and an additional Medicare tax on individual earned income over $200,000. In addition, individuals who fail to maintain minimum essential coverage would pay a yearly penalty.

Medicare, Medicaid Affected

A significant part of the House bill is devoted to changes in Medicare and Medicaid, according to Paul Clark, Senior Medicare Analyst with Wolters Kluwer Law & Business.

“Savings in these programs can help finance other parts of the reform program,” Clark said. “In addition, by setting standards of what it will and will not pay for, Medicare/Medicaid can affect the entire health care system, encouraging efficient and cost-savings practices in the treatment of all patients.”

Changes include reducing payments to Medicare Advantage providers, measures to close the “donut hole” in Part D drug coverage, and incentives to provide a better link between quality outcomes and payments.

“Dozens of changes have been proposed, in areas ranging from reducing hospital readmissions to expanding rural health care to increasing the pool of primary health care providers,” Clark said. “Even if health care reform as a whole is unsuccessful, many of these changes are likely to eventually become law.”

For More Information

To access the CCH Special Report, click here.

CCH’s comprehensive book, Law, Explanation and Analysis of Health Care Reform Legislation will be available immediately following the final passage of the bill. Single-copy price is $149, but those who pre-order can receive a $20 discount by using priority code Y6804. For more information or to order, click here or call 1-800-248-3248.

For additional timely and expert discussion of health reform, visit Health Reform Talk, a blog to help professionals decipher the many codes and puzzles of health care reform. The blog, at, covers a wide range of health reform issues and draws on the expertise of Wolters Kluwer Law & Business analysts. Wolters Kluwer Law & Business also publishes Health Care Reform Update NetNews , a free weekly newsletter delivered via e-mail. Click here to view an issue of the Health Care Reform Update NetNews.

About Wolters Kluwer Law & Business

Wolters Kluwer Law & Business is a leading provider of research products and software solutions in key specialty areas for legal and business professionals, as well as casebooks and study aids for law students. Its major product lines include Aspen Publishers, CCH, Kluwer Law International and Loislaw. Its markets include health care organizations, law firms, law schools, corporate counsel and professionals requiring legal and compliance information. Wolters Kluwer Law & Business, a unit of Wolters Kluwer, is based in New York City and Riverwoods, Ill.

Wolters Kluwer is a leading global information services and publishing company. The company provides products and services for professionals in the health, tax, accounting, corporate, financial services, legal, and regulatory sectors. Wolters Kluwer had 2008 annual revenues of €3.4 billion, employs approximately 20,000 people worldwide, and maintains operations in over 35 countries across Europe, North America, Asia Pacific, and Latin America. Wolters Kluwer is headquartered in Alphen aan den Rijn, the Netherlands. Its shares are quoted on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Visit for information about our market positions, customers, brands, and organization.

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