On Sunday, March 21, 2010, the House is scheduled consider H.R. 4872, the Reconciliation Act of 2010, under a rule that, according to press reports, would provide for two separate votes. The first vote would be on the Reconciliation Act of 2010 (which includes so-called "fixes" to make the bill palatable to House Democrats) and the second would be a vote on the Senate health care takeover bill (H.R. 3590)-including all of the special deals and kickbacks used to leverage votes from Senators. According to reports, the rule would provide for two hours of debate on the reconciliation bill. If that bill passes, the House would proceed to a vote on the Senate health care takeover. If the Senate bill passes the House, it would immediately proceed to the president to be signed and become law, regardless of the status of the reconciliation bill.
There is, however, no assurance whatsoever that the Senate will pass the reconciliation bill as is or take any action on the bill at all. In fact, on March 18, 2010, Roll Call reported that Senate Budget Chairman Kent Conrad (D-N.D.) said, "that it is unlikely the Senate will be able to pass a health care reconciliation bill unchanged from what the House passes." In addition, the history of reconciliation legislation suggests that this is highly unlikely that the bill will be passed as is, especially given the fact that 41 Republican Senators have already pledged to reject all "Byrd Rule" violations. In fact, of the 22 times Congress has considered reconciliation legislation since 1980, there has only been a single instance where the Senate has not somehow amended the reconciliation bill, and thus required further House action. The lone exception was the Omnibus Reconciliation Act of 1983.
The rule also includes the Manger's Amendment, which would be self-executed with the passage of the rule. The Manager's Amendment would make a number of changes to the bill. The amendment would include $13.5 billion in mandatory Pell Grants funding, lower the brand name pharmaceutical tax by $800 million over the next eight years, and provides $400 million in payments for "qualified hospitals." The amendment would also reduce the tax rate on medical devices from 2.9 percent to 2.2 percent, but expands the kinds of medical devices subject to the tax by including Class I Medical devices, such as bandages, tongue depressors, and bedpans. In addition, the amendment also makes a number of timing shifts for certain sections of the bill, reduces the growth of the true out-of-pocket threshold for the Medicare prescription drug benefit, strikes a section of the bill related to state-owned banks, commonly known as the Bismarck Bank Job.