Senate approves sweeping health reform bill, 60-39

Washington -- The Senate approved comprehensive health system reform legislation by a strict party-line vote of 60-39 during a rare Christmas Eve session.

Passage of the Patient Protection and Affordable Care Act was assured the previous day when the Senate moved to end debate and proceed to a final vote, the last of a series of procedural motions that required 60 votes to proceed. The legislation now goes to a conference committee, where lawmakers will try to negotiate a consensus bill between the Senate measure and a much different House version that passed by a vote of 220-215 on Nov. 7.

"Today, the Senate took an historic vote to improve our nation's health care system by expanding coverage to millions of Americans and strengthening the private insurance market to better serve the patients who rely on it," American Medical Association President J. James Rohack, MD, said in a statement. "The AMA supported passage of the bill because it contains a number of key improvements for our health care system, which currently is not working for far too many patients or the physicians who dedicate their lives to patient care."

Prior to the Senate vote, AMA President-elect Cecil B. Wilson, MD, announced the Association's backing during a Dec. 21 Capitol Hill appearance with Senate Majority Leader Harry Reid (D, Nev.) and other top Democrats. Dr. Wilson noted that the leaders had amended the bill to eliminate some earlier provisions that had prompted AMA concerns, such as a one-year Medicare pay patch that would have led to a projected 23% cut in 2011, an elective cosmetic surgery tax and a proposed Medicare enrollment fee.

But the AMA will continue to push for additional changes to the legislation during the conference negotiations. The Association, for instance, said it will not support a final House-Senate bill unless lawmakers make key revisions to: a proposed independent Medicare advisory board that could impose pay cuts on physicians, a plan to release Medicare data in the form of physician performance reports, and a requirement that doctors participate in Medicare quality reporting or face penalties.

In order to preserve AMA backing for the health system reform bill, the Association said Congress must also demonstrate that it is on track to approve separate legislation permanently repealing the Medicare physician payment formula before the current rate freeze expires at the end of February.