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Health Care Reform Memo - Special Edition: January 20, 2010

A Deloitte Center for Health Solutions publication

The health care reform memos are issued on a weekly basis, highlighting news from the previous week's activities in the new administration and implications for the C-suite and various stakeholder groups.

Massachusetts Senate race: Implications for health reform legislation

Republican State Senator Scott Brown won the Kennedy U.S. Senate seat over favorite Democratic Attorney General Martha Coakley 52-47 percent with more than 2.2 million voting in a pivotal race for health reform. The race changes the composition of the U.S. Senate, giving Republicans 41 votes — enough to filibuster pending health reform legislation.

For Democratic legislative leaders supportive of health reform, two possibilities exist:

  1. The U.S. House can vote on the Senate Bill approved 60-40 December 24, thus reversing recent concessions involving union exemptions from Cadillac taxes and other changes, and the Senate bill would go to the President for signature
  2. Democratic leaders can use reconciliation (a procedure requiring only 51 votes in the Senate and 218 in the House) to vote on a new bill that would not include non-budget items like insurance regulations (waivers of pre-existing condition, lifetime limits, medical loss ratio ceilings, and others) since reconciliation is limited to budgetary items only

A third option will be a re-start of the reform process: necessarily bi-partisan due to the new composition of the Senate, and given economic circumstances, probably less costly.

By the President’s State of the Union address January 27, one of these three options will be the focus of “Health Reform 2.0”.


“As I travel around the state, one thing is clear. The people do not want this trillion dollar health reform bill that will hurt businesses and raise health costs for everyone… We will not have any closed-door meetings and backroom deals… We need to start fresh. We can do better.” 

– U.S. Senator Scott Brown (R-MA), January 19, 2010 acceptance speech.

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