NU Online News Service, March 23, 2:48 p.m. EDT

WASHINGTON—President Obama has signed the historic bill reforming regulation and financing of health care, saying the bill provides "reforms that generations of Americans have fought for and marched for and hungered to see."

The bill is the Patient Protection and Affordable Care Act, (H.R. 3590.)

 At the same time, the reconciliation measure the Senate is considering to finance the reforms cleared a major hurdle when the Senate parliamentarian ruled informally that a provision of the bill imposing an excise tax on so-called “Cadillac plans would not violate budget rules.

Democrats needed the ruling in order to pass the bill with a simple 51-vote majority. Otherwise, the bill would have needed 60 votes in order to limit debate, votes Republicans say they would not provide.

It also allows Democratic incumbents in predominantly Republican states to bolster their reelection chances by voting against the measure.

At the same time, several Democratic officials and lobbyists projected that Democrats can count on 52 votes for the reconciliation package—and that the final vote will likely occur before the Senate leaves Friday for the two-week Easter recess.

In his comments at the signing ceremony, President Obama said that, “Today, after almost a century of trying -- today, after over a year of debate -- today, after all the votes have been tallied, health insurance reform becomes law in the United States of America."

While some aspects of the bill won't go into effect for years, Obama stressed that a "host of desperately needed reforms will take effect right away, this year," particularly the restrictions on insurance companies. Obama said the bill enshrines "the core principle that everybody should have some basic security when it comes to their health care."

The nonpartisan Congressional Budget Office said the legislation would extend coverage to 32 million Americans who lack it, ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade. If realized, the expansion of coverage would include 95 percent of all eligible individuals under age 65.

Meanwhile, insurance industry officials continued to provide a mixed reaction to the legislation.

For example, David Sampson, president and chief executive officer of the Property Casualty Insurers Association of America, lauded Congress’ decision to exclude from the bill provisions repealing the exemption from antitrust provisions afforded to health insurers under the McCarran-Ferguson Act.  

“We appreciate that Congress recognized repealing McCarran-Ferguson would not provide any benefits to the consumer or the insurance marketplace,” he said.

Tom Currey, president of the National Association of Insurance and Financial Agents, said that NAIFA members “are pleased that Congress has recognized the positive role that health insurance agents can play in helping small businesses and individuals acquire appropriate health insurance plans,” noting that the bill makes it possible for agents to continue to perform their traditional role.  

At the same time, he had mixed comments about the reconciliation measure that passed the House Sunday and is now being considered by the Senate.

 “The so-called ‘sidecar’ bill strengthens the individual mandate, and we support that,” Mr. Currey said.

On the other hand, he said, “We think the proposed 3.8 percent Medicare tax on the unearned income, including annuity payments, of higher income earners, sets a very bad precedent and should be dropped from the reconciliation package.”

Mr. Currey argued that, “We need to encourage people to put at least some of their retirement funds into lifetime annuities – not discourage them. This proposal will certainly do the latter.”

Janet Trautwein, CEO of the National Association of Health Underwriters, said the bill that became law today “does little” to truly rein in healthcare costs.

She also said the bill contains “an unworkable individual mandate which will encourage people to wait until they are sick to purchase coverage, causing premiums to skyrocket significantly for everyone.”