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What does health care reform mean for small business

Now that the health care bill and reconciliation have been passed by Congress and signed into law by President Obama, the next step will be writing regulations to enforce the new laws. This means that exactly how these new laws will impact American Rental Association (ARA) members and the equipment rental industry is unclear.

Both John Deere and Caterpillar last week announced their intention to respectively take a $150 million and $100 million write-down in the second quarter in anticipation of what the new health care laws might cost those companies.

The ARA, as well as the Small Business Coalition for Affordable Healthcare, is continuing to study the new law in order to be able to properly explain exactly how the law might impact small businesses.

Last week, a variety of different media outlets attempted to spell out what the bill means for consumers and small business, but any conclusions made at this time are premature.

As a service to Rental Pulse readers, however, we offer the following links to stories written about what you could see as a result of the legislation:

General articles about the provisions in the health care reform bills:

Articles specific to the provisions concerning small businesses:

Click here to read the full text of H.R. 3590, the Patient Protection and Affordable Care Act.

Click here to read the full text of the amendment to the Patient Protection and Affordable Care Act, H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010.

Click here to read a summary of H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010.


Special report: Next steps after Sunday's vote

By John McClelland
ARA vice president, Government Affairs

I am not accustomed to staying up past midnight on a Sunday night and the U.S. House of Representatives is not accustomed to being in session on a Sunday. However, Sunday, March 21, 2010, was a historic day that began with drama and uncertainty and ended with the knowledge that the way we buy health insurance in the United States has changed forever. The outcome became certain after a 4 p.m. news conference at which Rep. Bart Stupak (D-Mich.) announced that he and several other members of his pro-life group of Democratic legislators had reached agreement with the White House on the wording of an executive order that would preserve a strong prohibition on the use of federal funds for abortion. With Stupak and his supporters firmly in the ”yes” column for final passage, the outcome became a foregone conclusion.

Even if you were watching the proceedings Sunday, you may have been confused about what exactly was happening, so here is a basic guide to the votes that were taken throughout the day:

First there was a vote on the rule. The rule, set the terms of debate on the House floor. The rule passed by a vote of 224-206 will all Republicans and 28 Democrats voting against the rule. Contrary to earlier signals about having only one vote on a hybrid package so that House Members would not have to vote on the Senate bill so many had said they disliked, the final rule called for two votes, one on the Senate bill and another separate vote on the Reconciliation bill that fixes certain provisions of the Senate bill. Confused yet?

Well things got a bit tricky even before this. The next vote after the vote on the rule was the vote on the Senate bill, which just happened to be H.R. 3950. The Senate had to use a House bill to avoid Constitutional problems that require all legislation containing revenue measures to originate in the House. H.R. 3950 as amended passed the House by a vote of 219-212 with 34 Democrats (Adler-N.J., Altmire-Pa., Arcuri-N.Y., Barrow-Ga., Berry-Ark., Boren-Okla., Boucher-Va., Bright-Ala., Chandler-Ky., Childers-Miss., Davis –Ala., Davis-Tenn., Edwards-Texas, Herseth Sandlin-S.D., Holden-Pa., Kissell-N.C., Kratovil-Md., Lipinski-Ill., Lynch-Mass., Marshall-Ga., Matheson-Utah, McIntyre-N.C., McMahon, N.Y., Melancon-La., Minnick-Idaho, Nye-Va., Peterson-Minn., Ross-Ark., Shuler-Tenn., Skelton-Mo., Space-Ohio, Tanner-Tenn., Taylor-Miss., Teague-N.M.) breaking ranks and voting “no” on the bill. With this vote, the Senate bill goes to President Obama to be signed into law.

The unusual part of the series of events that has occurred to achieve final passage of the health care reform legislation came in the two votes that occurred after final passage of the Senate bill. The House brought up H.R. 4872, The Reconciliation Act of 2010. H.R. 4872 contains provisions that will “fix” some provisions of H.R. 3950 that House members find most objectionable. The catch is that any provision that is addressed in H.R. 4872 must have a primary impact on the budget or it will be ruled out of order in the Senate where the rules governing reconciliation are very strict, but where a simple majority of 51 votes can win passage of legislation. That is why the abortion issue could not be considered in H.R. 4872.

The first vote on H.R. 4872 was on a Motion to Recommit. If this motion had passed, the bill would have been sent back to the Budget Committee for more work, potentially killing the bill. The motion failed by a vote of 220-211. That set up a final vote on H.R. 4872 which passed by a vote of 220-211. That vote sent H.R. 4872 to the Senate for consideration. The Senate may pass H.R. 4872 as it stands, they may amend it and send it back to the House, or they may fail to pass the bill altogether.

If the Senate fails to act on H.R. 4872, provisions in the Senate bill (H.R. 3950) will remain in force since the President has signed that bill today. These are provisions like the special deal for Nebraska on Medicaid funding or higher taxes on “Cadillac” health plans. Bottom line is that health care reform has passed the Congress and the President will sign it. If changes are made using the reconciliation process, they will occur only if and when the President signs that bill.

One final word: On Monday, I received an e-mail from someone who opposed the health care reform bill and is running for Congress in November. He said that he will work to repeal the health care reform bill. Let me remind everyone that even if Republicans retake the House and Senate in November, they are unlikely to have the 60 votes in the Senate they will need to pass any legislation that overturns H.R. 3950, let alone the two-thirds majority it takes in both Houses to override a presidential veto.

We have said many times that elections have consequences and that it is very important that every citizen exercises his or her right to vote in our democracy. I think the passage of health care reform legislation is the clearest example that we have seen in a generation of why elections matter.



View from Washington, D.C.:
Senate passes health care bill


ARA Vice President, Government Affairs

Has Harry Reid found the magic formula for health care reform? Only time will tell. What is certain at this moment is that Sen. Reid (D-Nev.) has been able to pull together 60 Democrats in the Senate to vote yes on the final passage of The Patient Protection and Affordable Care Act of 2009. As expected, the vote did not occur until the early morning of Christmas Eve. Beyond reporting that the bill has passed the Senate, there is not much we can say. The fact is that before we have a law in the United States, both the House and Senate have to pass bills, and then they have to agree on a final product called a conference report which both Houses vote on again. Once the House and Senate have passed identical language, the bill can be sent to the president to be signed into law.

The only way to avoid a conference on this bill is to have the House take what the Senate has passed and vote it out of the House with the 218 votes necessary to pass. There are some technical reasons this could happen and many of those who are watching this process closely think that is just about the only way health reform is going to make it to the president. Liberal members of the House have said they want to keep things like the public option that was stripped from the Senate bill. A conference between the House and Senate would create an opportunity for those members to pull the bill back to the left. However, any such changes in the deal that allowed the Senate to pass the bill could kill the deal in later Senate votes. In short, this is now a game of chicken of the highest order and it is anybody’s guess as to who blinks first.

What does seem clear is that Democratic moderates in the Senate like Ben Nelson (D-Neb.), Blanche Lincoln (D-Ark.) and Mary Landrieu (D-La.), as well as independent Joe Lieberman (ID-Conn.), have a great deal of power to make or break a deal and President Obama will be telling liberals, and particularly House liberals, that they cannot kill a bill that does not pass their ideological purity test.


View from Washington, D.C.:
Long bumpy road ahead


ARA Vice President, Government Affairs


On Nov. 7, 2009, the U.S. House of Representatives passed H.R. 3962 by a vote of 220-215 in a rare Saturday session. The U.S. Senate, where Democrats have a supposed 60-vote “filibuster proof” majority, will next consider its own version of a health care reform bill.  So what does the Senate bill look like? Nobody knows. After weeks behind closed doors, Democratic leaders in the Senate have not unveiled their health care reform bill, which is supposed to be a “marriage” between the bills passed by the Senate Finance Committee and the Health Education, Labor and Pensions Committee. With senators like Joe Lieberman (I-Conn.) saying they will vote against a bill containing a public insurance option and Ben Nelson (D-Neb.) demanding tough anti-abortion language similar to that included in the amended House bill, nobody is willing to speculate about what will be in the bill that Senate Majority Leader Harry Reid (D-Nev.) will ultimately try to bring to the Senate floor.

There is one thing we can count on — whatever Sen. Reid brings to the floor will almost certainly be changed through a series of amendments that are sure to be offered by senators from both sides of the aisle. For those who can’t get enough of the political process, the next several weeks, or even months, will be packed with action. Look for all sorts of strategies, compromises and deals to come and go throughout the process. There is only one goal in mind — get 60 votes on final passage. Before that vote can be cast, however, there will be many more votes. So hold on to your hats, it is going to be a bumpy ride for health care. Stay tuned to RentalPulse for the latest information on the debate and ways you can make a difference by taking action.


ARA backs Small Business Coalition in opposition to health care reform bill

The American Rental Association (ARA) was among 58 employers, trade associations and organizations in the Small Business Coalition for Affordable Health Care to sign a letter opposing H.R. 3962, the Affordable Health Care for America Act. The letter was sent last week to all 435 members of the House of Representatives.

The letter voiced the group’s concern about the “devastating impact this legislation will have on their businesses, employees and overall economic recovery” and detailed what the group sees as “egregious provisions” such as an employer mandate tied to a punitive “pay-or-play,” a surtax, a public option, taking working solutions off the table, adding a big benefit package and more mandates and a big price tag for the government which would mean a bigger bill for small business.

To see a copy of the letter, click here.

This effort followed ARA’s own “call to action” last week, detailed in a Nov. 4 special RentalPulse asking members to contact their U.S. representative and tell them to vote “no” on H.R. 3962. The bill was introduced in the U.S. House of Representatives on Oct. 30. It was unclear late Friday if the bill would be voted on during the weekend or during the week of Nov. 9. 

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