Saga of Health Care

As the Congress struggled to enact Health Care Reform legislation, the process we witnessed requires some explanation because it was, in many ways, a historical lesson in legislative procedure.
First, we saw the U.S. House of Representatives whip itself into shape so that all committees of jurisdiction (the House Ways and Means, Energy and Commerce and Labor, Health and Human Services subcommittee of the Appropriations Committee) and the House leadership were on the same page. They did this without any support from the minority (Republican) party. In the House, a simple majority (218 votes) is needed to pass legislation and with 250 Democrats passing their version of the Health Care Reform legislation was completed by summer of 2009. The bill would have offered health care insurance coverage to all through a government plan; eliminated insurance denials for pre-existing conditions; required everyone and every employer to have health care coverage; reworked Medicare savings and taxes to pay for the coverage; and developed new health care information technology (IT) and workforce programs.
Enter the U. S. Senate, where in order to pass legislation (except for budget reconciliation), it is required that there be enough votes to shut off debate (i.e. prevent a filibuster); therefore the Democrats needed 60 votes for the bill to bring it up for a vote and avoid a filibuster. In the fall of 2009, the Senate began an effort to develop and pass its version of Health Care Reform and did not complete action until Christmas Eve of that year.
As passed, the Senate bill did not contain a government plan, (it had a private plan to cover those not insured), but did have a requirement for individuals and companies to purchase health insurance; a provision eliminating insurance coverage denials for pre-existing conditions; and, contained several Medicare and tax provisions to cover the cost of the program. Among those Medicare provisions were a "Productivity Adjustment" for laboratory services and a Laboratory Fee Schedule reduction of 1.75%.