Medicaid: Changes Made by the Reconciliation Act of 2010 to Senate-Passed Patient Protection and Affordable Care Act (H.R. 3590)

Evelyne P. Baumrucker, Coordinator
Analyst in Health Care Financing

Cliff Binder, Coordinator
Analyst in Health Care Financing

Julie Stone
Specialist in Health Care Financing

Elicia J. Herz
Specialist in Health Care Financing

On December 24, 2009, the Senate passed health reform legislation that would, among other changes, make statutory changes to Medicaid and the Children's Health Insurance Program (CHIP). The Patient Protection and Affordable Care Act (H.R. 3590) is under consideration by the House. 

On March 18, 2010, the House Rules Committee issued an amendment in the nature of a substitute to H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010, (hereafter referred to as the reconciliation bill). If passed, this reconciliation bill would amend H.R. 3590. 

The reconciliation bill includes two titles: (1) Coverage, Medicare, Medicaid, and Revenues, and (2) Education and Health. Title I contains provisions related to health care and revenues, including modifications to H.R. 3590's Medicaid and CHIP provisions. Title II includes amendments to the Higher Education Act of 1965, which authorizes most of the federal programs involving postsecondary education, and other health amendments. 

This report provides a brief summary of H.R. 3590 followed by a discussion of the modifications that would be made to the Senate-passed bill by the Medicaid and CHIP provisions contained in the reconciliation bill. This report reflects legislative changes contained reconciliation bill published by the House Committee on Rules on March 18, 2010. Selected highlights of the Medicaid and CHIP changes that would be made by the reconciliation bill to H.R. 3590 include provisions that: 

• increase primary care physician payment rates for selected patient treatments; 

• revise the definition of the average manufacturer price (AMP) to help make AMP more closely reflect the manufacturers' average prices; 

• delay the effective date of the Community First Choice Option; 

• change state FMAP rates for newly eligible populations; 

• provide an increase in the territories' spending rate caps beginning with the second quarter of FY2011; 

• provide additional program integrity funding through indexing of the Medicaid Integrity Program for fiscal years beginning with FY2010; and 

• modify Medicaid Disproportionate Share Hospital (DSH) payment reductions in H.R. 3590.


Date of Report: March 19, 2010
Number of Pages: 15
Order Number: R41125
Price: $19.95

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