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Federal Legislation
May 19, 2010

Senate “Patient Protection and Affordable Care Act”—Substituted into H.R. 3590

The House passed H.R. 3590 on March 21, 2010, in a party line vote, 219–212. It was signed into law on March 23, 2010.

HSLDA has been forced into the debate on health care because the leadership in the House and Senate has insisted on creating home visitation programs in their health care legislation.

After numerous false starts, dropped passes, and goal line fumbles, it appears that the health care reform proposal may still have life in it.

Since President Obama’s summit on February 25, Democrat leaders have been working to have the U.S. House of Representatives pass the Senate’s health care reform bill, “The Patient Protection and Affordable Care Act,” which was substituted into H.R. 3590. This is the same bill that the U.S. Senate passed on Christmas Eve. It contains numerous unpopular provisions, including special deals for certain states, federal subsidies for health insurance programs that include abortion, and home visitation programs.

If the House passes this bill, President Obama has promised he would sign it into law. Then, Democrat leaders have promised to write a new bill that is supposed to fix many of the unpopular provisions, and pass it into law via a technical path called budget reconciliation.

HSLDA strongly opposes the health care reform proposal that is being pushed through the House of Representatives. This mammoth bill will not only expand the government’s role in early education, it will interfere with medical decisions between you and your doctor and force employers to make decisions that could lead to lay-offs or lower wages. While health care reform is needed, the current health care reform bill is not the answer, as it will bring higher taxes and more government control over families.

Furthermore, it is doubtful that Congress will pass a second bill to fix many of the unpopular provisions in the original bill. In this current political environment, there are no guarantees that another health care bill could get through Congress, even if President Obama pushed hard for it.

“The Patient Protection and Affordable Care Act” was substituted into H.R. 3590 and is Senator Majority Leader Harry Reid’s (D-NV) health care bill. Senator Reid’s bill is the fifth out of six health care bills written this year that include home visitation programs. Harry Reid’s bill is a combination of the two bills that passed Senate committees (Finance Committee and the Health, Education, Labor, and Pensions Committee) previously in the year.

Senator Reid presented his 2,074-page bill late Thursday night, November 18, 2009. The Senate passed the bill 60–39 on Christmas Eve at 7 a.m.

9/17/2009Referred to the House Committee on Ways and Means.
10/8/2009On motion to suspend the rules and pass the bill; agreed to by the yeas and nays: (2/3 required): 416–0.
10/8/2009Received in the Senate. Read the first time. Placed on Senate legislative calendar under “Read the First Time.”
10/13/2009Read the second time. Placed on Senate legislative calendar under “General Orders.” Calendar No. 175.
10/18/2009Amendment in the nature of a substitute intended to be proposed by Mr. Reid.
11/21/2009Cloture on the motion to proceed to the bill invoked in Senate by Yea-Nay Vote. 60–39.
11/21/2009S.AMDT.2786 Amendment SA 2786 proposed by Senator Reid.
12/3/2009S.AMDT.2786 S.AMDT.2786 Considered by Senate.
12/24/2009Passed/agreed to in Senate: Passed Senate with an amendment and an amendment to the title by yea-vay vote of 60–9. Record vote number: 396.
3/21/2010Resolving differences—House actions: On motion that the House agree to the Senate amendments; Agreed to by recorded vote: 219–212 (Roll no. 165).
3/21/2010Cleared for White House.
3/22/2010Presented to President.
3/23/2010Signed by President.
3/23/2010Became Public Law No: 111-148.

Sponsor: Sen. Harry Reid (NV)

Bill Text (requires Adobe Acrobat Reader)

HSLDA’s Position:

Talking Points:

“The Patient Protection and Affordable Care Act” establishes home visitation programs by adding an amendment to the Social Security Act: Section 2951 on pages 568–595 will create “Maternal, Infant, and Early Childhood Home Visiting Programs.” To receive these grants states must establish goals for the next 3–5 years to:

  • Improve maternal and newborn health;
  • Prevent child injuries and reduction of emergency room visits;
  • Improve school readiness and achievement;
  • Reduce crime or domestic violence;
  • Improve a families economic self-sufficiency; and
  • Improve the coordination and referrals for other community resources and supports.

“The Patient Protection and Affordable Care Act” could lead to politically influenced parenting classes that pressure parents to raise their children how the government dictates: All the details of the home visitation programs are open to being politically influenced by government bureaucrats who may think that they know more about parenting than do parents. They may pressure parents to adopt child-rearing methods that are against the family’s religious beliefs. Home visitation officials may even threaten families with abuse and neglect investigations if the families do not choose to follow the official parenting education models.

“The Patient Protection and Affordable Care Act” will result in a huge increase in federal involvement in the home: While the act does assure that participation in the home visitation programs are voluntary, we are still concerned by the increase of federal involvement in early education and home visitations. These issues should left to state and local officials.

To apply for a grant, the federal government requires that a needs assessment be completed in each of the state’s school districts to identify “at-risk” communities. Those deemed “at-risk” will become priority communities for the home visitation programs. One or more of the following could be used to identify an “at risk” home:

  • Low-income families.
  • Families with pregnant women who have not attained age 21.
  • Families that have a history of substance abuse or neglect or have interactions with child welfare services.
  • Families that have a history of substance abuse or need substance abuse treatment.
  • Families that have users of tobacco products in the home.
  • Families that are or have children with low student achievement.
  • Families with children with developmental delays or disabilities.
  • Families with individuals who are serving or formerly served in the armed forces, including such families that have members of the armed forces who have had multiple deployments outside of the United States.

HSLDA sees these assessments made by the government as an invasion of privacy. Not only will states need to submit reports to the Secretary of Health and Human Services on these home visitation programs, but officials will be required to report to the federal government all the additional home visitation services that the states currently provide.

If a state fails to meet its goals by the new home visitation program’s third year, a new goal plan will need to by drawn up with technical assistance from the U.S. Secretary of Health and Human Services and the secretary’s self-appointed advisory panel. The new plan will have to include “provisions for the Secretary to monitor implantation of the plan and conduct continued oversight of the program, including through submission by the entity of regular reports to the Secretary.”