On March 21, 2010, the U.S. House of Representatives adopted without change the Patient Protection and Affordable Care Act (H.R. 3590), which was passed by the U.S. Senate on December 24, 2009. At the same time the House also passed the Health Care and Education Reconciliation Act of 2010, which includes a series of amendments to H.R. 3590 previously negotiated and agreed upon by the Democratic leadership of the House and Senate. The resulting overhaul of the country’s health care financing system is perhaps the single most important—and contentious—piece of federal social legislation in more than a generation. As of this writing, the Senate has yet to act on the House amendments, but it is widely anticipated that the Senate will do so despite intense and unified Republican opposition.

This advisory explains the key features of federal health care reform as it affects employers and group health plans. It assumes that the Senate will pass the amendments adopted by the House. For purposes of this advisory, the term “Act” means the provisions of the Senate bill that are unaffected by the House amendments; “Senate bill” means those provisions of H.R. 3590 that are subject to further change as a result of the House amendments; and “House amendments” means the changes proposed by the House to distinguish them from the provisions of the Senate bill.