health care and education reconciliation act of 2010 health care and education reconciliation act of 2010 the health care and education reconciliation act of 2010 (pub. l. 111–152 (text) (pdf), 124 stat. 1029) is a law that was enacted by the 111th united states congress, by means of the reconciliation process, in order to amend the affordable care act (aca) (pub. l. 111–148 (text) (pdf)). the law includes the student aid and fiscal responsibility act, which was attached as a rider. health care and education reconciliation act of 2010long titlean act to provide for reconciliation pursuant to title ii of the concurrent resolution on the budget for fiscal year 2010 (s. con. res. 13).enacted bythe 111th united states congresscitationspublic law111-152statutes at large124 stat. 1029 thru 124 stat. 1084 (55 pages)codificationacts amendedaffordable care actlegislative historyintroduced in the house as h.r. 4872 by john spratt (d-sc) on march 17, 2010committee consideration by budgetpassed the house on march 21, 2010 (220–211)passed the senate on march 25, 2010 (56-43) with amendmenthouse agreed to senate amendment on march 25, 2010 (220–207)signed into law by president barack obama on march 30, 2010 this article is part of a series onhealthcare reform in theunited states history debate legislation preceding social security amendments of 1965 emtala (1986) hipaa (1996) medicare modernization act (2003) psqia (2005) superseded affordable health care for america (h.r. 3962) america's affordable health choices (h.r. 3200) baucus health bill (s. 1796) proposed american health care act (2017) medicare for all act (2021, h.r. 1976) healthy americans act (2007, 2009) health security act (h.r. 3600) latest enacted affordable care act (h.r. 3590) health care and education reconciliation act (h.r. 4872) reforms obama administration proposals public opinion reform advocacy groups rationing insurance coverage systems free market health insurance exchange nationalized insurance publicly-funded single-payer canadian vs. american two-tier universal third-party payment models all-payer rate setting capitation fee-for-service global payment united states portal health care portal house votes by congressional district. democratic yea on both votes democratic nay on both votes democratic nay on first vote, not voting on second republican nay on both votes republican nay on first vote, not voting on second republican nay on first vote, no representative seated on second no representative seated senate vote by state. democratic yea democratic nay independent yea republican nay republican not voting it was passed by the u.s. house of representatives on march 21, 2010, by a vote of 220–211, and passed the senate by a vote of 56–43 on march 25, after having two minor provisions relating to pell grants stricken under the byrd rule. a few hours later, the amended bill was passed by the house with the vote of 220–207. the act was signed into law by president barack obama on march 30, 2010, at northern virginia community college. legislative history at the end of 2009, each house of congress passed its own health care reform bill, but neither house passed the other bill. the senate bill, the patient protection and affordable care act, became the most viable avenue to reform following the death of democratic senator ted kennedy and his replacement by republican scott brown. lacking a filibuster-proof super-majority in the senate, the obama administration and house speaker nancy pelosi encouraged the house to pass the senate bill and then pass a new bill to amend it using the reconciliation process. under the fiscal year 2010 budget resolution, the text of the reconciliation bill submitted to the budget committee had to have been reported by the relevant committees by october 15, 2009. therefore, the democrats combined the text of america's affordable health choices act of 2009 as reported out of the ways and means committee, and as it was reported out of the education and labor committee, and the text of the student aid and fiscal responsibility act as reported out of the education and labor committee. this version was never meant to be passed; it was only created so that the reconciliation bill would comply with the budget resolution. the bill was automatically amended to the version that was meant to be passed per the special rule that was reported out of the rules committee. the student aid and fiscal responsibility act was added to the reconciliation act as only one reconciliation bill can be passed each budget year, and it also faced a tough road through the senate due to republican filibuster and opposition from several centrist democratic senators. the move was also thought to give president obama two key victories in overhauling the health care and student loan system. it also eventually became clear that the budget savings caused by the student loan bill would become essential to the overall reconciliation bill by reducing the deficit enough for the overall bill to qualify for the reconciliation process. passage of the legislation in the united states house of representatives using the self-executing rule method was considered, but rejected by house democrats. instead, on march 21, 2010, the house held a series of votes: the first vote on ordering the previous question on the special rule resolution that set the terms of debate, the second on the rule itself, the third on the senate bill, the fourth on a minority attempt to amend the reconciliation bill itself, and finally a vote on the reconciliation bill itself. the reconciliation bill passed on a vote of 220–211, with all 178 republicans and 33 democrats voting against it. in the senate, the bill faced numerous amendments made by the republicans, which failed. republicans struck two provisions dealing with pell grants from the bill due to violations of budget reconciliation rules, forcing the bill to return to the house. the two provisions were the fourth paragraph of sec. 2101(a)(2)(c) and sec. 2101(a)(2)(d). on march 25, the bill passed the senate by a 56–43 vote, with all republicans and three democrats (blanche lincoln (d-ar), ben nelson (d-ne) and mark pryor (d-ar)) voting against it. later that same day, the house passed the amended bill by a 220–207 vote, sending it to president obama for a signature. on march 30, 2010 obama signed the health care and education reconciliation act of 2010, 7 days after he had signed the patient protection and affordable care act into law. provisions