The Senate voted 56-43 on Thursday to approve a set of improvements to the sweeping health care reform bill that was passed by the House on Sunday night, but it needed to send the bill back to the House after two provisions were changed in the student lending part of the bill.

The House approved the final changes later in the day by a 220-207 vote. The health care reconciliation bill increases tax credits to help pay for insurance premiums, closes the Medicare prescription drug “donut hole” and aims to reduce waste, fraud and abuse in Medicare. 

The reconciliation bill also eliminates the so-called “Cornhusker Kickback,” which would have covered $100 million in increases in Medicaid payments only in the state of Nebraska, as well as special treatment for Medicare Part D subsidies for Florida senior citizens. However, the bill preserves the so-called “Louisiana Purchase,” providing an extra $300 million in Medicaid spending for the Hurricane Katrina ravaged state.

“The bill we passed today is a set of common-sense improvements to the historic health care reform law,” said Senate Finance Committee Chairman Max Baucus, D-Mont., in a statement.

The reconciliation bill scales back the 40 percent tax on so-called “Cadillac” health insurance plans, delaying it from 2013 to 2018, and increasing the threshold from $8,500 to $10,200 for individuals and from $23,000 to $27,500 for families. It also includes a Medicare surtax of 0.9 percent on wages and 3.8 percent on investment income for individuals with adjusted gross incomes over $200,000, and $250,000 for couples.

The changes that necessitated the move back to the House involved provisions in a student lending bill that was added to the health care reform legislation in the House. The Senate parliamentarian agreed with Republicans on technical fixes to provisions that increase Pell grants for college students and reduce subsidies to private lenders.

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