There are currently 431 members of the House of Representatives. Assuming all Republicans vote no, Speaker Pelosi needs 216 Democrats to vote yes - meaning she can afford to lose 37 of her members at most.
As of now, CBS has tallied 19 Democrats who say they plan to vote no; 48 more say they are on the fence.
Those members are getting so many calls from constituents on both sides that house phone lines were overloaded today. Back in their home districts, the pressure is just as intense.
In an interesting development, the House of Representatives approved by voice vote a further extension of the COBRA / TCC subsidy program and the moratorium on the scheduled 21% Medicare Part B payment cut to physicians until the end of April (H.R. 4851). The current extensions expire at the end of this month. According to Business Insurance, "As part of a broader bill, H.R. 4213, the Senate last week approved a longer extension to enable employees laid off through the end of the year to receive the subsidy [and continues the moratorium until September 30, 2010], but the House has yet to take up that measure because of funding concerns about certain provisions in the bill, observers say."
The HHS Office for Civil Rights ("OCR") which enforces the HIPAA Privacy and Security Rules made an important announcement:
OCR will implement important privacy and security provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act through notice and comment rulemaking, as required by the Administrative Procedure Act. These provisions include: business associate liability; new limitations on the sale of protected health information, marketing, and fundraising communications; and stronger individual rights to access electronic medical records and restrict the disclosure of certain information. OCR continues work on a Notice of Proposed Rulemaking (NPRM) regarding these provisions. Although the effective date (February 17, 2010) for many of these HITECH Act provisions has passed, the NPRM and the final rule that follows will provide specific information regarding the expected date of compliance and enforcement of these new requirements.
However, interim final rules implementing HITECH Act provisions in two areas have already been issued and are currently in effect: enforcement and breach notification. New civil money penalty amounts apply to HIPAA Privacy and Security Rule violations occurring after February 17, 2009. Covered entities and business associates must comply now with breach notification obligations for breaches that are discovered on or after September 23, 2009. OCR announced previously that it would use its enforcement discretion not to impose fiscal sanctions with regard to breaches discovered before February 22, 2010. Since that date has passed, OCR will enforce the Breach Notification Interim Final Rule, including with the possible imposition of sanctions, as it does with the HIPAA Privacy and Security Rule requirements.
Finally, the American Medical Association as part of its ongoing effort to bend the cost curve upward "unveiled its new National Managed Care Contract (NMCC) and database to help physicians analyze and negotiate contracts with insurers and help provide relief from unfair corporate business practices."