Democrats use budget reconciliation to pass final Affordable Care Act fixes, establishing reconciliation as major policy vehicle

House Democrats passed the Health Care and Education Reconciliation Act of 2010 using the budget reconciliation procedure, amending the Senate-passed Affordable Care Act without needing another 60-vote cloture vote. The reconciliation bill included premium subsidy adjustments, Medicaid expansion thresholds, and student loan reforms. The maneuver was challenged by Republicans as an abuse of reconciliation, but Senate Parliamentarian Alan Frumin ruled the bill complied with the Byrd Rule.