On November 21, 2009, the U.S. Senate voted 60-39 on a cloture motion and to formally consider and debate the Patient Protection and Affordable Care Act (H.R.3590).  Senate moderates on Sunday threatened to scuttle the health care bill if their demands weren't met, frustrating rank-and-file Democrats who say their colleagues' views were out of step with American voters.

Differences with House Bill
Unlike the House bill, the Senate bill imposes a new payroll tax for individuals earning over $200,000 and taxes on insurance companies, drug companies and medical device manufacturers. Over the next decade, the bill would cost $848 billion, slightly less than the $1 trillion House measure. But much of those savings are realized because it would take effect in 2014, a year later than the House bill [source: AARP].

If You Are 50 and Over You Have a Huge Stake in these Reforms

On Saturday, November 8th the House approved a rule (in a 220-215 vote) setting parameters for considering Affordable Health Care for America Act H.R.3962 and the Medicare Physician Payment Reform Act of 2009 (H.R.3961). However, a floor vote was not taken on H.R.3961.  The AMA reports that the House is now expected to consider H.R.3961 during the week of November 16, 2009. As originally drafted, H.R.3691 would repeal the now 21.2 percent Medicare payment rate reduction for physician services in 2010 and restructure the sustainable growth rate (or SGR) formula.