WASHINGTON BUREAU — President Obama today signed H.R. 3590, the Patient Protection and Affordable Care Act bill, saying it will lead to “reforms that generations of Americans have fought for and marched for.”

Meanwhile, the Senate parliamentarian has ruled informally that the “Cadillac health plan excise tax” provision in a second major health bill, the Reconciliation Act of 2010, complies with the rules governing budget reconciliation bills. The House passed the Reconciliation Act, H.R. 4872, Sunday, but the Senate still must pass it before Obama can sign it into law.

Obama, who has often talked about the insurance struggles his own mother faced as she was dying of cancer, noted that some of the provisions in PPACA, particularly provisions affecting insurers, will take effect this year.

“Today, after almost a century of trying — today, after over a year of debate — today, after all the votes have been tallied, health insurance reform becomes law in the United States of America,” Obama said.

The bill enshrines “the core principle that everybody should have some basic security when it comes to their health care,” Obama said.

Republicans reacted angrily to the signing.

House Minority Leader John Boehner, R-Ohio called the event something that “looked and sounded like a liberal Democratic pep rally” for “a massive government takeover of health care.”

Sen. John McCain, R-Ariz., told an Arizona radio station that Democrats should not expect any cooperation from Republicans in the Senate for the rest of the year, according to The Hill, a Washington newspaper.

The Democrats are trying to use the budget reconciliation rules, rather than the ordinary Senate rules, to pass H.R. 4872 because of concerns about their ability to attract any Republican votes for the bill in the Senate.

Democrats and independents now hold 59 seats in the Senate, and Republicans hold 41 seats. The Democrats need 60 votes to get an ordinary bill to the floor in the Senate, but just 51 votes to pass a budget reconciliation bill.

Several Democratic officials and lobbyists are predicting that Democrats can count on getting 52 votes for H.R. 4872. They are expecting the final vote to occur before the Senate leaves Friday for the 2-week Easter recess.

REACTIONS

Officials in Florida, Pennsylvania, Texas and 11 other states have filed a suit to block implementation of PPACA is the U.S. District Court for the Northern District of Florida. The states are objecting to provisions that require individuals to have health coverage and provisions that would require states to pay to expand Medicaid programs.

Tom Currey, president of the National Association of Insurance and Financial Advisors, Falls Church, Va., says NAIFA members “are pleased that Congress has recognized the positive role that health insurance agents can play in helping small businesses and individuals acquire appropriate health insurance plans.”

If PPACA takes effect as written, agents should still to be able to perform their traditional role, Currey says.

Currey has problems with H.R. 4872. He says he likes a provision that would increase penalties for individuals who fail to have health coverage.

But “we think the proposed 3.8% Medicare tax on the unearned income, including annuity payments, of higher income earners, sets a very bad precedent and should be dropped from the reconciliation package,” Currey says. “We need to encourage people to put at least some of their retirement funds into lifetime annuities – not discourage them. This proposal will certainly do the latter.”

Janet Trautwein, chief executive officer of the National Association of Health Underwriters, Arlington, Va., says PPACA does little to rein in health care costs, and nothing to help alleviate the effects of the recession.

PPACA “will continue to exacerbate the problem by driving up private health insurance costs significantly for millions of American families and businesses and disrupt the quality coverage on which millions of Americans rely,” Trautwein says.

Ronald Williams, chairman of Aetna Inc., Hartford (NYSE:AET), says implementation of the health care access provisions in PPACA is important.

“But, as a nation, we need to come together to bring greater focus on addressing the many underlying factors that are driving soaring health care costs,” Williams says. “When the nation inevitably turns to finding ways of reducing this alarming trend, we stand ready to help.”

But some companies and organizations see PPACA and the Reconciliation Act more as opportunities than as threats.

EHealth Inc., Mountain View, Calif. (NASDAQ:EHTH), the parent of eHealthInsurance.com, has put out a statement suggesting that it can help implement PPACA because it already has experience with using the Web to get Americans into health plans.

“We are looking forward to doing our part to help uninsured access coverage as well as helping the national and state governments design winning strategies to achieve the promise of this legislation,” EHealth Chairman Gary Lauer says.