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They left one out. In both the House and Senate bills there is a provision that will allow Medicaid HMOs -- that is, privatized carriers serving Medicaid -- to receive the same rebates on prescription drug purchasing that the state agencies get when purchasing drugs for the Medicaid fee-for-service populations. This is actually huge, and one of the "gives" on the part of Big Pharma. Medicaid HMOs will now get 36-42 percent rebates on brand-name AND generic meds where they had previously only been able to negotiate about 6 percent. This measure in the bill is immediately enacted in the House version, and actually retroactive to 1/1/10 in the Senate version. I guess they left it out because it was way too wonky, too insider-baseball, and not directly visible to consumers.