Members of the Senate have just voted 56-43 to pass H.R. 4872, the Patient Protection and Affordable Care Act “fixer bill,” and the House is getting ready to re-vote on the bill.

Sen. Johnny Isakson, R-Ga., did not vote. All other Republicans voted against the bill. The Democrats who voted against the bill are Sens. Blanche Lincoln, D-Ark., Mark Pryor, D-Ark., and Ben Nelson, D-Neb.

Democrats have been using the budget reconciliation process rules to get H.R. 4872, the Reconciliation Act of 2010, through the Senate with just 51 votes, rather than the 60 votes that normally would be required.

Alan Frumin, the Senate parliamentarian, ruled early today that two college student aid provisions in H.R. 4872 are ineligible for consideration under budget reconciliation process rules.

Democrats are holding the re-vote on H.R. 4872 in the House to avoid the need to try to pass the bill in the House using ordinary Senate rules.

The student aid provisions would protect students from future cuts in grants if Congress does not provide enough money to pay for the grants. The provisions violate budget reconciliation process eligibility rules because they do not produce savings, according to Jim Manley, a spokesman for Senate Majority Leader Harry Reid, D-Nev.

The provisions are “minor,” but because they are likely to be subject to procedural challenges on the floor, and ultimately struck from the bill, they are being removed from the bill, Manley says.

The bill is going back to the House for a new vote because the House and Senate must approve the same version of the bill before President Obama can sign the bill into law.

House Majority Leader Steny Hoyer, D-Md., said today that the House would set to work on the H.R. 4872 re-vote as soon as the Senate wrapped up its work on the bill.

President Obama already has signed the PPACA bill, H.R. 3590, into law.

That bill will lead to many major changes, such as the creation of a health insurance exchange system, nonprofit health insurance cooperatives and a voluntary long term care benefits program, regardless of what happens to H.R. 4872.

If H.R. 4872 takes effect as written, without being amended, it would make a number of changes in PPACA.

H.R. 4872 would, very example, increase the penalty for affected individuals who fail to own qualified health coverage to $2,000, from $750; ease the effects of a proposed 40% “Cadillac plan excise tax” on issuers of expensive health insurance plans; and impose a new tax on income from annuities and other investment vehicles.

State regulators already are suing to block implementation of PPACA and H.R. 4872, and federal and state agencies likely will spend years implementing bill provisions.

Federal agencies are still developing regulations to implement the Health Insurance Portability and Accountability Act of 1996, a much less ambitious act.

The list of federal agencies responsible for implementing PPACA includes the Internal Revenue Service, the U.S. Department of Labor’s Employee Benefits Security Administration, and the U.S. Department of Health and Human Services.

Internal Revenue Service Commissioner Douglas Shulman talked about PPACA implementation during a House Ways and Means Committee oversight subcommittee hearing.

The IRS will not be auditing taxpayers to determine whether they have insurance, Shulman said.

Instead, HHS officials will work with insurers to verify whether taxpayers have the minimum required coverage, Shulman said.

Insurers will give the IRS standard forms “so they can, in turn, deliver about $500 billion in tax relief to help middle class families and small businesses pay for health insurance,” Shulman said.