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| Full title | An act to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes. |
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The Affordable Health Care for America Act (H.R. 3962, introduced October 29, 2009, passed on November 7, 2009) is a legislative bill of the United States House of Representatives during the 1st Session of the 111th Congress. Its primary sponsor is the Dean of the House, John Dingell of Michigan.
The Affordable Health Care for America Act is a revision of an earlier proposal, America's Affordable Health Choices Act of 2009 (H.R. 3200).[1] The revisions include refinements designed to meet the goals outlined in President Obama's address before a joint session of Congress on September 9, 2009 concerning health care reform.
On December 24, 2009, the United States Senate passed its health care bill with a vote of 60-39 along party lines, one Senator being absent.[2]
Contents |
Key provisions
The central changes made by the legislation include:
- prohibiting health insurers from refusing coverage based on patients' medical histories[3][4]
- prohibiting health insurers from charging different rates based on patients' medical histories or gender[3][4]
- repeal of insurance companies' exemption from anti-trust laws[4][5]
- establishing minimum standards for qualified health benefit plans[3]
- requiring most employers to provide coverage for their workers or pay a surtax on the worker's wages up to 8%[3][6]
- restrictions on abortion coverage in any insurance plans for which federal funds are used[4][6]
- an expansion of Medicaid to include more low-income Americans by increasing Medicaid eligibility limits to 150% of the Federal Poverty Level and by covering adults without dependents so as long as either or any segment doesn't fall under the narrow exceptions outlined by various clauses throughout the proposal.[7][8]
- a subsidy to low- and middle-income Americans to help buy insurance[6]
- a central health insurance exchange where the public can compare policies and rates[6]
- a government-run insurance plan (public option);[6] according to some analyses, the plan would be prohibited from covering abortions[9]
- requiring most Americans to carry or obtain qualifying health insurance coverage or possibly face a surtax for non-compliance.[3][10]
- a 5.4% surtax on individuals whose adjusted gross income exceeds $500,000 ($1 million for married couples filing joint returns)[3]
- a 2.5% excise tax on medical devices[3]
- reductions in projected spending on Medicare of $400 billion over a ten-year period[4]
- inclusion of language originally proposed in the Tax Equity for Domestic Partner and Health Plan Beneficiaries Act[11][12]
- inclusion of language originally proposed in the Indian Health Care Improvement Act Amendments of 2009.[13][14]
Comparison with Senate version
The Washington Post published comparison tables of the main House bill passed Nov. 7, with the main Senate version, unveiled Nov. 18,[15] which may be summarized as:
| House | Senate | Notes | |
|---|---|---|---|
| 10-Year Cost (billions) | $1,052 | $848 | Net subtracted from deficit |
| Number uninsured by 2019 (millions) | 17 | 23 | 54 without bill |
| Public option | Yes | Yes | S: Allows states to opt out |
| Individual mandate | Yes | Yes | Penalty tax or fine if coverage not carried (See Insurance subsidies below) |
| Employer mandate | Yes | Yes | Small businesses exempted |
| Abortion covered | No | Yes | Exceptions to both Both ban use of federal funds |
| New and increased taxes | Yes | Yes | H: Families with income > $1 million S: High-cost insurance plans; Wealthiest Americans Medicare taxes; Cosmetic surgery |
| Insurance reforms | Yes | Yes | H: Remove anti-trust exemption Both: Qualified Health Benefit Plan |
| Expand Medicaid | Yes | Yes | Max 2009 Income, Family of 4: H: $33,000 S: $29,000. |
| Insurance subsidies | Yes | Yes | Prorated to $88,000 for family of 4 (2009) H: Premium subsidies; S: Tax credits |
Major actions
By the House
The Affordable Health Care for America Act, H.R. 3962, was introduced in the House of Representatives on October 29, 2009 and referred to several Committees for consideration.
On November 6, 2009, the House Committee on Energy and Commerce was discharged. The House Committee on Rules introduced House Resolution 903 (H.Res. 903) along with a Committee Report, No. 111-330. The Committee Report detailed the amendments considered as adopted if and when the bill passed the full House in Parts A & B, it provided the Stupak–Pitts Amendment for consideration in Part C as well as the Boehner Amendment, a substitute for the bill, in Part D. The House Resolution outlined the process to be followed for Parts A thru D in relation to H.R. 3962 and set the rules for debating the proposed bill.
The following day, House Resolution 903 was voted on and passed.[16] This, in effect, added the amendments outlined in Rules Committee Report No. 111-330, Parts A & B, to H.R. 3962. Part C, the Stupak–Pitts Amendment, was brought up, considered and passed.[17][18] Part D, the Boehner Substitute Amendment, was then brought up, considered but failed passage.[19][20]
The newly amended bill eventually passed the House of Representatives at 11:19 PM EST on Saturday, November 7, 2009 by a vote of 220-215. The bill passed with support of 219 Democrats, together with one Republican (Joseph Cao - LA) who voted only after the necessary 218 votes had already been cast. Thirty-nine Democrats voted against the bill. All members of the House voted, and none voted "present".[21]
Both before and after passage in the House, significant controversy surrounded the Stupak–Pitts Amendment, added to the bill to prohibit coverage of abortions – with limited exceptions – in the public option or in any of the exchange's private plans sold to customers receiving federal subsidies. In mid-November, it was reported that 40 House Democrats have said they will not support a final bill containing the Amendment's provisions.[22]
By the Senate
The Affordable Health Care for America Act, H.R. 3962, as engrossed or passed by the House of Representatives, was received in the Senate, read into the record and placed on the Senate Legislative Calendar under General Orders (Calendar No. 210, Nov. 16, 2009).
On Christmas Eve of 2009, the Senate arrived at 7am Eastern Time, the first time the Senate had met on Christmas Eve since 1895, and passed the bill to be compromised by both houses of Congress by a vote of 60-39.
See also
References
- ^ Topline Changes From Introduced Bill to Blended Bill, (PDF), House Committee on Energy and Commerce, 29 October 2009.
- ^ Pear, Robert (December 24, 2009). "Senate Passes Health Care Overhaul Bill". The New York Times. http://www.nytimes.com/2009/12/25/health/policy/25health.html?_r=1&hp. Retrieved December 24, 2009.
- ^ a b c d e f g Congressional Research Service (CRS) Summary of H.R. 3962 as introduced, the Library of Congress, 29 October 2009
- ^ a b c d e Espo, David (November 8, 2009). "Landmark health bill passes House on close vote". Associated Press. PhysOrg.com. http://www.physorg.com/news176878805.html. Retrieved November 24, 2009.
- ^ H.R. 3962 Affordable Health Care for America Act, Division A, Title II, Subtitle F, Section 262, 111th Congress.
- ^ a b c d e Hulse, Carl; Pear, Rolbert (November 7, 2009). "Sweeping Health Care Plan Passes House". The New York Times. http://www.nytimes.com/2009/11/08/health/policy/08health.html. Retrieved November 24, 2009.
- ^ H.R. 3962 Affordable Health Care for America Act, Division B, Title VII, Subtitle A (entire), 111th Congress.
- ^ Leary, Alex (November 12, 2009). "Health care reform: Where the House, Senate agree and disagree". St. Petersburg Times. http://www.tampabay.com/news/politics/national/health-care-reform-where-the-house-senate-agree-and-disagree/1051127. Retrieved November 24, 2009.
- ^ Werner, Erica (November 7, 2009). "House passes amendment prohibiting coverage of abortions in government-run healthcare plan". Star-Telegram. http://www.star-telegram.com/health/story/1745370.html. Retrieved November 24, 2009.
- ^ H.R. 3962 Affordable Health Care for America Act, Division A, Title V, Subtitle A, Part 1, Subpart A, Section 501, 111th Congress.
- ^ Cole, Michael (2009-11-07). "House Passes Health Reform Bill with Key LGBT Provisions". Human Rights Campaign. http://www.hrcbackstory.org/2009/11/house-passes-health-reform-bill-with-key-lgbt-provisions/. Retrieved 2009-11-09.
- ^ H.R. 3962 Affordable Health Care for America Act, Division A, Title V, Subtitle B, Part 3, Section 571, 111th Congress.
- ^ H.R. 3962 Affordable Health Care for America Act, Division D (entire), 111th Congress.
- ^ H.R. 2708 Indian Health Care Improvement Act Amendments of 2009, 111th Congress
- ^ Note: requires latest browser and Flash updates
Health-Care Reform: How the Bills Stack Up, The Washington Post, September 16, 2009 (upd. November 18, 2009) - ^ Roll call vote 882, via Clerk.House.gov - H.Res.903: On Agreeing to the Resolution
- ^ H.Amdt. 509, the Stupak of Michigan Amendment
- ^ Roll call vote 884, via Clerk.House.gov - H.Amdt.509: On Agreeing to the Stupak of Michigan Amendment
- ^ H.Amdt. 510, the Boehner of Ohio Substitute Amendment
- ^ Roll call vote 885, via Clerk.House.gov - H.Amdt.510: On Agreeing to the Boehner of Ohio Substitute Amendment
- ^ Roll call vote 887, via Clerk.House.gov - H.R.3962: On Passage Affordable Health Care for America Act
- ^ MacGillis, Alec (November 14, 2009). "Health-care reform and abortion coverage: Questions and answers". Washington Post. http://www.washingtonpost.com/wp-dyn/content/article/2009/11/14/AR2009111401597.html?hpid=topnews. Retrieved November 24, 2009.
External links
- Chris L. Peterson, A Comparative Analysis of Private Health Insurance Provisions of H.R. 3962 and S.Amdt. 2786 to H.R. 3590, Congressional Research Service, R40981, December 16, 2009
- Plain Text, PDF or XML formats of H.R. 3962, passed in the House of Representatives & as received in the Senate via FDsys
- Summary of H.R. 3962 as introduced (October 29, 2009) by the Congressional Research Service (CRS) via THOMAS.
- Briefings of the Alliance for Health Reform, Washington, DC, 2008-2009
- Entry for the Act at GovTrack
- Video of Speaker Pelosi and Democrat leaders unveiling the bill : C-SPAN
- Latest Congressional Budget Office scoring (all previous scoring for now superseded; H.R. 3200 no longer applies)
- Update of Current Analysis - H.R. 3962, Affordable Health Care for America Act, November 25, 2009
- Superseded analysis - H.R. 3962, Affordable Health Care for America Act, November 6, 2009
- Preliminary Analysis of Subsidies to and Payments by Enrollees in Insurance Exchanges, November 3, 2009
- Preliminary analysis - H.R. 3962, Affordable Health Care for America Act, October 29, 2009
- Centers for Medicare and Medicaid Services Estimates of the impact of H.R. 3962
- Estimated Financial Effects of the “America’s Affordable Health Choices Act of 2009” (H.R. 3962), as Passed by the House on November 7, 2009, November 13, 2009
- Superseded analysis Estimated Financial Effects of the “America’s Affordable Health Choices Act of 2009” (H.R. 3200), as Reported by the Ways and Means Committee, October 21, 2009
- Additional House committee generated information accompanying H.R. 3962 (November 6, 2009)
- House Committee on Energy and Commerce
- House Committee on Ways & Means
- House Committee on Education & Labor
- House Committee on Rules (Manager's Amendment, Member Amendments, Rules Reports & similar found here)
- H.Res. 903, and related Rules Committee Report 111-330
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