Affordable Health Care for America Act
Encyclopedia
The Affordable Health Care for America Act (or HR 3962) was a bill
that was crafted by the United States House of Representatives
in November 2009. At the encouragement of the Obama administration, the 111th Congress devoted much of its time to enacting reform of the United States' health care system
. Known as the "House bill," it was the House of Representative's chief legislative proposal during the health reform debate, but the Affordable Health Care for America Act as originally drafted never became law.
On December 24, 2009, the Senate passed an alternative health care bill, the Patient Protection and Affordable Care Act
(H.R. 3590). In 2010, the House abandoned its reform bill in favor of amending the Senate bill (via the reconciliation
process) in the form of the Health Care and Education Reconciliation Act of 2010
.
is the Senate version, passed December 24. The following table compares the two versions.
, John Dingell
of Michigan
.
The bill is a revised version of an earlier measure, the proposed America's Affordable Health Choices Act of 2009
(HR 3200 ). The revisions included refinements designed to meet the goals outlined in the President's address to a joint session of Congress in September, 2009
concerning health care reform.
On November 6, 2009, the House Committee on Energy and Commerce was discharged. The House Committee on Rules introduced House Resolution 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. 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. Part D, the Boehner Substitute Amendment, was then brought up, considered but failed passage.
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 the majority of Democrats, together with one Republican
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".
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 said they will not support a final bill containing the Amendment's provisions. Stupak has said that 15–20 Democrats will oppose adoption of the Senate bill because of objections to its abortion provisions as well as its tax on high-value health insurance plans. In March 2010, Stupak voted for the Senate language health care bill excluding the Stupak Amendment language.
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).
Latest Congressional Budget Office scoring (all previous scoring for now superseded; H.R. 3200 no longer applies)
Centers for Medicare and Medicaid Services
Estimates of the impact of H.R. 3962
Additional House committee generated information accompanying H.R. 3962 (November 6, 2009)
Bill (proposed law)
A bill is a proposed law under consideration by a legislature. A bill does not become law until it is passed by the legislature and, in most cases, approved by the executive. Once a bill has been enacted into law, it is called an act or a statute....
that was crafted by the United States House of Representatives
United States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...
in November 2009. At the encouragement of the Obama administration, the 111th Congress devoted much of its time to enacting reform of the United States' health care system
Health care reform in the United States
Health care reform in the United States has a long history, of which the most recent results were two federal statutes enacted in 2010: the Patient Protection and Affordable Care Act , signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010 , which amended the PPACA and...
. Known as the "House bill," it was the House of Representative's chief legislative proposal during the health reform debate, but the Affordable Health Care for America Act as originally drafted never became law.
On December 24, 2009, the Senate passed an alternative health care bill, the Patient Protection and Affordable Care Act
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
(H.R. 3590). In 2010, the House abandoned its reform bill in favor of amending the Senate bill (via the reconciliation
Reconciliation (United States Congress)
Reconciliation is a legislative process of the United States Senate intended to allow consideration of a budget bill with debate limited to twenty hours under Senate Rules...
process) in the form of the Health Care and Education Reconciliation Act of 2010
Health Care and Education Reconciliation Act of 2010
The Health Care and Education Reconciliation Act of 2010 is a law that was enacted by the 111th United States Congress, by means of the reconciliation process, in order to amend the Patient Protection and Affordable Care Act...
.
Key provisions
The central changes made by the legislation include:- prohibiting health insurers from refusing coverage based on patients' medical historiesPre-existing conditionA pre-existing condition is a risk with extant causes that is not readily compensated by standard, affordable insurance premiums. Pre-existing condition exclusions by the insurance industry are meant to cope with adverse selection by potential customers. Such exclusions have become a topic in the...
- prohibiting health insurers from charging different rates based on patients' medical histories or gender
- repeal of insurance companies' exemption from anti-trust laws
- establishing minimum standards for qualified health benefit plansQualified Health Benefit PlanA Qualified Health Benefit Plan is a health care plan that follows rules included in the proposed Affordable Health Care for America Act , preceded by America's Affordable Health Choices Act of 2009...
- requiring most employers to provide coverage for their workers or pay a surtax on the workers wage up to 8%
- restrictions on abortionAbortionAbortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
coverage in any insurance plans for which federal funds are used - an expansion of MedicaidMedicaidMedicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
to include more low-income Americans by increasing Medicaid eligibility limits to 133% of the Federal Poverty Level and by covering adults without dependents as long as either or any segment doesn't fall under the narrow exceptions outlined by various clauses throughout the proposal. - a subsidySubsidyA subsidy is an assistance paid to a business or economic sector. Most subsidies are made by the government to producers or distributors in an industry to prevent the decline of that industry or an increase in the prices of its products or simply to encourage it to hire more labor A subsidy (also...
to low- and middle-income Americans to help buy insurance - a central health insurance exchangeHealth insurance exchangeA health insurance exchange is a set of state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance that is eligible for Federal subsidies...
where the public can compare policies and rates - requiring most Americans to carry or obtain qualifying health insurance coverage or possibly face a surtaxSurtaxA surtax may be a tax levied upon a tax, or a tax levied upon income.-United Kingdom:In 1929, Supertax was renamed Sur-tax...
for non-compliance. - a 5.4% surtaxSurtaxA surtax may be a tax levied upon a tax, or a tax levied upon income.-United Kingdom:In 1929, Supertax was renamed Sur-tax...
on individuals whose adjusted gross income exceeds $500,000 ($1 million for married couples filing joint returns) - a 2.5% excise tax on medical deviceMedical deviceA medical device is a product which is used for medical purposes in patients, in diagnosis, therapy or surgery . Whereas medicinal products achieve their principal action by pharmacological, metabolic or immunological means. Medical devices act by other means like physical, mechanical, thermal,...
s - reductions in projected spending on MedicareMedicare (United States)Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
of $400 billion over a ten-year period - inclusion of language originally proposed in the Tax Equity for Domestic Partner and Health Plan Beneficiaries ActTax Equity for Domestic Partner and Health Plan Beneficiaries ActThe Tax Parity for Health Plan Beneficiaries Act is a bill in the 112th Congress that would equalize tax treatment for employer-provided health coverage for domestic partners and other non-spouse, non-dependent beneficiaries."- Previous versions of the bill :...
- inclusion of language originally proposed in the Indian Health Care Improvement Act Amendments of 2009.
- imposing a $2,500 limit on contributions to flexible spending accountFlexible spending accountA flexible spending account , also known as a flexible spending arrangement, is one of a number of tax-advantaged financial accounts that can be set up through a cafeteria plan of an employer in the United States...
s (FSAs), which allow for payment of health costs with pre-tax funds, to pay for a portion of health care reform costs.
Comparison with House version
The main House reform bill was the Affordable Health Care for America Act, which passed November 7, 2009. The Patient Protection and Affordable Care ActPatient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
is the Senate version, passed December 24. The following table compares the two versions.
| 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 | No | |
| Individual mandate | Yes | Yes | Penalty tax or fine if coverage not carried (See Insurance subsidies below) |
| Employer mandate | Yes | Yes | Small businesses exempted |
| Abortion Abortion Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced... coverage |
No | Yes | H: No in public option or subsidized plans; may be covered by separate riders S: Yes, but must be paid for separately without subsidies |
| New and increased taxes | Yes | Yes | H: Families with income > $1 million S: High-cost insurance plans; Wealthiest Americans Medicare taxes; Indoor tanning tax |
| Insurance reforms | Yes | Yes | H: Remove anti-trust exemption Both: Define qualified health benefit plan |
| Expand Medicaid Medicaid Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent... |
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 |
| Tax equity for domestic partners Tax Equity for Domestic Partner and Health Plan Beneficiaries Act The Tax Parity for Health Plan Beneficiaries Act is a bill in the 112th Congress that would equalize tax treatment for employer-provided health coverage for domestic partners and other non-spouse, non-dependent beneficiaries."- Previous versions of the bill :... |
Yes | No |
History
The bill was introduced on October 29, 2009 and passed on November 7, during the 1st Session of the 111th Congress. Its primary sponsor was the Dean of the HouseDean of the United States House of Representatives
The Dean of the United States House of Representatives is the longest continuously serving member of the House. The present Dean is John Dingell, a Democrat of Michigan....
, John Dingell
John Dingell
John David Dingell, Jr. is the U.S. Representative for , serving since 1955 . He is a member of the Democratic Party...
of Michigan
Michigan
Michigan is a U.S. state located in the Great Lakes Region of the United States of America. The name Michigan is the French form of the Ojibwa word mishigamaa, meaning "large water" or "large lake"....
.
The bill is a revised version of an earlier measure, the proposed America's Affordable Health Choices Act of 2009
America's Affordable Health Choices Act of 2009
The proposed America's Affordable Health Choices Act of 2009 was an unsuccessful bill introduced in the U.S. House of Representatives on July 14, 2009. The bill was introduced during the first session of the 111th Congress as part of an effort of the Democratic Party leadership to enact health...
(HR 3200 ). The revisions included refinements designed to meet the goals outlined in the President's address to a joint session of Congress in September, 2009
Barack Obama speech to joint session of Congress, September 2009
United States President Barack Obama discussed his plan for health care reform in a speech delivered to a joint session of the 111th United States Congress on September 9, 2009 at 8:00 PM . The speech was delivered to Congress on the floor of the chamber of the United States House of...
concerning health care reform.
House actions
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 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. 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. Part D, the Boehner Substitute Amendment, was then brought up, considered but failed passage.
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 the majority of Democrats, together with one Republican
Joseph Cao
Anh "Joseph" Quang Cao is the former U.S. Representative for , serving from 2009 until 2011. He is a member of the Republican Party. In April 2011, he announced he will be a candidate for Attorney General of Louisiana in 2011, however in September 2011 he pulled out of the race.He was the first...
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".
Both before and after passage in the House, significant controversy surrounded the Stupak–Pitts Amendment
Stupak–Pitts Amendment
The Stupak–Pitts Amendment was a proposed amendment to the Affordable Health Care for America Act of 2010 . It was submitted by Representatives Bart Stupak and Joseph R. Pitts...
, added to the bill to prohibit coverage of abortions – with limited exceptions – in the public option or in any of the exchange
Health insurance exchange
A health insurance exchange is a set of state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance that is eligible for Federal subsidies...
's private plans sold to customers receiving federal subsidies. In mid-November, it was reported that 40 House Democrats said they will not support a final bill containing the Amendment's provisions. Stupak has said that 15–20 Democrats will oppose adoption of the Senate bill because of objections to its abortion provisions as well as its tax on high-value health insurance plans. In March 2010, Stupak voted for the Senate language health care bill excluding the Stupak Amendment language.
Senate actions
The Affordable Health Care for America Act, H.R. 3962, as engrossedEngrossed bill
In the United States Senate, an engrossed bill is the official copy of a bill or joint resolution passed by the Senate and certified by the Secretary of the Senate....
or passed by the House of Representatives, was received in the Senate, read into the record and placed on the Senate Legislative Calendar
Legislative calendar
A legislative calendar is used by legislatures to plan their business during the legislative session.- Calendar :Typically, one of the first items mentioned on the calendar is passing the bill enacting procedures and deadlines for the session. Time may also be allotted for considering the budget...
under General Orders
Standing Rules of the United States Senate, Rule VIII
Rule VIII of the Standing Rules of the United States Senate, established by the Senate Committee on Rules and Administration, governs the order of business in the Senate.- Order of proceedings:...
(Calendar No. 210, Nov. 16, 2009).
H.R. 3962 as eventually enacted
A different bill, under the same bill number H.R. 3962, was eventually passed by Congress and, on June 25, 2010, was signed by the President. This is the "Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.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 ServiceCongressional Research ServiceThe Congressional Research Service , known as "Congress's think tank", is the public policy research arm of the United States Congress. As a legislative branch agency within the Library of Congress, CRS works exclusively and directly for Members of Congress, their Committees and staff on a...
, 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 FDsysFederal Digital SystemThe Federal Digital System replaces GPOAccess, an information storage system to house electronic government documents, from 1994 with a modern information management system. FDsys authenticates, preserves, versions, and provides permanent public access to federal government information...
- Summary of H.R. 3962 as introduced (October 29, 2009) by the Congressional Research ServiceCongressional Research ServiceThe Congressional Research Service , known as "Congress's think tank", is the public policy research arm of the United States Congress. As a legislative branch agency within the Library of Congress, CRS works exclusively and directly for Members of Congress, their Committees and staff on a...
(CRS) via THOMAS. - Briefings of the Alliance for Health Reform, Washington, DC, 2008-2009
- Entry for the Act at ovTrack]
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
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
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)
- , and related Rules Committee Report 111-330