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Affordable Health Care for America Act
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Long titleAn 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] that included additional refinements geared toward meeting the goals outlined in President Barack Obama's address before a joint session of the 111th Congress on September 9, 2009 concerning health care reform.

Key provisions

The central changes made by the legislation include:

  • prohibiting health insurers from charging different rates based on patients' medical histories or gender[2][3]
  • prohibiting health insurers from refusing coverage based on patients' medical histories[2][3]
  • repeal of insurance companies' exemption from anti-trust laws[3][4]
  • requiring most employers to provide coverage for their workers or pay a surtax on the worker's wages up to 8%[2][5]
  • restrictions on abortion coverage in any insurance plans for which federal funds are used[3][5]
  • 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.[6][7]
  • a subsidy to low- and middle-income Americans to help buy insurance[5]
  • a central health insurance exchange where the public can compare policies and rates[5]
  • a government-run insurance plan (public option);[5] according to some analyses, the plan would be prohibited from covering abortions[8]
  • requiring most Americans to carry / obtain qualifying health insurance coverage or possibly face a surtax for non-compliance. [2][9]
  • a 5.4% surtax on individuals whose adjusted gross income exceeds $500,000 ($1 million for married couples filing joint returns)[2]
  • a 2.5% excise tax on medical devices[2]
  • reductions in projected spending on Medicare of $400 billion over a ten-year period[3]
  • inclusion of language originally proposed in the Tax Equity for Domestic Partner and Health Plan Beneficiaries Act[10][11]
  • inclusion of language originally proposed in the Indian Health Care Improvement Act Amendments of 2009.[12][13]

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 (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.[14] 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.[15][16] Part D, the Boehner Substitute Amendment, was then brought up, considered but failed passage.[17][18]

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".[19]

Criticism

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.[20]

John Murphy, an independent candidate for Congress from the 16th District of Pennsylvania in 2006 and 2008, has called the bill "a de facto bailout of the healthcare insurance companies" pointing out that "Here we have a health care bill which will not only drive up insurance costs but will not even permit the government to negotiate with pharmaceutical companies, thereby driving up pharmaceutical costs as well! The Congressional Budget Office (CBO) estimates that only 2% of Americans will be able to participate in this plan while 33% of Americans will remain either uninsured or underinsured."[21]

Marcia Angell, M. D., Senior Lecturer in the Department of Social Medicine at Harvard Medical School and former Editor-in-Chief of the New England Journal of Medicine, has written "...older under-65's will be more likely to go without insurance, even if they have to pay fines. That's OK with the industry, since these would be among their sickest customers. (Shouldn't age be considered a pre-existing condition?)" and "...health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector." She lists five recommendations for modification of this bill.[22]

See also

References

  1. ^ Topline Changes From Introduced Bill to Blended Bill, (PDF), House Committee on Energy and Commerce, 29 October 2009.
  2. ^ a b c d e f Congressional Research Service (CRS) Summary of H.R. 3962 as introduced, the Library of Congress, 29 October 2009
  3. ^ a b c d e "Landmark health bill passes House on close vote", by Erica Werner, Associated Press, November 8, 2009
  4. ^ H.R. 3962 Affordable Health Care for America Act, Division A, Title II, Subtitle F, Section 262, 111th Congress.
  5. ^ a b c d e "Sweeping Health Care Plan Passes House", by Carl Hulse and Rolbert Pear, New York Times, November 7 ,2009
  6. ^ H.R. 3962 Affordable Health Care for America Act, Division B, Title VII, Subtitle A (entire), 111th Congress.
  7. ^ "Health care reform: Where the House, Senate agree and disagree", By Alex Leary, St. Petersburg Times, Novermber 12, 2009
  8. ^ House passes amendment prohibiting coverage of abortions in government-run healthcare plan
  9. ^ H.R. 3962 Affordable Health Care for America Act, Division A, Title V, Subtitle A, Part 1, Subpart A, Section 501, 111th Congress.
  10. ^ Cole, Michael (2009-11-07). "House Passes Health Reform Bill with Key LGBT Provisions". Human Rights Campaign. Retrieved 2009-11-09.
  11. ^ H.R. 3962 Affordable Health Care for America Act, Division A, Title V, Subtitle B, Part 3, Section 571, 111th Congress.
  12. ^ H.R. 3962 Affordable Health Care for America Act, Division D (entire), 111th Congress.
  13. ^ H.R. 2708 Indian Health Care Improvement Act Amendments of 2009, 111th Congress
  14. ^ Roll call vote 882, via Clerk.House.gov - H.Res.903: On Agreeing to the Resolution
  15. ^ H.Amdt. 509, the Stupak of Michigan Amendment
  16. ^ Roll call vote 884, via Clerk.House.gov - H.Amdt.509: On Agreeing to the Stupak of Michigan Amendment
  17. ^ H.Amdt. 510, the Boehner of Ohio Substitute Amendment
  18. ^ Roll call vote 885, via Clerk.House.gov - H.Amdt.510: On Agreeing to the Boehner of Ohio Substitute Amendment
  19. ^ Roll call vote 887, via Clerk.House.gov - H.R.3962: On Passage Affordable Health Care for America Act
  20. ^ "Health-care reform and abortion coverage: Questions and answers, washingtonpost.com, November 14, 2009]
  21. ^ JOHN A. MURPHY "Can Lieberman Save Single Payer? (Why Progressives Should Back a Filibuster of the Health Care Bill)" CounterPunch November 9, 2009
  22. ^ Marcia Angell, M. D., "Is the House Health Care Bill Better than Nothing?" Huffington Post November 9, 2009.
Latest Congressional Budget Office scoring (all previous scoring for now superseded; H.R. 3200 no longer applies)
Additional House committee generated information accompanying H.R. 3962 (November 6, 2009)
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