establishing a National Healthcare Workforce Commission to be composed of 15 individuals who will assess healthcare needs and make recommendations to congressional leaders [6]
requiring most employers to provide coverage for their workers or pay a surtax on the workers wage up to 8%
restrictions on abortion coverage in any insurance plans for which federal funds are used[4][7]
an expansion of Medicaid 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,[8][9]
a subsidy to low- and middle-income Americans to help buy insurance[7]
allowing insurers to continue to dictate limits on evaluation and care provided consumers by their physicians ("managed" or "rationed" care)
avoidance of capitating or regulating premiums which are routinely and in accordance with this law, charged by an insurance company for coverage, which might make the coverage non-affordable with regard to a consumer's income[7]
requiring most Americans to carry or obtain qualifying health insurance coverage or face a fine 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]
inclusion of language originally proposed in the Indian Health Care Improvement Act Amendments of 2009[13][14]
imposing a $2,500 limit on contributions to flexible spending accounts (FSAs), which allow for payment of health costs with pre-tax funds, to pay for a portion of health care reform costs[3][15]
Comparison with Senate versionedit
The main House reform bill was the Affordable Health Care for America Act, which passed on November 7, 2009. The Patient Protection and Affordable Care Act is the Senate version, passed December 24.[16] The following table compares the two versions.
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 Archived September 20, 2014, at the Wayback Machine. 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 through 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.[20] 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.[21][22] Part D, the Boehner Substitute Amendment, was then brought up, considered but failed passage.[23][24]
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".[25]
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.[26] 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.[27][28] In March 2010, Stupak voted for the Senate language health care bill excluding the Stupak Amendment language.
Senate actionsedit
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).
H.R. 3962 as eventually enactededit
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."[29]
^Pear, Robert (December 24, 2009). "Senate Passes Health Care Overhaul Bill". The New York Times. Archived from the original on November 15, 2013. Retrieved December 24, 2009.
^ abcdefgCongressional Research Service (CRS) Summary Archived October 17, 2013, at the Wayback Machine of H.R. 3962 as introduced, the Library of Congress, October 29, 2009
^ abcdeEspo, David (November 8, 2009). "Landmark health bill passes House on close vote". PhysOrg.com. Associated Press. Archived from the original on June 6, 2011. Retrieved November 24, 2009.
^H.R. 3962 Affordable Health Care for America Act, Division A, Title II, Subtitle F, Section 262, 111th Congress.
^McNeal, Gloria (2010). "The Healthcare Reform Bill and Its Impact on the Nursing Profession". The ABNF Journal. 21 (2): 38. PMID 20533752. Retrieved September 17, 2013.
^ abcdHulse, Carl; Pear, Rolbert (November 7, 2009). "Sweeping Health Care Plan Passes House". The New York Times. Archived from the original on March 31, 2011. 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. Archived from the original on December 5, 2009. 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 (November 7, 2009). "House Passes Health Reform Bill with Key LGBT Provisions". Human Rights Campaign. Archived from the original on November 12, 2009. Retrieved November 9, 2009.
^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
^"A Comparison of House Senate Health Care Bills", Detroit Free Press, December 24, 2009
^ abcdefghijklmHealth-Care Reform: How the Bills Stack Up, The Washington Post, September 16, 2009 (updated December 24, 2009), Retrieved February 5, 2010
^Moulton, Brian (March 18, 2010). "House Posts Health Care Bill, Leaves Out LGBT-Specific Provisions". Human Rights Campaign. Archived from the original on March 23, 2010. Retrieved March 22, 2010.
^Topline Changes From Introduced Bill to Blended Bill Archived November 3, 2009, at the Wayback Machine, (PDF), House Committee on Energy and Commerce, October 29, 2009.
^Roll call vote 882, via Clerk.House.gov – H.Res.903: On Agreeing to the Resolution
^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.3590: On Passage Affordable Health Care for America Act
^MacGillis, Alec (November 14, 2009). "Health-care reform and abortion coverage: Questions and answers". Washington Post. Retrieved November 24, 2009.
^Kantor, Jodi (January 6, 2010). "Abortion Foe Defies Party on Health Care Bill". New York Times. Retrieved January 7, 2010.
^Weisman, Jonathan (February 24, 2010), "Stupak: 15–20 Dems Can’t Back Obama Health Plan", Washington Wire, The Wall Street Journal, Retrieved February 24, 2010
^Public Law no. 111-192, summarized at [1]. For the full text of what was actually enacted under the heading "H.R. 3962," see [2].
External linksedit
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
111th Congress. "P.L. 111-192 – Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010". U.S. Government Printing Office. p. 29.{{cite web}}: CS1 maint: numeric names: authors list (link)
111th Congress. "H.R. 3962 (IH) – To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes". U.S. Government Printing Office. p. 1990.{{cite web}}: CS1 maint: numeric names: authors list (link) 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[permanent dead link] as introduced (October 29, 2009) by the Congressional Research Service (CRS) via THOMAS.
Briefings of the Alliance for Health Reform, Washington, DC, 2008–2009
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 Archived September 20, 2014, at the Wayback Machine