The Affordable Health Care for America Act (or HR 3962) was a
bill
Bill(s) may refer to:
Common meanings
* Banknote, paper cash (especially in the United States)
* Bill (law), a proposed law put before a legislature
* Invoice, commercial document issued by a seller to a buyer
* Bill, a bird or animal's beak
Plac ...
that was crafted by the
United States House of Representatives
The United States House of Representatives, often referred to as the House of Representatives, the U.S. House, or simply the House, is the Lower house, lower chamber of the United States Congress, with the United States Senate, Senate being ...
of the
111th United States Congress
The 111th United States Congress was a meeting of the legislative branch of the United States federal government from January 3, 2009, until January 3, 2011. It began during the last weeks of the George W. Bush administration, with th ...
on October 29, 2009. The bill was sponsored by Representative
Charles Rangel
Charles Bernard Rangel (, ; born June 11, 1930) is an American politician who was a U.S. representative for districts in New York from 1971 to 2017. A member of the Democratic Party, he was the second-longest serving incumbent member of the Ho ...
.
At the encouragement of the
Obama administration
Barack Obama's tenure as the 44th president of the United States began with his first inauguration on January 20, 2009, and ended on January 20, 2017. A Democrat from Illinois, Obama took office following a decisive victory over Republican ...
, the 111th Congress devoted much of its time to enacting reform of the United States' health care system. Known as the "House bill,” HR 3962 was the House of Representatives' chief legislative proposal during the health reform debate.
On December 24, 2009, the Senate passed an alternative health care bill, the
Patient Protection and Affordable Care Act
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by Presi ...
(H.R. 3590). In 2010, the House abandoned its reform bill in favor of amending the Senate bill (via the
reconciliation
Reconciliation or reconcile may refer to:
Accounting
* Reconciliation (accounting)
Arts, entertainment, and media Sculpture
* ''Reconciliation'' (Josefina de Vasconcellos sculpture), a sculpture by Josefina de Vasconcellos in Coventry Cathedra ...
process) in the form of the
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 Affordable Care Act (ACA) (). The law includes the St ...
.
Key provisions
The central changes that would have been made by the legislation, had it been enacted, included the following:
* prohibiting health insurers from refusing coverage based on patients' medical historiesCongressional Research Service (CRS) Summary of H.R. 3962 as introduced, the Library of Congress, October 29, 2009
* prohibiting health insurers from charging different rates based on patients' medical histories or gender
* repeal of insurance companies' exemption from
anti-trust
Competition law is the field of law that promotes or seeks to maintain market competition by regulating anti-competitive conduct by companies. Competition law is implemented through public and private enforcement. It is also known as antitrust l ...
laws Affordable Health Care for America Act, Division A, Title II, Subtitle F, Section 262, 111th Congress.
* establishing minimum standards for qualified health benefit plans
* establishing a National Healthcare Workforce Commission to be composed of 15 individuals who will assess healthcare needs and make recommendations to congressional leaders
* requiring most employers to provide coverage for their workers or pay a surtax on the workers wage up to 8%
* restrictions on
abortion
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
coverage in any insurance plans for which federal funds are used
* an expansion of
Medicaid
Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and pers ...
to include more
low-income
Poverty is the state of having few material possessions or little
Americans by increasing Medicaid eligibility limits to 133% of the
Federal Poverty Level
In the United States, poverty has both social and political implications. In 2020, there were 37.2 million people in poverty. Some of the many causes include income inequality, inflation, unemployment, debt traps and poor education.Western, B ...
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, Affordable Health Care for America Act, Division B, Title VII, Subtitle A (entire), 111th Congress.
* a
subsidy
A subsidy or government incentive is a form of financial aid or support extended to an economic sector (business, or individual) generally with the aim of promoting economic and social policy. Although commonly extended from the government, the ter ...
to low- and middle-income Americans to help buy insurance
* a central
health insurance exchange
In the United States, health insurance marketplaces, also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection ...
where the public can compare policies and rates
* 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
* requiring most Americans to carry or obtain qualifying health insurance coverage or face a
fine
Fine may refer to:
Characters
* Sylvia Fine (''The Nanny''), Fran's mother on ''The Nanny''
* Officer Fine, a character in ''Tales from the Crypt'', played by Vincent Spano
Legal terms
* Fine (penalty), money to be paid as punishment for an offe ...
surtax
A surtax is a tax levied upon another tax, also known as tax surcharge.
Canada
The provincial portion of the value-added tax on goods and services in two Canadian jurisdictions, Québec and Prince Edward Island, was formerly calculated as a surt ...
on individuals whose adjusted gross income exceeds $500,000 ($1 million for married couples filing joint returns)
* a 2.5%
excise tax
file:Lincoln Beer Stamp 1871.JPG, upright=1.2, 1871 U.S. Revenue stamp for 1/6 barrel of beer. Brewers would receive the stamp sheets, cut them into individual stamps, cancel them, and paste them over the Bunghole, bung of the beer barrel so when ...
on
medical device
A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...
s
* reductions in projected spending on Medicare of $400 billion over a ten-year period
* inclusion of language originally proposed in the
Tax Equity for Domestic Partner and Health Plan Beneficiaries Act The Tax Parity for Health Plan Beneficiaries Act ( and ) 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 ve ...
Affordable Health Care for America Act, Division A, Title V, Subtitle B, Part 3, Section 571, 111th Congress.
* inclusion of language originally proposed in the Indian Health Care Improvement Act Amendments of 2009 Affordable Health Care for America Act, Division D (entire), 111th Congress. Indian Health Care Improvement Act Amendments of 2009, 111th Congress
* imposing a $2,500 limit on contributions to
flexible spending account
In the United States, a flexible spending account (FSA), also known as a flexible spending arrangement, is one of a number of tax-advantaged financial accounts, resulting in payroll tax savings. One significant disadvantage to using an FSA is th ...
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 Senate 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 Act
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by Presi ...
is the Senate version, passed December 24.Health-Care Reform: How the Bills Stack Up ''The Washington Post'', September 16, 2009 (updated December 24, 2009), Retrieved February 5, 2010 The following table compares the two versions.
* 2015 year rates are based on the second tier level of a silver plan that was determine by D.O.R.A
* 2015 Federal Poverty Level is now 133% to 401%
* Everyone must obtain health insurance that meets the Minimal Essential Coverage (MEC) that is define by the department of Human Services (DHS)
* Affordable is based on percentage of 9.5% annual income of an individual
* There is no out of pocket cost of Preventive care even on grandfather plan
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 House The dean of the House is, in some legislatures, the member with the longest unbroken record of service.
U.C. Mandal, ''Dictionary Of Public Administration'' (2007), p. 123. Specific examples include:
* Dean of the United States House of Representa ...
,
John Dingell
John David Dingell Jr. (July 8, 1926 – February 7, 2019) was an American politician who served as a member of the United States House of Representatives from 1955 until 2015. A member of the Democratic Party, he holds the record for longest ...
of
Michigan
Michigan () is a state in the Great Lakes region of the upper Midwestern United States. With a population of nearly 10.12 million and an area of nearly , Michigan is the 10th-largest state by population, the 11th-largest by area, and the ...
.
The bill is a revised version of an earlier measure, the proposed
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 eff ...
(HR 3200 Topline Changes From Introduced Bill to Blended Bill , (PDF), ''House Committee on Energy and Commerce'', October 29, 2009.). 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.
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
The Committee on Rules, or more commonly, the Rules Committee, is a committee of the United States House of Representatives. It is responsible for the rules under which bills will be presented to the House of Representatives, unlike other commit ...
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 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. 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
Exchange may refer to:
Physics
*Gas exchange is the movement of oxygen and carbon dioxide molecules from a region of higher concentration to a region of lower concentration. Places United States
* Exchange, Indiana, an unincorporated community
* ...
'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
engrossed
Western calligraphy is the art of writing and penmanship
as practiced in the Western world, especially using the Latin alphabet (but also including calligraphy, calligraphic use of the Cyrillic alphabet, Cyrillic and Greek alphabet, Greek alphabe ...
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
A general officer is an officer of high rank in the armies, and in some nations' air forces, space forces, and marines or naval infantry.
In some usages the term "general officer" refers to a rank above colonel."general, adj. and n.". OED On ...
(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."Public Law no. 111-192, summarized a For the full text of what was actually enacted under the heading "H.R. 3962," se
See also
*
Patient Protection and Affordable Care Act
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by Presi ...
Congressional Research Service
The Congressional Research Service (CRS) is a public policy research institute of the United States Congress. Operating within the Library of Congress, it works primarily and directly for members of Congress and their committees and staff on a c ...
, 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
The Congressional Research Service (CRS) is a public policy research institute of the United States Congress. Operating within the Library of Congress, it works primarily and directly for members of Congress and their committees and staff on a c ...
H.R. 3200
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 United States Congress, 111 ...
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services (CMS), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer M ...