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Affordable Health Care for America Act Clearinghouse
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October 29, 2009
 UPDATED: 11/17/09Read the bill: You can read a copy of H.R. 3962, the Affordable Health Care for America Act, by clicking here (PDF). You can also read a copy of the Manager's Amendment to the bill here (PDF). Section-by-section analysis: The House Energy and Commerce Committee has produced a section-by-section analysis of the bill, which you can read here (PDF). Share your thoughts: Please share your thoughts about this effort to offer every American access to quality, affordable health insurance by submitting a comment below. You can also submit feedback by filling our Congressman Schauer's constituent survey on health insurance reform. Schauer statement on the bill (11/7/09): "Today I was proud to cast a vote in favor of the Affordable Health Care for America Act because it will offer every single American access to quality, affordable health insurance, strengthen Medicare for seniors by closing the prescription drug donut hole, and lower health care costs for Michigan businesses to help them compete. Additionally, this legislation and accompanying measures will reduce the federal deficit by $109 billion over the next ten years, according to the nonpartisan Congressional Budget Office. "After talking to thousands of families, small business owners, doctors and seniors, it became clear to me that our current health care system is broken. Health costs for small businesses have skyrocketed 129% since 2000, and if we don't act now, health care costs for average Michigan families will continue to increase by $1,800 each year for the next ten years, seniors will continue to fall into the Medicare Part D donut hole, and rising health care costs will continue to add to the Federal deficit. This situation is unsustainable, and unacceptable. "For families, this bill will help lower medical costs and offer peace of mind by preventing big health insurance companies from denying coverage due to a 'pre-existing condition' or the loss of a job. For seniors, it will offer greater security by closing the prescription drug donut hole, eliminating co-payments for preventive services and extending the life of the Medicare Trust Fund. And for small businesses - like the one my wife and I own - it offers tax credits and access to affordable group rates through a health insurance exchange, which will lower costs and allow entrepreneurs to re-invest in their business. "Today's historic vote marks a major step towards repairing the economic damage done to families, seniors, businesses, and the federal deficit under America's broken health care system. It lays the groundwork for long-term economic growth, and a stronger, healthier America." ADDITIONAL RESOURCES Town Hall: Thanks again to the hundreds of people who attended our recent town hall meetings. If you weren't able to attend, you can download copies of our PowerPoint presentation and our health care handout here and here (PDFs) What's in it for Michigan: You can learn more about what's in the new health insurance reform bill for Michigan families, seniors and small businesses by reading this fact sheet (PDF), prepared by the House Energy and Commerce Committee. Guide for seniors: You can learn more about what's in the bill for senior citizens and people with disabilities by clicking here (PDF). Guide for small businesses: To learn more about how health insurance reform will help lower health care costs for small businesses, click here (PDF). What's in the bill for rural America: Learn more about how the bill will benefit rural Michigan families and small businesses by clicking here (PDF). Who's supporting health insurance reform: Nonpartisan groups representing Americans from all walks of life have lent their support to this critical legislation, such as AARP, the National Security to Preserve Social Security and Medicare, Consumers Union, the American Medical Association, the American Cancer Society, and the National Farmers’ Union. How the bill will reduce the deficit: You can read the latest cost estimate from the nonpartisan Congressional Budget Office here. Over the next decade, this plan will reduce the federal deficit by $109 billion. MIT Study: Click here to read an independent study conducted by MIT economist Jonathan Gruber about how House Proposal Lowers Non-Group Premiums. Q: Is health care reform constitutional? A: Yes. The 10th amendment to the U.S. Constitution states that the powers not delegated to the federal government by the Constitution, nor prohibited by it to the states, are reserved to the states … or to the people. But the Constitution gives Congress broad power to regulate activities that have an effect on interstate commerce. Congress has used this authority to regulate many aspects of American life, from labor relations to education to health care to agricultural production. Since virtually every aspect of the heath care system has an effect on interstate commerce, the power of Congress to regulate health care is essentially unlimited. HOW WILL HEALTH INSURANCE REFORM AFFECT YOU? TOP 14 PROVISIONS THAT WILL TAKE EFFECT IMMEDIATELY 1. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE — Reduces the donut hole by $500 and institutes a 50% discount on brand-name drugs, effective January 1, 2010. 2. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POOL) — Creates a temporary insurance program until the Exchange is available for individuals who have been uninsured for several months or have been denied a policy because of pre-existing conditions. 3. BANS LIFETIME LIMITS ON COVERAGE—Prohibits health insurance companies from placing lifetime caps on coverage. 4. ENDS RESCISSIONS—Prohibits insurers from nullifying or rescinding a patient’s policy when they file a claim for benefits, except in the case of fraud. 5. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 27TH BIRTHDAY THROUGH PARENTS’ INSURANCE— Requires health plans to allow young people through age 26 to remain on their parents’ insurance policy, at the parents’ choice. 6. ELIMINATES COST-SHARING FOR PREVENTIVE SERVICES IN MEDICARE—Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. 7. IMPROVES HELP FOR LOW-INCOME MEDICARE BENEFICIARIES—Improves the low-income protection programs in Medicare to assure more individuals are able to access this vital help. 8. PROVIDES NEW CONSUMER PROTECTIONS IN MEDICARE ADVANTAGE— Prohibits Medicare Advantage plans from charging enrollees higher cost-sharing for services in their private plan than what is charged in traditional Medicare. 9. IMMEDIATE SUNSHINE ON PRICE GOUGING—Discourages excessive price increases by insurance companies through review and disclosure of insurance rate increases. 10. CONTINUITY FOR DISPLACED WORKERS—Allows Americans to keep their COBRA coverage until the Exchange is in place and they can access affordable coverage. 11. CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. 12. HELP FOR EARLY RETIREES—Creates a $10 billon fund to finance a temporary reinsurance program to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. 13. COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for a doubling of the number of patients seen by the centers over the next 5 years. 14. INCREASING NUMBER OF PRIMARY CARE DOCTORS — Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. TOP 10 CHANGES IN H.R. 3962 FROM H.R. 3200 (the previous House bill) 1. REDUCES THE DEFICIT MORE—According to the CBO, the revised bill reduces the deficit by $30 billion over the first 10 years. (The original bill reduced the deficit by $6 billion over the first 10 years). The revised bill also continues to reduce the deficit over the second 10 years. 2. ENDS HEALTH INSURANCE COMPANIES’ BLANKET EXEMPTION FROM ANTI-TRUST LAWS—In order to open up health insurance markets to real competition, the revised bill ends insurers’ blanket exemption from anti-trust laws, bringing antitrust enforcement to the two most abusive practices of health insurers – price fixing and market allocation. 3. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 27TH BIRTHDAY THROUGH PARENTS’ INSURANCE—The revised bill requires health plans to allow young people through age 26 to remain on their parents’ policy, at their parents’ choice. 4. CREATES A NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—The revised bill creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. The measure provides a cash benefit to help individuals with community-based services. 5. EXEMPTS SMALL BUSINESSES WITH PAYROLLS BELOW $500,000 FROM EMPLOYER MANDATE—The revised bill exempts a greater number of small businesses from the employer mandate – exempting 86% of all America’s businesses. Specifically, the bill exempts firms with payrolls up to $500,000 (instead of $250,000) from the mandate and provides only a graduated penalty for not offering coverage for firms with payrolls between $500,000 and $750,000 (instead of firms with payrolls between $250,000 and $400,000.) 6. LIMITS THE “HEALTH CARE SURCHARGE” TO MILLIONAIRES—Under the revised bill, only the wealthiest 0.3% of Americans would pay a surcharge on the portion of their income above $500,000 (instead of $280,000) for individuals and $1 million (instead of $350,000) for couples, in order to help make health insurance affordable for middle class families. 7. ADDRESSING GEOGRAPHIC VARIATIONS IN MEDICARE PAYMENTS/MOVING TO MEDICARE PAYMENTS REWARDING QUALITY AND COST-EFFECTIVENESS—The revised bill provides that the Institute of Medicine (IOM), through two studies, will make recommendations on how to fix the current Medicare reimbursement system, including addressing current geographic variations. Under the bill, the Centers for Medicare and Medicaid Services (CMS) will implement the IOM recommendations on changes to Medicare payment systems unless disapproved by Congress. 8. BEGINS CLOSING THE MEDICARE PART D DONUT HOLE IMMEDIATELY—The revised bill moves forward the effective date of reducing the donut hole by $500 and instituting a 50% discount for brand-name drugs in the donut hole, from January 1, 2011 to January 1, 2010. It also completes elimination of the donut hole by 2019 (instead of 2024). 9. IMMEDIATE HELP FOR THE UNINSURED (INTERIM HIGH-RISK POOL)—To fill the gap before the Exchange is available, the revised bill immediately creates an insurance program with financial assistance for those who have been uninsured for several months or denied a policy because of pre-existing conditions. 10. HHS NEGOTIATION OF DRUG PRICES—Under the revised bill, the Secretary of HHS is required to negotiate drug prices on behalf of Medicare beneficiaries.
The opinions expressed below are those of their respective authors and do not necessarily represent those of this office.
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