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 onabortion coverage in any insurance plans for which federal funds are used[4][7]
an expansion ofMedicaid to include morelow-income Americans by increasing Medicaid eligibility limits to 133% of theFederal 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]
asubsidy 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 afine 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 toflexible 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]
The main House reform bill was theAffordable Health Care for America Act, which passed on November 7, 2009. ThePatient Protection and Affordable Care Act is the Senate version, passed December 24.[16] The following table compares the two versions.
House voting map for H.R. 3590 where green indicates a 'Yes' and red a 'No'.
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. TheHouse Committee on Rules introduced House Resolution 903 (H.Res. 903) along with a Committee Report,No. 111-330Archived September 20, 2014, at theWayback 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 theStupak–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 withone 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 theStupak–Pitts Amendment added to the bill to prohibit coverage of abortions – with limited exceptions – in thepublic option or in any of theexchange'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.
The Affordable Health Care for America Act, H.R. 3962, asengrossed or passed by the House of Representatives, was received in the Senate, read into the record and placed on theSenate Legislative Calendar underGeneral Orders (Calendar No. 210, Nov. 16, 2009).
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]
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