Affordable Health Care for America Act
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The Affordable Health Care for America Act (H.R. 3962) is the final, merged version of the health care reform legislation that the House has been working on for much of 2009. The bill contains a moderate compromise on the public option by requiring the HHS Secretary to negotiate provider reimbursement rates rather than having them tied to Medicare. The bill also would require all individuals to have insurance, establish a new health insurance exchange, require most employers to provide insurance, ban insurance companies from denying coverage because of pre-existing conditions and more.
This bill has been estimated to extend health insurance to roughly 96 percent of the population at a ten year cost of $894 billion. It contains a number of tax and revenue provisions that result in it being deficit neutral over the 10-year budget period.
Expanding Coverage and Choice
- Established a new Health Insurance Exchange for individuals and employers to use for comparison shopping between health care plans. The Exchange will carry plans that meet certain minimum coverage standards and will be available to the general public as a website and telephone hotline.
- Creates a government-run public health insurance option to compete with the private plans offered on the Exchange. Unlike a previous version of the bill that would tie the public option to Medicare rates, the public option would have reimbursment rates that are negotiated by the Secretary of HHS. The Congressional Budget Office has estimated that the negotiated-rate public option would have higher premiums, on average, than similar private plans.
- The bill contains a number of consumer protections including a ban on insurance companies denying coverage because of pre-existing medical conditions. It would also prohibit annual and lifetime caps on benefits and would only allow insurance companies to consider age, geographic region and family size when setting rates.
- A long-standing exemption from the federal antitrust laws would be ended by the bill.