America's Affordable Health Choices Act of 2009
Encyclopedia
The proposed America's Affordable Health Choices Act of 2009 (or HR 3200) 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 effort of the Democratic Party leadership to enact health care reform. The bill was not approved by the House, but was superseded by a similar bill, the proposed Affordable Health Care for America Act
(HR 3962), which was passed by the House in November 2009, by a margin of 220-215 votes.
A similar bill to HR 3200, called the "Affordable Health Choices Act" (HR 1679)), was introduced in the Senate
on September 17, 2009. It too was unsuccessful as the Senate approved instead another proposal called the "Patient Protection and Affordable Care Act
".
According to the Congressional Budget Office
, HR 3200 includes tax increases and spending cuts that reduce the net increase in the federal deficit to 1% of 2008 tax revenues. The CBO director subsequently noted that, in terms of total National Health Expenditure, non-governmental spending will increase as coverage expands.
The bill was originally sponsored by Representatives John Dingell
, Charles Rangel
, Henry Waxman
, George Miller, Pete Stark
, Frank Pallone
, and Robert Andrews
. The 1017 page PDF version of the bill is the first of three health care reform-related legislative proposals expected from the Democratic congressional leadership. Votes in the U.S. House of Representatives on this bill and on the United States National Health Care Act, an alternative that would establish a national, universal single-payer health insurance, were previously expected in September 2009 and again in October 2009, before the actual November 2009 vote took place.
published comparison tables of the main House version with the two main Senate versions, which themselves may be summarized as:
is a non-partisan organization that analyzes the effect on the federal budget of proposed and existing legislation on behalf of the Congress. CBO analyzed the bill as of July 14, 2009 and reported the following:
In terms of what would happen for consumers, the CBO's methodology in a report in late July used a public plan with premiums about 10% lower than private plans.
The act creates new standards, indented by lawmakers as methods of consumer protection
, for what would be considered a minimally acceptable insurance plan. Employers that currently offer insurance have a five year grace period after the act begins before they would subject to the standards. Individuals would be free to purchase their own private insurance, or work with the public option, in this period and afterward.
. It will consist of 9 more individuals who are not federal employees that are appointed by the President of the United States
. It will also consist of 9 members who are appointed by the Comptroller General of the United States
. Also, up to eight more members will be appointed in even numbers by the President of the United States
who are federal employees and officers. Each member of the committee will serve three year terms. The Health Benefits Advisory Committee will recommend to the United States Secretary of Health and Human Services
benefit standards and periodic updates to such standards.
reimbursement for physicians who provide voluntary counseling about such subjects as living wills. The provision is based on a separate bill that was cosponsored by Republican
Charles Boustany
of Louisiana
, a surgeon, and is similar to end-of-life counseling signed by President George W. Bush
. This Advance Care Planning Consultation section was criticized by some Republicans
and conservatives
such as Betsy McCaughey, a lobbyist for the healthcare industry who also helped to defeat the Clinton health care plan of 1993. These critics allege that it includes mandatory language aimed at pressing elderly and disabled patients toward euthanasia
. Their interpretation was the basis for the charge about this section by prominent Republican 2008 Vice Presidential candidate Sarah Palin
.
However, the "level of productivity in society" or panels claim is not mentioned in the actual legislation, which is structured primarily to amend a specific clause in the Social Security Act, Section 1861 of definitions that are used in sections regarding reimbursements for end-of-life counseling, including the use of Advance Directives.
Charles Boustany's Democratic
cosponsor, Earl Blumenauer
of Oregon, has called this attack on the bill "an all-time low".
Blumenauer said the measure would block funds for counseling that presents suicide or assisted suicide as an option, and called references to death panels or euthanasia "mind-numbing". He said that "the majority of Congressional Republicans supported the similar provisions for terminally ill elderly patients that were part of the 2003 prescription drug bill" and that, out of the dozens of Republican proposals for revising the bill, "not a single word" was said against end-of-life counseling. He said that Rush Limbaugh
, Virginia Foxx
, Newt Gingrich
, Charles Grassley and other Republicans defended the death panel story only after Betsy McCaughey's editorials, and that some people at town hall meetings even wanted to "keep government out of their Medicare," a government run program. Blumenauer said that as recently as April 2008 then-governor Palin supported end-of-life counseling as part of Health Care Decisions Day. Palin's office called this comparison "hysterically funny" and "desperate". Republican Senator Johnny Isakson
, who co-sponsored a 2007 end-of-life counseling provision, called the euthanasia claim "nuts". Analysts who examined the end-of-life provision Palin cited agreed that it merely authorized Medicare
reimbursement for physicians who provide voluntary counseling for advance health care directives (including living wills). According to TIME and ABC, Palin and McCaughey made false euthanasia claims.
The page 425 legislation began as a separate bill that was co-sponsored by Republicans Charles Boustany
, Patrick Tiberi and Geoff Davis
. Boustany, a heart surgeon, said the end-of-life legislation was a "good medical practice". 204 GOP House members and 42 GOP Senators voted for a 2003 Medicare prescription drug bill that included end-of-life counseling. The 2003 legislation only covered end-of-life counseling for terminally ill patients, which the Republican Charles Grassley supported. Grassley said that the 2009 end-of-life counseling would "pull the plug on grandma" and that "You shouldn't have counseling at the end of life, you should have done that 20 years before," which is what the 2009 legislation would allow. Republican Newt Gingrich
defended the death panel claim, but previously praised the Gundersen Lutheran Health System
for encouraging the widespread use of Advance Directives.
The federal requirement that hospitals help patients with things like living wills began when Republican George H. W. Bush
was President. Section 1233 merely allows doctors to be paid for their time. However, between 30 percent and 45 percent of Americans believed in the death panel story. According to PolitiFact, private health insurance companies already ration health care by income, by denying health insurance to those with pre-existing conditions and by caps on health insurance payments. Rationing exists now, and will continue to exist with or without health care reform.
The "death panel" argument was endorsed by an erroneous editorial in the Investor's Business Daily
, which analogized the bill to the National Health Service
(NHS) in the United Kingdom
and editorialized: "People such as scientist Stephen Hawking
wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless." The Investor's Business Daily editorialists had to beat a retreat and quickly retracted its claim after it was pointed out that Hawking is in fact British, and has lived his entire life in the United Kingdom with treatment from the NHS. Stephen Hawking responded, "I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived."
On a separate issue, physician and conservative commentator Charles Krauthammer
has criticized what he sees as a naive focus on living wills by the policymakers over other types of medical advice. He has written: "When my father was dying, my mother and brother and I had to decide how much treatment to pursue. What was a better way to ascertain my father's wishes: What he checked off on a form... or what we, who had known him intimately for decades, thought he would want?"
report has stated that the proposed public option is a 'lightning rod
' in American public opinion about healthcare reform. Republicans, people with the insurance industry, and employer groups have discussed the concern that the availability of a public plan would make it difficult for private insurers to compete. This may then lead to a situation where most people end up being covered by the public insurance option.
The Congressional Budget Office
's analysis in late July stated that this would not be the case for the "public option" included in H.R. 3200, projecting that only about 11 to 12 million people would enroll in the public option. The Lewin Group, a research firm that is part of a subsidiary of UnitedHealth Group
but is run independently, has estimated that over 100 million people would join the public plan if it were structured like Medicare
, which would then make it the dominant insurer.
A model similar to one proposed by the late Senator Ted Kennedy
would bring in between 21.5 million and 67.5 million according to the group. A 2008 report by the Urban Institute
stated the public option would probably settle into a 'niche
' in the insurance market with other firms still able to compete.
The bill bases the publicly authorized insurance plan fees on industry averages, so there is no clear economic competitive advantage versus existing private insurance. The health insurance subsidy is available to anyone with a qualifying level of income buying insurance from the exchange regardless of whether they choose a public or private plan. A poll done by Penn, Schoen and Berland Associates for the AARP
stated that only 37% of Americans correctly identified the definition of the 'public option' being proposed, numbers very close to respondents guessing randomly among answers.
In a June 2009 NBC News
/Wall Street Journal survey, 76% said it was either "extremely" or "quite" important to "give people a choice of both a public plan administered by the federal government and a private plan for their health insurance." A July survey by Rasmussen Reports
found 50% of Americans opposed the idea of a public option and 35% expressed support. An August 2009 NBC News/Wall Street Journal poll found 47% of Americans opposed and 43% expressing support. CNN
Polling Director Keating Holland has stated that partisan affiliations drive people's opinions on the issue.
s held by members of Congress during the August 2009 congressional recess were the site of protests and disruptions by opponents of this health care reform legislation. Steven Pearlstein
of The Washington Post
wrote that the concerns raised in most of these town hall disruptions are factually incorrect claims made by some conservative members of Congress and some in the right-wing media in opposition of the reform bill. Wendell Potter, who has been an executive of Cigna
, a for-profit health insurer, stated that health insurance companies "are very much behind the town hall disruptions that you see and a lot of the deception that’s going on in terms of disinformation that many Americans, apparently, are believing."
Many proponents of the reform bill have accused organizations such as FreedomWorks
, a corporate and individual funded activist group, of organizing these protests to look like grassroots opposition. FreedomWorks representatives have stated that they represent grassroots dissatisfaction and disputed the allegations. The chairman of FreedomWorks is former Republican House Majority Leader and healthcare lobbyist Dick Armey
. Health Care for America Now (HCAN), a union and individual-funded liberal activist group, organized and co-ordinated health care reform proponents in the town hall meetings. FreedomWorks has accused them of astroturfing
, which HCAN disputes. The Service Employees International Union
(SEIU), a labor union, has been accused by opponents of the reform bill of busing paid operatives into town halls to demonstrate in support of the measure. The group denies the accusation.
Rasmussen Reports
found in a late-August survey that a 49% plurality of Americans believe that protesters genuinely express their own views while 37% consider them to be a creation of special interest groups and lobbyists. An early-August survey stated that 35% viewed the protests unfavorably and 41% viewed them favorably. Both polls showed highly partisan differences in people's view of the town halls.
has written in the Washington Post in late August that, in his opinion, polls now indicate that senior citizens are becoming fearful of healthcare reform, due to concerns that funding subsidies for the uninsured would require cuts to the popular Medicare program. He said that the specific changes "don't involve anything of the kind (most of the savings would come from reducing overpayments to the private insurers that participate in the Medicare Advantage program)". He argued that, as a result, an odd but potent political alliance has emerged with Republicans arguing to protect the existing Medicare program despite its position historically which has been to oppose Medicare as an entitlement.
Peter R. Orszag
, the then director of the CBO
, argued in June 2008 that the Medicare program as currently structured is unsustainable without significant reform, as tax revenues dedicated to the program are not sufficient to cover its rapidly increasing expenditures. According to the CBO
, spending on Medicare will grow from $485 billion during 2009 to $879 billion by 2018. President Obama said at a White House news conference on July 22 that, without changes, the system is guaranteed “to basically break the federal budget”. He argued that it is necessary to cut wasteful spending which is known to exist (over-testing, no IT, lack of co-ordination, hospital re-admissions) in order to cut costs in order to protect Medicare in the future and cut the projected national deficit.
The act, as currently structured, does not cut present Medicare benefits. It reduces projected future increases in Medicare spending such as inpatient hospital service payments and ambulatory care payments that would otherwise undergo annual re-adjustments. These changes would save $196 billion from Medicare over 10 years and removing wasteful subsidies to insurers for Medicare Advantage plan would save a further $156 billion according to the CBO
. Gail Wilensky
, a deputy assistant to President Bush Snr advising him on health and welfare issues from 1992–1993 and previously a director of Medicare and Medicaid has expressed concern that this might affect seniors access to health care if the changes are made too quickly, while other activists such as Stuart Guterman of the Commonwealth Fund
argue that Medicare Advantage plans cost the taxpayer $1,000 per policyholder more than if the person had been insured through traditional fee for services.
has also commented on the issue.
prohibits federal funding for abortions in government related health programs unless they are performed in cases of rape, incest, or to save the life of the mother. A political controversy has broken out about whether or not the 'public plan' in HR 3200 will cover abortions, which, if done, would be funded by premiums paid by individuals to that agency and not by outside payments. After rejecting Democratic Rep. Lois Capps's amendment to segregate abortion funding, the House or Representatives voted for tighter restrictions on federal funding for elective abortions via the Stupak Amendment.
'Americans for Stable Quality Care' is an activist group that has devised television ads in support of this type of healthcare reform. Although the group gets funding from the drug lobby PhRMA as well as from the Service Employees International Union
, it does not disclose this fact in the ads themselves. The head of the Public Relations Society of America
, Michael Cherenson, has accused the group of dishonest 'front group' manipulations (his group does not use the exact term 'astroturfing
' since it respects the trademark). The vice chairperson of PhRMA has disputed the allegation and referred to the campaign as completely "transparent".
111th United States Congress
The One Hundred Eleventh United States Congress was the meeting of the legislative branch of the United States federal government from January 3, 2009 until January 3, 2011. It began during the last two weeks of the George W. Bush administration, with the remainder spanning the first two years of...
as part of an effort of the Democratic Party leadership to enact health care reform. The bill was not approved by the House, but was superseded by a similar bill, the proposed Affordable Health Care for America Act
Affordable Health Care for America Act
The Affordable Health Care for America Act was a bill that was crafted by the United States House of Representatives in November 2009. At the encouragement of the Obama administration, the 111th Congress devoted much of its time to enacting reform of the United States' health care system...
(HR 3962), which was passed by the House in November 2009, by a margin of 220-215 votes.
A similar bill to HR 3200, called the "Affordable Health Choices Act" (HR 1679)), was introduced in the Senate
United States Senate
The United States Senate is the upper house of the bicameral legislature of the United States, and together with the United States House of Representatives comprises the United States Congress. The composition and powers of the Senate are established in Article One of the U.S. Constitution. Each...
on September 17, 2009. It too was unsuccessful as the Senate approved instead another proposal called the "Patient Protection and Affordable Care Act
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
".
According to the Congressional Budget Office
Congressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....
, HR 3200 includes tax increases and spending cuts that reduce the net increase in the federal deficit to 1% of 2008 tax revenues. The CBO director subsequently noted that, in terms of total National Health Expenditure, non-governmental spending will increase as coverage expands.
The bill was originally sponsored by Representatives John Dingell
John Dingell
John David Dingell, Jr. is the U.S. Representative for , serving since 1955 . He is a member of the Democratic Party...
, Charles Rangel
Charles B. Rangel
Charles Bernard "Charlie" Rangel is the U.S. Representative for , serving since 1971. A member of the Democratic Party, he is the third-longest currently serving member of the House of Representatives. As its most senior member, he is also the Dean of New York's congressional delegation...
, Henry Waxman
Henry Waxman
Henry Arnold Waxman is the U.S. Representative for , serving in Congress since 1975. He is a member of the Democratic Party. He is considered to be one of the most influential liberal members of Congress...
, George Miller, Pete Stark
Pete Stark
Fortney Hillman "Pete" Stark, Jr. is the U.S. Representative for , serving since 1973. He is a member of the Democratic Party. Currently he is the 5th most senior Representative, as well as 6th most senior member of Congress overall...
, Frank Pallone
Frank Pallone
Frank Pallone, Jr. is the U.S. Representative for , serving since 1993. He is a member of the Democratic Party. He previously represented the 3rd district from 1988 to 1993.-Early life, education, and early political career:...
, and Robert Andrews
Rob Andrews
Robert Ernest "Rob" Andrews is the U.S. Representative for , serving since 1990. He is a member of the Democratic Party. The district includes most of Camden County and parts of Burlington County and Gloucester County....
. The 1017 page PDF version of the bill is the first of three health care reform-related legislative proposals expected from the Democratic congressional leadership. Votes in the U.S. House of Representatives on this bill and on the United States National Health Care Act, an alternative that would establish a national, universal single-payer health insurance, were previously expected in September 2009 and again in October 2009, before the actual November 2009 vote took place.
Elements of the bill
The summary of the bill includes the following elements, among others:- Establishes a mandate to purchase private insurance for most individuals with an income above poverty level.
- Creates a mechanism to enforce the mandate in a sliding scaleSliding scale feesSliding scale fees are variable costs for products, services, or taxes based on one's ability to pay. Such fees are thereby reduced for those who have lower incomes or less money to spare after their personal expenses, regardless of income....
tax on those who do not purchase health insurance for most legal United States residents with an income above poverty level. - Prohibits pre-existing conditionPre-existing conditionA pre-existing condition is a risk with extant causes that is not readily compensated by standard, affordable insurance premiums. Pre-existing condition exclusions by the insurance industry are meant to cope with adverse selection by potential customers. Such exclusions have become a topic in the...
exclusions. - Requires adjusted community ratingCommunity ratingCommunity rating is a concept usually associated with health insurance, which requires health insurance providers to offer health insurance policies within a given territory at the same price to all persons without medical underwriting, regardless of their health status.Pure community rating...
, guaranteed issue, and guaranteed renewal of individual and small group health insurance that: limits age rating variation of premiums to 2:1 (200 percent), prohibits gender and health status rating variation of premiums, allows variation of premiums by geographic area and family (vs. individual) enrollment. - Prohibits cancellation of coverage except for evidence of fraud.
- Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family.
- Requires Health and Human Services to create a non-subsidized public health insurance planPublic health insurance optionThe public health insurance option is a proposed government-run health insurance agency which competes with other health insurance companies. It is not the same as Publicly-funded health care. Called the public insurance option or public option, for short, it was a proposed health insurance plan...
with pricing based on private industry averages. Three optional levels of coverage are to be offered by the plan which must set premiums at a level sufficient to fully finance the costs of the health benefits the administrative costs related to operating the plan. - Establishes a Health Insurance Exchange (HIE) within a proposed Health Choices Administration, to provide a market place for insurers to sell qualifying plans on a public web site.
- Requires the creation of a risk equalizationRisk equalizationRisk equalization is a way of equalizing the risk profiles of insurance members in order to avoid loading premiums on the insured to some predetermined extent.- Health care :...
pool that will allow qualifying plans to minimize the impact of adverse selectionAdverse selectionAdverse selection, anti-selection, or negative selection is a term used in economics, insurance, statistics, and risk management. It refers to a market process in which "bad" results occur when buyers and sellers have asymmetric information : the "bad" products or services are more likely to be...
of enrollees among the plans. - Provides a tax creditTax creditA tax credit is a sum deducted from the total amount a taxpayer owes to the state. A tax credit may be granted for various types of taxes, such as an income tax, property tax, or VAT. It may be granted in recognition of taxes already paid, as a subsidy, or to encourage investment or other behaviors...
for low-income individuals and families to help pay insurance premiums. - Requires employers with payroll costs over $500,000 to provide health insurance that meets the minimum standard of coverage allowed in the HIE.
- Provides for a tax on employers that do not provide the required health insurance.
- Provides for a tax on couples with adjusted joint gross income exceeding $350,000 (80% of this figure for single people)
- Reduces Medicare payments to hospitals with excessive re-admissions.
- Further expands Medicaid eligibility and scope of covered preventive services, for lower-income individuals and families.
- Increases Medicaid payments to physicians for primary care.
- Provides for a phased-in elimination of the Medicare Part DMedicare Part DMedicare Part D is a federal program to subsidize the costs of prescription drugs for Medicare beneficiaries in the United States. It was enacted as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and went into effect on January 1, 2006.- Eligibility and...
coverage gapDonut Hole (Medicare)The Medicare Part D coverage gap — informally known as the Medicare donut hole — is the difference of the initial coverage limit and the catastrophic coverage threshold, as described in the Medicare Part D prescription drug program administered by the United States federal government...
and requires drug manufactures to discount and/or rebate additional qualifying drugs originally excluded from the plan. - Requires the Secretary of Health and Human Services (HHS) to develop quality measures for the delivery of health care services in the United States.
- Establishes the Health Benefits Advisory Committee chaired by the Surgeon General of the United StatesSurgeon General of the United StatesThe Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps and thus the leading spokesperson on matters of public health in the federal government...
. - Prioritizes any eventual implementation of best practices in the delivery of health care.
- Establishes a National Prevention and Wellness Strategy along with appropriations for its trust fund.
- Outlines Administrative standards that reduces costs and improves service, including the ability for Administrators to determine an accurate total financial estimate at the point of service as well as enabling real time electronic transfer of funds to take place if possible (mirrors currently existing laws).
House Committees' mark-ups
America's Affordable Health Choices Act of 2009 has been amended in the nature of substitute during mark-up proceedings since its original introduction recorded in the Congressional Record on July 14, 2009. These amendments have only been voted on by each Committee involved in order to pass out of the Committee phase but have not been voted on by the full House membership, which is needed before the originally introduced legislation can be changed to reflect any amendments recommended by the Committees and passed by a full House vote.House Committee on Energy and Commerce
- See external link to Mark-Up Summary
House Committee on Ways and Means
- See external link to Mark-Up Summary
House Committee on Education and Labor
- Kucinich Amendment
-
- The Kucinich Amendment to Health Care Bill HR 3200 grants states rights to single payer health care at the state level. This is how CanadaHealth care in CanadaHealth care in Canada is delivered through a publicly-funded health care system, which is mostly free at the point of use and has most services provided by private entities. It is guided by the provisions of the Canada Health Act. The government assures the quality of care through federal standards...
adopted single payer, with SaskatchewanSaskatchewanSaskatchewan is a prairie province in Canada, which has an area of . Saskatchewan is bordered on the west by Alberta, on the north by the Northwest Territories, on the east by Manitoba, and on the south by the U.S. states of Montana and North Dakota....
passing it first. In July 2009, the House Education and Labor Committee approved the Kucinich Amendment by a vote of 27–19, with 14 Democrats and 13 Republicans voting for it.
- The Kucinich Amendment to Health Care Bill HR 3200 grants states rights to single payer health care at the state level. This is how Canada
- See external link to Mark-Up Summary
Comparison with Senate versions
The Washington PostThe Washington Post
The Washington Post is Washington, D.C.'s largest newspaper and its oldest still-existing paper, founded in 1877. Located in the capital of the United States, The Post has a particular emphasis on national politics. D.C., Maryland, and Virginia editions are printed for daily circulation...
published comparison tables of the main House version with the two main Senate versions, which themselves may be summarized as:
| 3 Versions | House | Senate Health | Senate Finished | Notes |
|---|---|---|---|---|
| Deficit increase(+)/ reduction(-) to 2019 ($B) | -104 | +597 | -81 | Senate Health Committee has no jurisdiction to modify taxes |
| Cost($B) | 1279 | 645 | 845 | |
| Number of uninsured | 17M | 34M | 25M | 54M uninsured by 2019 without bill |
| Public option | Yes | Yes | No | |
| Individual mandate | Yes | Yes | Yes | (see Insurance subsidies) |
| Employer mandate | Yes | Yes | No | |
| New taxes($k) | fam>350 | No* | plan>21 | *outside Senate Health Committee jurisdiction |
| Insurance reforms | Yes | Yes | Yes | |
| Expand Medicaid | Yes | No* | Yes | *outside Senate Health Committee jurisdiction |
| Insurance subsidies | Yes | Yes | Yes | prorated to $88k/family of 4, or tax creds(S.Fin) |
CBO analysis of the bill
The U.S. Congressional Budget OfficeCongressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....
is a non-partisan organization that analyzes the effect on the federal budget of proposed and existing legislation on behalf of the Congress. CBO analyzed the bill as of July 14, 2009 and reported the following:
In terms of what would happen for consumers, the CBO's methodology in a report in late July used a public plan with premiums about 10% lower than private plans.
Health exchange details
Businesses with ten or fewer employees can use the exchange in the first year after the act begins. The cutoff changes to twenty or fewer employees the next year. On the third year, the 'Health Choices Commissioner' has the authority to phase in businesses with more employees. The legislation does not specify any further phases, leaving that up to the officer to decide.The act creates new standards, indented by lawmakers as methods of consumer protection
Consumer protection
Consumer protection laws designed to ensure fair trade competition and the free flow of truthful information in the marketplace. The laws are designed to prevent businesses that engage in fraud or specified unfair practices from gaining an advantage over competitors and may provide additional...
, for what would be considered a minimally acceptable insurance plan. Employers that currently offer insurance have a five year grace period after the act begins before they would subject to the standards. Individuals would be free to purchase their own private insurance, or work with the public option, in this period and afterward.
Health Benefits Advisory Committee
According to Division A, Title I, Subtitle C, Section 123 of HR 3200, a Health Benefits Advisory Committee shall be established to be chaired by the Surgeon General of the United StatesSurgeon General of the United States
The Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps and thus the leading spokesperson on matters of public health in the federal government...
. It will consist of 9 more individuals who are not federal employees that are appointed by the President of the United States
President of the United States
The President of the United States of America is the head of state and head of government of the United States. The president leads the executive branch of the federal government and is the commander-in-chief of the United States Armed Forces....
. It will also consist of 9 members who are appointed by the Comptroller General of the United States
Comptroller General of the United States
The Comptroller General of the United States is the director of the Government Accountability Office , a legislative branch agency established by Congress in 1921 to ensure the fiscal and managerial accountability of the federal government...
. Also, up to eight more members will be appointed in even numbers by the President of the United States
President of the United States
The President of the United States of America is the head of state and head of government of the United States. The president leads the executive branch of the federal government and is the commander-in-chief of the United States Armed Forces....
who are federal employees and officers. Each member of the committee will serve three year terms. The Health Benefits Advisory Committee will recommend to the United States Secretary of Health and Human Services
United States Secretary of Health and Human Services
The United States Secretary of Health and Human Services is the head of the United States Department of Health and Human Services, concerned with health matters. The Secretary is a member of the President's Cabinet...
benefit standards and periodic updates to such standards.
Reimbursement for counseling about living wills
One often-cited provision of the un-passed bill would have authorized MedicareMedicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
reimbursement for physicians who provide voluntary counseling about such subjects as living wills. The provision is based on a separate bill that was cosponsored by Republican
Republican Party (United States)
The Republican Party is one of the two major contemporary political parties in the United States, along with the Democratic Party. Founded by anti-slavery expansion activists in 1854, it is often called the GOP . The party's platform generally reflects American conservatism in the U.S...
Charles Boustany
Charles Boustany
Charles William Boustany, Jr. is the U.S. Representative for , serving since 2005. He is a member of the Republican Party.-Early life, education, and medical career:...
of Louisiana
Louisiana
Louisiana is a state located in the southern region of the United States of America. Its capital is Baton Rouge and largest city is New Orleans. Louisiana is the only state in the U.S. with political subdivisions termed parishes, which are local governments equivalent to counties...
, a surgeon, and is similar to end-of-life counseling signed by President George W. Bush
George W. Bush
George Walker Bush is an American politician who served as the 43rd President of the United States, from 2001 to 2009. Before that, he was the 46th Governor of Texas, having served from 1995 to 2000....
. This Advance Care Planning Consultation section was criticized by some Republicans
Republican Party (United States)
The Republican Party is one of the two major contemporary political parties in the United States, along with the Democratic Party. Founded by anti-slavery expansion activists in 1854, it is often called the GOP . The party's platform generally reflects American conservatism in the U.S...
and conservatives
American conservatism
Conservatism in the United States has played an important role in American politics since the 1950s. Historian Gregory Schneider identifies several constants in American conservatism: respect for tradition, support of republicanism, preservation of "the rule of law and the Christian religion", and...
such as Betsy McCaughey, a lobbyist for the healthcare industry who also helped to defeat the Clinton health care plan of 1993. These critics allege that it includes mandatory language aimed at pressing elderly and disabled patients toward euthanasia
Euthanasia
Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering....
. Their interpretation was the basis for the charge about this section by prominent Republican 2008 Vice Presidential candidate Sarah Palin
Sarah Palin
Sarah Louise Palin is an American politician, commentator and author. As the Republican Party nominee for Vice President in the 2008 presidential election, she was the first Alaskan on the national ticket of a major party and first Republican woman nominated for the vice-presidency.She was...
.
However, the "level of productivity in society" or panels claim is not mentioned in the actual legislation, which is structured primarily to amend a specific clause in the Social Security Act, Section 1861 of definitions that are used in sections regarding reimbursements for end-of-life counseling, including the use of Advance Directives.
Charles Boustany's Democratic
Democratic Party (United States)
The Democratic Party is one of two major contemporary political parties in the United States, along with the Republican Party. The party's socially liberal and progressive platform is largely considered center-left in the U.S. political spectrum. The party has the lengthiest record of continuous...
cosponsor, Earl Blumenauer
Earl Blumenauer
Earl Blumenauer is the U.S. Representative for , serving since 1996. He is a member of the Democratic Party. The district includes most of Portland east of the Willamette River. A native of Portland, he previously spent over 20 years as a public official representing the city.-Early...
of Oregon, has called this attack on the bill "an all-time low".
Blumenauer said the measure would block funds for counseling that presents suicide or assisted suicide as an option, and called references to death panels or euthanasia "mind-numbing". He said that "the majority of Congressional Republicans supported the similar provisions for terminally ill elderly patients that were part of the 2003 prescription drug bill" and that, out of the dozens of Republican proposals for revising the bill, "not a single word" was said against end-of-life counseling. He said that Rush Limbaugh
Rush Limbaugh
Rush Hudson Limbaugh III is an American radio talk show host, conservative political commentator, and an opinion leader in American conservatism. He hosts The Rush Limbaugh Show which is aired throughout the U.S. on Premiere Radio Networks and is the highest-rated talk-radio program in the United...
, Virginia Foxx
Virginia Foxx
Virginia Foxx is the U.S. Representative for , serving since 2005. She is a member of the Republican Party. The district takes in much of the northwestern portion of the state and a portion of Winston-Salem....
, Newt Gingrich
Newt Gingrich
Newton Leroy "Newt" Gingrich is a U.S. Republican Party politician who served as the House Minority Whip from 1989 to 1995 and as the 58th Speaker of the U.S. House of Representatives from 1995 to 1999....
, Charles Grassley and other Republicans defended the death panel story only after Betsy McCaughey's editorials, and that some people at town hall meetings even wanted to "keep government out of their Medicare," a government run program. Blumenauer said that as recently as April 2008 then-governor Palin supported end-of-life counseling as part of Health Care Decisions Day. Palin's office called this comparison "hysterically funny" and "desperate". Republican Senator Johnny Isakson
Johnny Isakson
John Hardy "Johnny" Isakson is the junior United States Senator from Georgia and a member of the Republican Party. Previously, he represented in the House....
, who co-sponsored a 2007 end-of-life counseling provision, called the euthanasia claim "nuts". Analysts who examined the end-of-life provision Palin cited agreed that it merely authorized Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
reimbursement for physicians who provide voluntary counseling for advance health care directives (including living wills). According to TIME and ABC, Palin and McCaughey made false euthanasia claims.
The page 425 legislation began as a separate bill that was co-sponsored by Republicans Charles Boustany
Charles Boustany
Charles William Boustany, Jr. is the U.S. Representative for , serving since 2005. He is a member of the Republican Party.-Early life, education, and medical career:...
, Patrick Tiberi and Geoff Davis
Geoff Davis
Geoffrey C. "Geoff" Davis is the U.S. Representative for , serving since 2005. He is a member of the Republican Party....
. Boustany, a heart surgeon, said the end-of-life legislation was a "good medical practice". 204 GOP House members and 42 GOP Senators voted for a 2003 Medicare prescription drug bill that included end-of-life counseling. The 2003 legislation only covered end-of-life counseling for terminally ill patients, which the Republican Charles Grassley supported. Grassley said that the 2009 end-of-life counseling would "pull the plug on grandma" and that "You shouldn't have counseling at the end of life, you should have done that 20 years before," which is what the 2009 legislation would allow. Republican Newt Gingrich
Newt Gingrich
Newton Leroy "Newt" Gingrich is a U.S. Republican Party politician who served as the House Minority Whip from 1989 to 1995 and as the 58th Speaker of the U.S. House of Representatives from 1995 to 1999....
defended the death panel claim, but previously praised the Gundersen Lutheran Health System
Gundersen Lutheran Medical Center
Gundersen Lutheran Medical Center a comprehensive health care network including one of the nation's largest multi-specialty group medical practices, regional community clinics, hospital, home care, behavioral health services, vision centers, pharmacies, and air and ground ambulances.Gundersen...
for encouraging the widespread use of Advance Directives.
The federal requirement that hospitals help patients with things like living wills began when Republican George H. W. Bush
George H. W. Bush
George Herbert Walker Bush is an American politician who served as the 41st President of the United States . He had previously served as the 43rd Vice President of the United States , a congressman, an ambassador, and Director of Central Intelligence.Bush was born in Milton, Massachusetts, to...
was President. Section 1233 merely allows doctors to be paid for their time. However, between 30 percent and 45 percent of Americans believed in the death panel story. According to PolitiFact, private health insurance companies already ration health care by income, by denying health insurance to those with pre-existing conditions and by caps on health insurance payments. Rationing exists now, and will continue to exist with or without health care reform.
The "death panel" argument was endorsed by an erroneous editorial in the Investor's Business Daily
Investor's Business Daily
Investor's Business Daily is a national newspaper in the United States, published Monday through Friday, that covers international business, finance, and the global economy...
, which analogized the bill to the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
(NHS) in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
and editorialized: "People such as scientist Stephen Hawking
Stephen Hawking
Stephen William Hawking, CH, CBE, FRS, FRSA is an English theoretical physicist and cosmologist, whose scientific books and public appearances have made him an academic celebrity...
wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless." The Investor's Business Daily editorialists had to beat a retreat and quickly retracted its claim after it was pointed out that Hawking is in fact British, and has lived his entire life in the United Kingdom with treatment from the NHS. Stephen Hawking responded, "I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived."
On a separate issue, physician and conservative commentator Charles Krauthammer
Charles Krauthammer
Charles Krauthammer, MD is an American Pulitzer Prize–winning syndicated columnist, political commentator, and physician. His weekly column appears in The Washington Post and is syndicated to more than 275 newspapers and media outlets. He is a contributing editor to the Weekly Standard and The New...
has criticized what he sees as a naive focus on living wills by the policymakers over other types of medical advice. He has written: "When my father was dying, my mother and brother and I had to decide how much treatment to pursue. What was a better way to ascertain my father's wishes: What he checked off on a form... or what we, who had known him intimately for decades, thought he would want?"
Competition
A CNNCNN
Cable News Network is a U.S. cable news channel founded in 1980 by Ted Turner. Upon its launch, CNN was the first channel to provide 24-hour television news coverage, and the first all-news television channel in the United States...
report has stated that the proposed public option is a 'lightning rod
Lightning rod
A lightning rod or lightning conductor is a metal rod or conductor mounted on top of a building and electrically connected to the ground through a wire, to protect the building in the event of lightning...
' in American public opinion about healthcare reform. Republicans, people with the insurance industry, and employer groups have discussed the concern that the availability of a public plan would make it difficult for private insurers to compete. This may then lead to a situation where most people end up being covered by the public insurance option.
The Congressional Budget Office
Congressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....
's analysis in late July stated that this would not be the case for the "public option" included in H.R. 3200, projecting that only about 11 to 12 million people would enroll in the public option. The Lewin Group, a research firm that is part of a subsidiary of UnitedHealth Group
UnitedHealth Group
UnitedHealth Group Incorporated is a diversified health and "well-being" company. Headquartered in Minnetonka, Minnesota, UnitedHealth Group offers a spectrum of products and services through two operating businesses: United Healthcare and Optum. Through its family of subsidiaries and divisions,...
but is run independently, has estimated that over 100 million people would join the public plan if it were structured like Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
, which would then make it the dominant insurer.
A model similar to one proposed by the late Senator Ted Kennedy
Ted Kennedy
Edward Moore "Ted" Kennedy was a United States Senator from Massachusetts and a member of the Democratic Party. Serving almost 47 years, he was the second most senior member of the Senate when he died and is the fourth-longest-serving senator in United States history...
would bring in between 21.5 million and 67.5 million according to the group. A 2008 report by the Urban Institute
Urban Institute
The Urban Institute is a Washington, D.C.-based think tank that carries out nonpartisan economic and social policy research, collects data, evaluates social programs, educates the public on key domestic issues, and provides advice and technical assistance to developing governments abroad...
stated the public option would probably settle into a 'niche
Niche market
A niche market is the subset of the market on which a specific product is focusing; therefore the market niche defines the specific product features aimed at satisfying specific market needs, as well as the price range, production quality and the demographics that is intended to impact...
' in the insurance market with other firms still able to compete.
The bill bases the publicly authorized insurance plan fees on industry averages, so there is no clear economic competitive advantage versus existing private insurance. The health insurance subsidy is available to anyone with a qualifying level of income buying insurance from the exchange regardless of whether they choose a public or private plan. A poll done by Penn, Schoen and Berland Associates for the AARP
AARP
AARP, formerly the American Association of Retired Persons, is the United States-based non-governmental organization and interest group, founded in 1958 by Ethel Percy Andrus, PhD, a retired educator from California, and based in Washington, D.C. According to its mission statement, it is "a...
stated that only 37% of Americans correctly identified the definition of the 'public option' being proposed, numbers very close to respondents guessing randomly among answers.
In a June 2009 NBC News
NBC News
NBC News is the news division of American television network NBC. It first started broadcasting in February 21, 1940. NBC Nightly News has aired from Studio 3B, located on floors 3 of the NBC Studios is the headquarters of the GE Building forms the centerpiece of 30th Rockefeller Center it is...
/Wall Street Journal survey, 76% said it was either "extremely" or "quite" important to "give people a choice of both a public plan administered by the federal government and a private plan for their health insurance." A July survey by Rasmussen Reports
Rasmussen Reports
Rasmussen Reports is an American media company that publishes and distributes information based on public opinion polling. Founded by pollster Scott Rasmussen in 2003, the company updates daily indexes including the President's job approval rating, and provides public opinion data, analysis, and...
found 50% of Americans opposed the idea of a public option and 35% expressed support. An August 2009 NBC News/Wall Street Journal poll found 47% of Americans opposed and 43% expressing support. CNN
CNN
Cable News Network is a U.S. cable news channel founded in 1980 by Ted Turner. Upon its launch, CNN was the first channel to provide 24-hour television news coverage, and the first all-news television channel in the United States...
Polling Director Keating Holland has stated that partisan affiliations drive people's opinions on the issue.
Town halls
A number of town hall meetingTown hall meeting
A town hall meeting is an American English term given to an informal public meeting. Everybody in a town community is invited to attend, not always to voice their opinions, but to hear the responses from public figures and elected officials about shared subjects of interest. Attendees rarely voted...
s held by members of Congress during the August 2009 congressional recess were the site of protests and disruptions by opponents of this health care reform legislation. Steven Pearlstein
Steven Pearlstein
Steven Pearlstein is an American columnist. He writes a column on business and the economy that is published twice weekly in The Washington Post...
of The Washington Post
The Washington Post
The Washington Post is Washington, D.C.'s largest newspaper and its oldest still-existing paper, founded in 1877. Located in the capital of the United States, The Post has a particular emphasis on national politics. D.C., Maryland, and Virginia editions are printed for daily circulation...
wrote that the concerns raised in most of these town hall disruptions are factually incorrect claims made by some conservative members of Congress and some in the right-wing media in opposition of the reform bill. Wendell Potter, who has been an executive of Cigna
CIGNA
Cigna , headquartered in Bloomfield, Connecticut, is a global health services company, owing to its expanding international footprint and the fact that it provides administrative services only to approximately 80 percent of its clients...
, a for-profit health insurer, stated that health insurance companies "are very much behind the town hall disruptions that you see and a lot of the deception that’s going on in terms of disinformation that many Americans, apparently, are believing."
Many proponents of the reform bill have accused organizations such as FreedomWorks
FreedomWorks
FreedomWorks is a conservative non-profit organization based in Washington D.C., United States. FreedomWorks trains volunteers, assists in campaigns, and encourages them to mobilize, interacting with both fellow citizens and their political representatives....
, a corporate and individual funded activist group, of organizing these protests to look like grassroots opposition. FreedomWorks representatives have stated that they represent grassroots dissatisfaction and disputed the allegations. The chairman of FreedomWorks is former Republican House Majority Leader and healthcare lobbyist Dick Armey
Dick Armey
Richard Keith "Dick" Armey is a former U.S. Representative from Texas's and House Majority Leader . He was one of the engineers of the "Republican Revolution" of the 1990s, in which Republicans were elected to majorities of both houses of Congress for the first time in four decades. Armey was...
. Health Care for America Now (HCAN), a union and individual-funded liberal activist group, organized and co-ordinated health care reform proponents in the town hall meetings. FreedomWorks has accused them of astroturfing
Astroturfing
Astroturfing is a form of advocacy in support of a political, organizational, or corporate agenda, designed to give the appearance of a "grassroots" movement. The goal of such campaigns is to disguise the efforts of a political and/or commercial entity as an independent public reaction to some...
, which HCAN disputes. The Service Employees International Union
Service Employees International Union
Service Employees International Union is a labor union representing about 1.8 million workers in over 100 occupations in the United States , and Canada...
(SEIU), a labor union, has been accused by opponents of the reform bill of busing paid operatives into town halls to demonstrate in support of the measure. The group denies the accusation.
Rasmussen Reports
Rasmussen Reports
Rasmussen Reports is an American media company that publishes and distributes information based on public opinion polling. Founded by pollster Scott Rasmussen in 2003, the company updates daily indexes including the President's job approval rating, and provides public opinion data, analysis, and...
found in a late-August survey that a 49% plurality of Americans believe that protesters genuinely express their own views while 37% consider them to be a creation of special interest groups and lobbyists. An early-August survey stated that 35% viewed the protests unfavorably and 41% viewed them favorably. Both polls showed highly partisan differences in people's view of the town halls.
Medicare issues
Ezra KleinEzra Klein
Ezra Klein is a liberal American blogger and columnist for The Washington Post, columnist for Bloomberg, a columnist for Newsweek, and a contributor to MSNBC...
has written in the Washington Post in late August that, in his opinion, polls now indicate that senior citizens are becoming fearful of healthcare reform, due to concerns that funding subsidies for the uninsured would require cuts to the popular Medicare program. He said that the specific changes "don't involve anything of the kind (most of the savings would come from reducing overpayments to the private insurers that participate in the Medicare Advantage program)". He argued that, as a result, an odd but potent political alliance has emerged with Republicans arguing to protect the existing Medicare program despite its position historically which has been to oppose Medicare as an entitlement.
Peter R. Orszag
Peter R. Orszag
Peter Richard Orszag is an American economist who is a Vice Chairman of Global Banking at Citigroup. He is also a columnist at Bloomberg View...
, the then director of the CBO
Congressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....
, argued in June 2008 that the Medicare program as currently structured is unsustainable without significant reform, as tax revenues dedicated to the program are not sufficient to cover its rapidly increasing expenditures. According to the CBO
Congressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....
, spending on Medicare will grow from $485 billion during 2009 to $879 billion by 2018. President Obama said at a White House news conference on July 22 that, without changes, the system is guaranteed “to basically break the federal budget”. He argued that it is necessary to cut wasteful spending which is known to exist (over-testing, no IT, lack of co-ordination, hospital re-admissions) in order to cut costs in order to protect Medicare in the future and cut the projected national deficit.
The act, as currently structured, does not cut present Medicare benefits. It reduces projected future increases in Medicare spending such as inpatient hospital service payments and ambulatory care payments that would otherwise undergo annual re-adjustments. These changes would save $196 billion from Medicare over 10 years and removing wasteful subsidies to insurers for Medicare Advantage plan would save a further $156 billion according to the CBO
Congressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....
. Gail Wilensky
Gail Wilensky
Gail R. Wilensky is an American health economist who has worked for Republican administrations and candidacies. Wilensky headed Medicare under the first president Bush and works at Project HOPE.-External links:**...
, a deputy assistant to President Bush Snr advising him on health and welfare issues from 1992–1993 and previously a director of Medicare and Medicaid has expressed concern that this might affect seniors access to health care if the changes are made too quickly, while other activists such as Stuart Guterman of the Commonwealth Fund
Commonwealth Fund
The Commonwealth Fund is a private U.S. foundation whose stated purpose is to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, especially for society's most vulnerable.-History:...
argue that Medicare Advantage plans cost the taxpayer $1,000 per policyholder more than if the person had been insured through traditional fee for services.
Illegal immigrants
HR 3200 states that illegal immigrants are not eligible for the proposed taxpayer-funded affordable premium credits. Republicans have stated that there is nothing in the bill to enforce this. A group of 21 House Democrats, led by Rep. Michael M. Honda, are trying to change those requirements. He has argued that the restriction "will only add to uncompensated care costs and costly emergency room visits. Costs due to such visits will be shifted and distributed among all those who have been mandated to carry insurance. With skyrocketing health care costs, legislators should do all that we can to contain costs for working American families". The Center for Immigration StudiesCenter for Immigration Studies
The Center for Immigration Studies is a non-profit research organization that advocates Immigration reduction in the United States. Founded in 1985, its executive director is Mark Krikorian. As a 501 organization, it is subject to limits or absolute prohibitions on engaging in political...
has also commented on the issue.
Abortion funding
The Hyde AmendmentHyde Amendment
In U.S. politics, the Hyde Amendment is a legislative provision barring the use of certain federal funds to pay for abortions. It is not a permanent law, rather it is a "rider" that, in various forms, has been routinely attached to annual appropriations bills since 1976...
prohibits federal funding for abortions in government related health programs unless they are performed in cases of rape, incest, or to save the life of the mother. A political controversy has broken out about whether or not the 'public plan' in HR 3200 will cover abortions, which, if done, would be funded by premiums paid by individuals to that agency and not by outside payments. After rejecting Democratic Rep. Lois Capps's amendment to segregate abortion funding, the House or Representatives voted for tighter restrictions on federal funding for elective abortions via the Stupak Amendment.
Ad campaign funding
"America's Health Insurance Plans", a lobbyist group, opposed the bill.'Americans for Stable Quality Care' is an activist group that has devised television ads in support of this type of healthcare reform. Although the group gets funding from the drug lobby PhRMA as well as from the Service Employees International Union
Service Employees International Union
Service Employees International Union is a labor union representing about 1.8 million workers in over 100 occupations in the United States , and Canada...
, it does not disclose this fact in the ads themselves. The head of the Public Relations Society of America
Public Relations Society of America
The ' , based in New York City, is the world's largest organization for public relations professionals. The organization has more than 21,000 members, including professionals from public relations agencies, corporations, government, health care institutions, military, professional services firms,...
, Michael Cherenson, has accused the group of dishonest 'front group' manipulations (his group does not use the exact term 'astroturfing
Astroturfing
Astroturfing is a form of advocacy in support of a political, organizational, or corporate agenda, designed to give the appearance of a "grassroots" movement. The goal of such campaigns is to disguise the efforts of a political and/or commercial entity as an independent public reaction to some...
' since it respects the trademark). The vice chairperson of PhRMA has disputed the allegation and referred to the campaign as completely "transparent".
See also
- Public opinion on health care reform in the United StatesPublic opinion on health care reform in the United StatesPublic opinion on health care reform in the United States is mixed. Many Americans express a desire for health care reform because they see health care as too expensive and because they perceive that insurance companies avoid meeting health costs through coverage exclusions, caps, and co-pays...
- 111th United States Congress111th United States CongressThe One Hundred Eleventh United States Congress was the meeting of the legislative branch of the United States federal government from January 3, 2009 until January 3, 2011. It began during the last two weeks of the George W. Bush administration, with the remainder spanning the first two years of...
- United States National Health Care Act
- Wyden-Bennett Act
- America’s Healthy Future ActAmerica’s Healthy Future ActThe America’s Healthy Future Act is a proposed law by Democratic Senator Max Baucus of Montana, who chairs the Senate Finance Committee, on September 16, 2009. It is also colloquially known as the Baucus Health Bill, the Baucus Health Plan, or BaucusCare. Baucus initially publicly released a...
- Qualified Health Benefit PlanQualified Health Benefit PlanA Qualified Health Benefit Plan is a health care plan that follows rules included in the proposed Affordable Health Care for America Act , preceded by America's Affordable Health Choices Act of 2009...
External links
- H.R.3200 America's Affordable Health Choices Act of 2009 from the Library of Congress
- H.R.3200 (RH) - America's Affordable Health Choices Act of 2009, as originally introduced in the House from GPO's FDsys.
- Additional Committee documentation since the introduction of H.R. 3200 in Congress (July 14, 2009):
- President Obama REMARKS BY THE PRESIDENT TO A JOINT SESSION OF CONGRESS ON HEALTH CARE September 9, 2009
- Capps amendment to H.R. 3200. House Energy and Commerce Committee. 30 Jul 2009.