- Speaker Pelosi Unveils New Version of House Bill
- November 3, 2009 | Author: Susan Feigin Harris
- Law Firm: Baker & Hostetler LLP - Houston Office
Today, House Speaker Nancy Pelosi (D-Calif.) and other House leaders unveiled H.R. 3962, the Affordable Health Care for America Act, in a ceremony on the West Front of the U.S. Capitol. A product of the merged versions of the healthcare reform bills (H.R. 3200) adopted by the House Education and Labor, Energy and Commerce, and Ways and Means committees, the 1990-page bill would extend coverage to 96 percent of Americans at an estimated cost of $894 billion over ten years. Rep. Louise Slaughter, Chair of the House Rules Committee, has announced a scheduled hearing and markup for H.R. 3962 next week with the goal of a vote by the full House by November 11. The full text of the Affordable Health Care for America Act is posted on the committee website at http://www.rules.house.gov/.
Highlights and key changes from the previous version of the House bill (H.R. 3200) follow below. Also be sure to look for additional details on H.R. 3962 in future issues of the Health Law Update.
- Includes a public health insurance option that authorizes the Secretary of the U.S. Department of Health and Human Services (HHS) to negotiate payment rates with providers that participate in the public plan; clarifies that members of Congress may enroll in the public option.
- Provides start-up loans to establish not-for-profit CO-OPs that compete with private insurers and the public health insurance option.
- Establishes a temporary government program (i.e., high-risk pool) for those who have been uninsured for several months or denied a policy because of pre-existing conditions.
- Provides for an expansion of mandatory Medicaid coverage from 133 percent of poverty to 150 percent.
- Repeals the antitrust exemption for insurers "so that it no longer shields these insurers from liability for fixing prices, dividing up territories, or monopolizing their market."
- Establishes new voluntary state grant program designed to encourage states to implement alternatives to traditional medical malpractice litigation.
- Permits states to enter into agreements to allow for the sale of insurance across state lines.
- Creates a new, voluntary, public, long-term care insurance program to assist persons with functional limitations as a supplement to Medicaid and private long-term care insurance.
- Creates a Center for Medicare & Medicaid Payment Innovation within CMS to test and expand new payment models that encourage higher quality and lower cost.
- Increases the independence of the Comparative Effectiveness Research Commission and establishes a separate independent funding stream for the Commission; clarifies that comparative effectiveness reports "are not considered as mandates for payment, coverage or treatment and that no federal officer or employee will interfere with the practice of medicine."
- Provides for a number of insurance market reforms including prohibition on exclusion for pre-existing conditions, prohibiting insurance companies from placing lifetime caps on coverage and prohibiting employers from reducing retirees’ health benefits, unless the reduction is also made to benefits for active participants. Also allows individuals through age 26 not otherwise covered to remain on their parents’ health insurance at their parents’ discretion.
The overhaul of the Medicare physician payment formula (SGR) was removed from the bill. The House plans to address the physician payment fix as separate legislation (H.R. 3961).