The Congressional Budget Office (CBO) estimates the net cost of expanding coverage at $891 billion, consistent with the $900 billion coverage mark laid out by President Obama in September. The legislation will be fully paid for. CBO estimates the bill reduces the deficit by at least $30 billion over 10 years, not counting the additional deficit reduction generated by the CLASS Act.

 “Tonight, for the first time in our nation’s history, the House voted to guarantee every American access to quality, affordable health insurance,” said U.S. Rep. George Miller (D-CA), the Chairman of the House Education and Labor Committee. “Our bill embodies President Obama’s goals and reflects what we have heard from the American people. Because of this legislation, never again will Americans have to worry about losing their health care if they lose their job or get sick. For all of the great leaders before us who tried to get this done, and for all of the workers and families who will finally have greater health benefits and financial security because of this bill, tonight we made history.”

“God has been good to our country and this Congress and that means we have a responsibility to extend our power to make certain that every American has access to quality, affordable health care,” said U.S. Rep. Charles B. Rangel (D-NY), the Chairman of the House Ways and Means Committee. “We are so proud of this bill because it will cover 96 percent of our nation and ensure that no one will be denied health care because they have a pre-existing condition, or lose their coverage because they lose their job.  This is truly an historic effort to improve the health and well-being of our nation, create jobs and grow our economy.”

“Today is a historic moment for the House of Representatives.” said U.S. Rep. Henry A. Waxman (D-CA), the Chairman of the House Energy and Commerce Committee. “It is a significant victory that the House has passed comprehensive health reform legislation for all Americans.  This bill will at long last reform the health care system by expanding choices, reducing costs, and providing people with peace of mind about their health insurance.”  

“With this historic vote, tens of millions of Americans are closer to getting health insurance.  With this historic vote, we stand to reduce our deficit by billions of dollars over the next decade,” said U.S. Rep. John D. Dingell (D-MI), the Chairman Emeritus of the Energy and Commerce Committee and lead sponsor of H.R. 3962. “With this historic vote we are closer to bringing relief to American families who are forced to decide whether they will pay the mortgage or their health insurance premium.  And with this historic vote, we will help American business compete in the global marketplace.  Many legendary members who served in this body before have fought for national health insurance reform, only to never see it happen.  It is a great honor to serve with a new generation of members who today took bold action, delivering on our promise of change.  Our actions will earn the respect and appreciation of Americans for generations to come.”

 “With this historic vote we are one step closer to fulfilling the promise of making the world's best health care system more affordable and accessible to all. This plan significantly limits the costs that have been spiraling out of control for decades, which have threatened the health, well-being and economic stability of our nation,” said U.S. Rep. Rob Andrews (D-NJ), the Chairman of the Health, Employment, Labor and Pensions Subcommittee. “Making health care more affordable not only reduces the burden on families and businesses, but also frees up the resources needed to create and sustain countless jobs without adding to our nation's deficit. While there is still much work to do, I value the discussions and debates that I have shared with my constituents and colleagues over these past few months. I am proud and humbled to be part of such historic change that will improve the quality of life for millions of Americans and help put our country back on the course of long prosperity.”

“The Affordability Health Care for America Act will mark history with reforms that will put nearly every American within reach of quality health care at affordable costs,” said U.S. Rep. Frank Pallone, Jr. (D-NJ) the Chairman of Energy and Commerce Subcommittee on Health. “More important than the history books is what it will mean for all Americans. It will stop the insurance industry from denying or cutting off care and it will help prevent illness before it strikes. And it will reduce the amount spent on medical care in the country without adding one dime to the deficit. It will make the best of the health care system and help allow America live up to its promise and its ideals.”

“Today's vote is the most important in my career," said U.S. Rep. Pete Stark (D-CA), the Chairman of the House Ways and Means Health Subcommittee.  “I am proud to have helped author this legislation, which will finally guarantee affordable, quality health care to every American.  I urge the Senate to act so we can achieve health care reform this year.”
The legislation will ensure affordability for workers and middle-class families, security for seniors with a stronger, more solvent Medicare program, and a healthy fiscal future.

The key components of the Affordable Health Care for America Act include:

Increasing choice and competition. The bill will protect and improve consumers’ choices.

• If people like their current plans, they will be able to keep them.
• Individuals who aren’t currently covered by their employers and small businesses will be able to purchase coverage through a new Health Insurance Exchange where consumers can comparison shop from a menu of affordable, quality health care options that will include private plans, health co-ops, and a new public health insurance option. The public health insurance option will operate on a level playing field with private insurers, spurring additional competition.
• This Exchange will create competition based on quality and price that leads to better coverage and care. Patients and doctors will have control over decisions about their health care, instead of insurance companies.

Giving Americans peace of mind. The legislation will ensure that Americans have portable, secure health care coverage – so that they won’t lose care if their employer drops their plan or they lose their job.

• Every American who receives coverage through the Exchange will have a plan that includes comprehensive and quality health care benefits.
• It will end increases in premiums or denials of care based on pre-existing conditions, race, or gender, and will strictly limit age rating.
• The proposal will also eliminate co-pays for preventive care, and cap out-of-pocket expenses to protect every American from bankruptcy.

Improving quality of care for every American. The legislation will ensure that Americans of all ages, from young children to retirees, have access to greater quality of care by focusing on prevention, wellness, and strengthening programs that work.

• Guarantees that every child in America will have health care coverage that includes dental, hearing, and vision benefits.
• Provides better preventive and wellness care. Every health care plan offered through the Exchange and by employers, after a grace period, will cover preventive care at no cost to the patient.
• Increases the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
• Strengthens Medicare and Medicaid and closes the Medicare Part D “donut hole” so that seniors and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

Ensuring shared responsibility. The bill will ensure that individuals, employers, and the federal government share responsibility for a quality and affordable health care system.

• Employers can continue offering coverage to workers, and those with payrolls over $500,000 who choose not to offer coverage will contribute a fee of up to eight percent of payroll.
• All individuals will generally be required to get coverage, either through their employer or the exchange, or pay a penalty of 2.5 percent of income.  Individuals facing difficulties can apply for hardship waivers from the penalty.
• The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families, to make premiums affordable and reduce cost-sharing.

Protecting consumers and reducing waste, fraud, and abuse. The legislation will put the interests of consumers first, protect them from insurer discrimination and mistreatment, and reduce waste, fraud and abuse.

• Provides transparency in plans in the Health Exchange so that consumers have clear, complete information, in plain English, to select the plan that best meets their needs.
• Establishes consumer advocacy offices as part of the Exchange to protect consumers, answer questions, and assist with any problems related to their plans.
• Simplifies paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers, and employers will all benefit from a streamlined, less confusing, more consumer-friendly system.
• Increases funding of efforts to reduce waste, fraud and abuse; and creates enhanced oversight of Medicare and Medicaid programs.

Reducing the deficit and ensuring the solvency of Medicare and Medicaid. The legislation will be entirely paid for – it will not add a dime to the deficit and will actually reduce the deficit over at least the next two decades. It will also put Medicare and Medicaid on the path to a more fiscally sound future, so seniors and low-income Americans can continue to receive quality health care benefits for years to come.

• Pays for the entire cost of the legislation though a combination of savings achieved by making Medicare and Medicaid more efficient – without cutting seniors’ benefits in any way – and through revenue generated from placing a surcharge on the top 0.3 percent of all households in the U.S.(married couples with adjusted gross income of over $1,000,000) and other revenue measures.
• CBO estimates the bill will reduce the deficit by at over $30 billion over ten years, not counting the additional deficit reduction generated by the CLASS Act.
• Extends the life of the Medicare trust fund by 5 years.
• Estimates also show the bill will slow the rate of growth of the Medicare program from 6.6 percent annually to 5.3 percent annually.

To view a copy of the Affordable Health Care for America Act, H.R. 3962, click here.

To view the immediate benefits for Americans that kick in under this legislation, click here.

To view a bill summary, detailed fact sheets and more information on what the health insurance reform will mean for Americans, click here.

Hundreds of thousands of people are losing insurance each month. At least 36 million   Americans have no coverage at all – including nearly 50,000 people who live in my district in Northern California.

Over half of all personal bankruptcies are due to a medical incident.  Businesses are chocking on bloated health care costs.  Innovation is being stifled.  Our competitiveness is undermined.

But this year is different. This time is different. The American people cannot afford to wait any longer, and today we will cast a history-making vote to guarantee all Americans access to quality, affordable health insurance.

We must not fail again.

An unprecedented effort by the House led us to this milestone. Three committees and our diverse Caucus worked together in an extensive and coordinated fashion, with one purpose – to fulfill a decades-old, and yet still urgent, promise.

We engaged the public in one of the most transparent debates of federal legislation in history, including over 2,000 events across the U.S. since July alone.

The result is a bill that reflects what we have heard from workers and families, from small business owners and economists, from seniors and college students, from doctors and nurses.

The Affordable Health Care for America Act will directly meet the needs of Americans and the goals that President Obama set for reform: it lowers costs for families and businesses, protects people’s choice of doctors and health plans, reduces the deficit, and ensures access to quality, affordable health insurance for all Americans.

For the first time in U.S. history, all uninsured Americans will be able to purchase quality, affordable coverage through a new Health Insurance Exchange, where they will be able to choose from a menu of options: a public health insurance option or several private plans.

And for those that already have insurance, our bill will grant them the security of knowing that their coverage will always be there.

Never again will Americans worry about losing their health care if they change or lose their job.

Never again will someone be denied health care coverage because of a pre-existing condition.

Never again will a patient have to worry about their insurance company rescinding their policy when they need coverage the most.

Never again will a small business owner have to worry about unpredictable and unaffordable premiums.
Our bill, H.R. 3962, will end the many injustices that workers, families, and businesses face in today’s system. It will finally make health insurance work for consumers – not insurance CEOs.

Let me be specific about what our reforms will mean for the American people:

•    No more co-pays or deductibles for preventative care;
•    No more rate increases because of a pre-existing condition, gender, or occupation;
•    An annual cap on out-of-pocket expenses;
•    Guaranteed affordable dental, hearing and vision care for children;
•    Lower prescription drug costs for seniors;
•    Young people will be able to stay on their parents insurance through their 27th birthday; and
•    A ban on lifetime caps on what insurance companies will pay, so patients will never again be one treatment away from medical bankruptcy.

In my district, the 7th district of California, that means:

•    406,000 residents who receive coverage through their employer will benefit from insurance reforms;
•    Credits in the Exchange will help 123,000 households obtain affordable health insurance; and
•    13,800 small businesses will have access to provide affordable coverage for their employees.

As I mentioned earlier, this legislation meets our commitment to fiscal responsibility.  

Every piece of this bill is fully paid for through a combination of revenue raised by placing a surcharge on the wealthiest Americans and savings generated by making Medicare and Medicaid more efficient.

These reforms will strengthen Medicare for seniors and shift our system’s focus from quantity of health procedures to quality of care and producing healthier outcomes for patients.

The Congressional Budget Office reports that our bill will reduce the deficit by more than $100 billion over the next decade and slow the growth of health spending, leading 11 chief health care economists to declare our legislation “vital to the nation’s fiscal and economic future.”

As with previous efforts to reform health care, this bill received an enormous amount of public scrutiny. In the last few months, opponents of health reform have conjured up every falsehood imaginable about this bill in an effort to scare the American people and once again try to stymie reform.

But as I said, I believe that this year is different. Our legislation has been tested in public and the momentum continues to grow in support of the bill.

The American people have seen through the lies and distortions. And they are not fooled by the hoax of an eleventh-hour Republican bill that is nothing more than a cruel rebuke to the needs of families.  Their bill would do nothing but maintain the status quo and guarantee insurance profits at the expense of tens of millions of hard working Americans.

The American people understand the true meaning of our bill. They know it will cover 96 percent of the American people. They know that, under our bill, if they lose their job they will continue to have health coverage for their children, spouses and families.
They know that this bill means that if they have cancer, the insurance company can no longer pull the rug out from under them while they’re in the middle of treatment.

They know that this bill will protect them, through any economic cycle.

Nearly fifty years ago, as he was fighting to expand health care benefits, President Kennedy said,

“All of the great revolutionary movements of the Franklin Roosevelt Administration we now take for granted. But I refuse to see us live on the accomplishments of another generation. I refuse to see this country and all of us shrink from the struggles which are our responsibility in our times.”

The struggle for health insurance reform is our responsibility today. This is our moment to revolutionize health care in this country.

We have arrived at this historic moment thanks to the hard work of so many people.

I would like to thank my good friends and colleagues, Chairman Rangel and Chairman Waxman, and our three subcommittee chairs, Representatives Rob Andrews, Frank Pallone and Pete Stark, and especially Dean John Dingell. We could not have had better teammates in this journey.  

I would also like to thank the Democratic Leadership, our Speaker, Ms. Nancy Pelosi, the Majority Leader, Mr. Steny Hoyer, our Whip, Mr. James Clyburn, and all the members of leadership for the countless hours they spent working with the committee chairs to arrive at this point today.

And of course we could not have completed the work on this bill without the work of our incredibly talented staff, who worked long nights and weekends for months on end. They are the unsung heroes of this process, and I know all our colleagues join me in thanking them for their extraordinary work.

From my staff I would like to thank Mark Zuckerman, Alex Nock, Danny Weiss, Michele Varnhagen, Megan O’Reilly, Jody Calemine, Tico Almeida, Meredith Regine, James Schroll, Rachel Racusen, Aaron Albright, Amy Peake, Courtney Rochelle, and Mike Kruger.

Finally, I’d like to pay tribute to my mentor and friend, Sen. Edward M. Kennedy. Health care was the cause of Ted’s lifetime. Our effort would have been impossible had he not carried the torch of justice and equality for all those years.

I know I am not alone when I say that I sincerely wish Ted Kennedy could be with us today to see his dream of quality, affordable health care for all become a reality.   

Mr. Speaker, this is the most important bill I have ever worked on during my many years of service in Congress.

I could not be prouder to have helped to write this bill, to encourage each of my colleagues to support it, and to cast my vote in favor of the Affordable Health Care for America Act.

We stand at the doorstep of history.

Let us go in.

“Tonight CBO confirmed that the Republicans’ only solution for health reform is to preserve the status quo,” said U.S. Rep. George Miller (D-CA), the chairman of the House Education and Labor Committee. “It will leave 52 million Americans literally out in the cold, does nothing to help low-income and middle-class families afford quality health care, and protects insurance companies’ power to deny claims and stand between patients and their doctors.”

“Their bill fundamentally fails to repair our broken health care system. Under this proposal, Americans will continue to lose coverage if they have a pre-existing condition or lose their job, seniors will continue to suffer from the donut hole, and millions of Americans will file medical bankruptcy due to illness. This legislation may be a nice giveaway to insurance companies, but it is not the comprehensive reform American needs to cover the tens of millions of uninsured and reduce the hidden costs all Americans pay to cover them.”

According to CBO’s analysis:

•    Only 3 million people would gain coverage, “roughly in line with the current share”. “By 2019, CBO By 2019, the number of nonelderly people without health insurance would be reduced by about 3 million relative to current law, leaving about 52 million nonelderly residents uninsured. The share of legal nonelderly residents with insurance coverage in 2019 would be about 83 percent, roughly in line with the current share.” [p. 3]

•    Would not lower premiums for most consumers. “And in the large group market, which represents nearly 80 percent of total private premiums, the amendment would lower average insurance premiums in 2016 by zero to 3 percent compared with amounts under current law, according to CBO’s estimates.” [p. 5]

•    Premiums could increase for older consumers. “For example, states that loosened rating rules in the market for individually purchased insurance to allow premiums to vary more on the basis of age would cause premiums for older people to increase and premiums for younger people to decrease.” [p.7]

To view the CBO letter, click here.

“Sick workers advised to stay home by their employers shouldn’t have to choose between their livelihood, and their coworkers’ or customer’s health,” said Miller. “This will not only protect employees, but it will save employers money by ensuring that sick employees don’t spread infection to co-workers and customers, and will relieve the financial burden on our health system swamped by those suffering from H1N1.”

“To help control the spread of the H1N1 flu virus, workers who are sick should stay at home,” said Woolsey. “This bill will ensure that workers who are directed to stay home by their employers can do so without paying a financial penalty.”

The Centers for Disease Control estimates that a sick worker will infect one in ten co-workers. As a result, the CDC and other public health officials have advised employers to be flexible when dealing with sick employees and to develop leave policies that will not punish workers for being ill.

At least 50 million American workers do not have access to paid sick leave, many in lower-wage jobs that have direct contact with the public such as the food-service and hospitality industry, schools and health care fields. The National Partnership for Women and Families estimates that the economy loses $180 billion in productivity a year when sick employees show up to work, also known as “presenteeism.”

Among other provisions, the Emergency Influenza Containment Act:

• Guarantees a sick worker up to five paid sick leave days a year if an employer ‘directs’ or ‘advises’ a sick employee to stay home or go home.
• Covers both full-time and part-time workers (on a pro-rated basis) in businesses with 15 or more workers. Employers that already provide at least 5 days’ paid sick leave are exempt.
• An employer can end paid sick leave at any time by informing the employee that the employer believes they’re well enough to return to work. Employees may continue on unpaid leave under the Family Medical Leave Act or other existing sick leave policies.
• Employees who follow their employer’s direction to stay home because of contagious illness cannot be fired, disciplined or made subject to retaliation for following directions. 
• Takes effect 15 days after being signed into law and sunsets after two years.

“This underscores that this legislation will control health care costs and lower health care premiums for families and individuals relative to today,” said Chairman Henry A. Waxman, Chairman Charles B. Rangel, and Chairman George Miller.  “The Affordable Health Care for America Act will make health insurance and health care accessible for millions of low-income and middle-class families who currently lack affordable coverage.”

A Kaiser/HRET survey found that in 2009, premiums for employer-sponsored coverage are $4,824 for individuals and $13,375 for family policies.  Current employer insurance is comparable to the coverage individuals and families will be able to expect in the Exchange with the bill’s insurance reforms and consumer protections in place.  One recent projection estimated that health insurance premiums in 2016 will be over $8,000 for individuals and over $24,000 for families if health reform is not enacted.

CBO additionally recognizes that the House affordability credits and insurance reforms offer more help to more people than the Senate Finance Committee proposal.   These provisions work in tandem to make it more attractive and likely for all people, including older Americans and those with pre-existing conditions, to get insurance instead of remaining uninsured when compared to the Senate Finance Committee proposal.  The House legislation insures seven million more individuals, reaching 96 percent of all Americans.

The Affordable Health Care for America Act (H.R. 3962), which blends and updates the three versions of previous bills passed by the House committees of jurisdiction in July, embodies President Obama’s key goals for health reform. It will slow the growth in out-of-control costs, introduce competition into the health care marketplace to keep coverage affordable and insurers honest, protect people’s choices of doctors and health plans, and assure all Americans access to quality, stable, affordable health care.

The legislation will ensure that 96 percent of Americans will be covered by a quality, affordable health plan. The Congressional Budget Office estimates the cost of expanding coverage at $894 billion, consistent with the $900 billion coverage mark laid out by President Obama. And the legislation will be paid for. CBO estimates the bill reduces the deficit by at least $30 billion over 10 years.

After the House Committees of jurisdiction debated and reported versions of the legislation in July, members of Congress have solicited unprecedented levels of input from the American people.   Since then, the committees, House leadership, and the entire caucus have worked to revise the legislation to reflect the priorities that Members heard from their constituents.

“For over 70 years, generations have fought to bring the promise of quality, affordable health care to every American. Today is a groundbreaking moment in this historic effort,” said U.S. Rep. George Miller (D-CA), the Chairman of the House Education and Labor Committee. “The Affordable Health Care for America Act reflects the hard work and input of many members of Congress and the American people and lives up to the principles that President Obama has laid out. We are closer than ever to guaranteeing every American access to quality, affordable health insurance and giving middle-class families and businesses relief from crushing costs, while reducing our deficit.”  

“For too long, health care has been a privilege, not a right in America,” said U.S. Rep. Charles B. Rangel (D-NY), the Chairman of the House Ways and Means Committee. “This bill ensures that every American has access to high-quality, affordable care that meets their needs, while also working to slow the staggering growth of health care costs.  We have worked long and hard to develop this consensus legislation that incorporates feedback from our constituents to deliver reform that will and protect and strengthen coverage for those who have it and help cover those who are currently uninsured.”

“This is a bill that strengthens the legislation we started with in the House,” said U.S. Rep. Henry A. Waxman (D-CA), the Chairman of the House Energy and Commerce Committee. “It reflects the views that Members heard from constituents in thousands of meetings this summer and fall.  It accommodates diverse views and suggestions from Members from all parts of the House. It incorporates the priorities and principles the President requested of the Congress.  We listened, learned, and made improvements, and are now poised to act on a bill that will at long last make affordable, quality health care for all a reality.”

“We have the world’s best doctors and nurses, but because millions of our people have no access to the care they provide, we’ve become the unhealthiest industrialized nation on the globe.  That is about to change because of H.R. 3962,” said U.S Rep. John D. Dingell (D-MI), the Chairman Emeritus of the Energy and Commerce Committee and lead sponsor of H.R. 3962. “Not only will the legislation cover 96 percent of our citizens, but it will reduce the deficit and help our businesses get equal footing with international competitors.  The bill offers the chance to dramatically improve the quality of life in our nation.  For more than 70 years, great leaders like FDR, Truman, Clinton, Ted Kennedy and my dear old dad have fought for a bill like this. We are too close to fail them now.”

“This is a historic moment.  We are one step closer to fulfilling the promise of President Obama by bringing change to Washington,” said U.S. Rep. Rob Andrews (D-NJ), the Chairman of the Health, Employment, Labor and Pensions Subcommittee. The Affordable Health Care for America Act will create a better health care system that will create jobs, promote wellness, and reduce health care costs for all Americans. We will continue the fight on behalf of those suffering from ever increasing health care costs and inadequate health insurance coverage. I am honored to have participated in the creation of this important bill.”

“This is history in the making for health care in America,” said U.S. Rep. Frank Pallone, Jr. (D-NJ) the Chairman of Energy and Commerce Subcommittee on Health. “Once these reforms are enacted, every American will be able to take comfort in the knowledge they will have access to affordable health care and that insurance coverage won't be denied or taken away. Good health is a basic need shared by all Americans, this will make quality health care a basic right for everyone.”

“As we've worked to reduce the overall cost of this bill, I am most proud that we've done so without shifting greater costs to middle and lower income families,” said U.S. Rep. Pete Stark (D-CA), the Chairman of the Ways and Means Subcommittee on Health. “A strong public health insurance option is a key component to holding down those costs by injecting real competition and accountability into the health care marketplace.  While achieving savings from Medicare, we have also re-invested in the program to eliminate the prescription drug donut hole and strengthen the program’s financial footing. This bill is a real win for American people of all ages, America's businesses of all sizes, and the budgets of our nation and our families.”
The legislation will ensure affordability for workers and middle-class families, security for seniors with a stronger, more solvent Medicare program, and a healthy fiscal future.

Members also introduced at the same time critically important companion legislation, the Medicare Physician Payment Reform Act (H.R. 3961).  That bill will permanently reform Medicare’s physician payment system and place it on a more sustainable footing for physicians and beneficiaries in the future.

The key components of the Affordable health Care for America Act include:

Increasing choice and competition. The bill will protect and improve consumers’ choices.

• If people like their current plans, they will be able to keep them.
• For individuals who aren’t currently covered by their employer, and some small businesses, the proposal will establish a new Health Insurance Exchange where consumers can comparison shop from a menu of affordable, quality health care options that will include private plans, health co-ops, and a new public health insurance option. The public health insurance option will play on a level playing field with private insurers, spurring additional competition.
• This Exchange will create competition based on quality and price that leads to better coverage and care. Patients and doctors will have control over decisions about their health care, instead of insurance companies.

Giving Americans peace of mind. The legislation will ensure that Americans have portable, secure health care coverage – so that they won’t lose care if their employer drops their plan or they lose their job.

• Every American who receives coverage through the Exchange will have a plan that includes standardized, comprehensive and quality health care benefits.
• It will end increases in premiums or denials of care based on pre-existing conditions, race, or gender, and strictly limit age rating.
• The proposal will also eliminate co-pays for preventive care, and cap out-of-pocket expensesto protects every American from bankruptcy.

Improving quality of care for every American. The legislation will ensure that Americans of all ages, from young children to retirees have access to greater quality of care by focusing on prevention, wellness, and strengthening programs that work.

• Guarantees that every child in America will have health care coverage that includes dental, hearing and vision benefits.
• Provides better preventive and wellness care. Every health care plan offered through the exchange and by employers after a grace period will cover preventive care at no cost to the patient.
• Increases the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
• Strengthens Medicare and Medicaid and closes the Medicare Part D ‘donut hole’ so that seniors and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

Ensuring shared responsibility. The bill will ensure that individuals, employers, and the federal government share responsibility for a quality and affordable health care system.

• Employers can continue offering coverage to workers, and those who choose not offer coverage contribute a fee of eight percent of payroll.
• All individuals will generally be required to get coverage, either through their employer or the exchange, or pay a penalty of 2.5 percent of income, subject to a hardship exemption.
• The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.

Protecting consumers and reducing waste, fraud, and abuse. The legislation will put the interests of consumers first, protect them from problems in getting and keeping health care coverage, and reduce waste, fraud, and abuse.

• Provides transparency in plans in the Health Exchange so that consumers have the clear, complete information, in plain English, needed to select the plan that best meets their needs.
• Establishes consumer advocacy offices as part of the Exchange in order to protect consumers, answer questions, and assist with any problems related to their plans.
• Simplifies paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers, and employers will all encounter a streamlined, less confusing, more consumer friendly system.
• Increases funding of efforts to reduce waste, fraud and abuse; creates enhanced oversight of Medicare and Medicaid programs.

Reducing the deficit and ensuring the solvency of Medicare and Medicaid. The legislation will be entirely paid for – it will not add a dime to the deficit. It will also put Medicare and Medicaid on the path to a more fiscally sound future, so seniors and low-income Americans can continue to receive the quality health care benefits for years to come.

• Pays for the entire cost of the legislation though a combination of savings achieved by making Medicare and Medicaid more efficient – without cutting seniors’ benefits in any way – and  revenue generated from placing a surcharge the top 0.3 percent of all households in the U.S.(married couples with adjusted gross income of over $1,000,000) and other tax measures.
• The Congressional Budget estimates the bill will reduce the deficit by at least $100 billion over ten years.
• Estimates also show the bill will slow the rate of growth of the Medicare program from 6.6 percent annually to 5.3 percent annually.

To view a copy of the Affordable Health Care for American Act, H.R. 3926, click here.

To view a copy of the Medicare Physician Payment Reform Act, H.R. 3961, click here.

To view a bill summary, detailed fact sheets and more information on what the health insurance reform will mean for American, click here.

“Veterans have provided an invaluable service to our country and recognizing the importance of that service, Congress will ensure that the health care they receive is of the highest quality and that they are able to fulfill any individual responsibility requirements with such coverage,” the chairmen wrote to Reps. Bob Filner (D-CA) and Steve Buyer (R-IN).

“It is our intention that enrollment in veterans health care pursuant to chapter 17 of title 38, United States Code is acceptable coverage without additional caveats or requirements and that veterans and their dependents will have the ability to get additional healthcare coverage through the health insurance exchange established by the health insurance exchange established by H.R. 3200 if they so choose. This will ensure that with respect to H.R. 3200, veterans of this country meet their obligations for obtaining health insurance under the tax code, and have the further option to access additional coverage for themselves and their families.”

The full text of their letter is below.





The Honorable Bob Filner
Chairman
Committee on Veterans’ Affairs
335 Cannon House Office Building
Washington, DC 20515

The Honorable Steve Buyer
Ranking Member
Committee on Veterans’ Affairs
335 Cannon House Office Building
Washington, DC 20515

Dear Chairman Filner and Ranking Member Buyer:

As we continue to put together health reform legislation to ensure every American has access to quality affordable health care, we want to be very clear about our intentions with respect to veterans.
           
Veterans have provided an invaluable service to our country and recognizing the importance of that service, Congress will ensure that the health care they receive is of the highest quality and that they are able to fulfill any individual responsibility requirements with such coverage.

It is our intention that enrollment in veterans health care pursuant to chapter 17 of title 38, United States Code is acceptable coverage without additional caveats or requirements and that veterans and their dependents have the ability to get additional healthcare coverage through the health insurance exchange established by H.R. 3200 if they so choose.  This will ensure that with respect to H.R. 3200, veterans of this country meet their obligations for obtaining health insurance under the tax code, and have the further option to access additional coverage for themselves and their families.

We commit to you, Chairman Filner and Ranking member Buyer, and all veterans, to clarify the legislative language in H.R. 3200 to reflect the above assurances as the reported bills from the Committees on Energy and Commerce, Ways and Means, and Education and Labor are merged, sent to the Committee on Rules and eventually the House floor for consideration.

We look forward to continuing to work closely with you and other members on each of the committees interested in these issues to put together a health reform bill that fulfills this country’s commitment to veterans. 

Respectfully,

Henry A. Waxman                    Charles B. Rangel                                 George Miller
Chairman                                 Chairman                                              Chairman
Committee on Energy               Committee on Ways and Means           Committee on
and Commerce                                                                                     Education and Labor

cc:       The Honorable Joe Barton
            Ranking Member
            Committee on Energy and Commerce

            The Honorable Dave Camp
            Ranking Member
            Committee on Ways and Means

            The Honorable John Kline
            Ranking Member
            Committee on Education and Labor

“President Obama’s excellent address moves us closer to the finish line. He laid out specific benchmarks for reform and proved he wants to put good, sound policies above politics. He extended an open hand to all lawmakers, from both sides of the aisle, who are interested in working together to find common ground. He indisputably refuted the many cynical lies and distractions that opponents of health reform have been spreading for months. He reaffirmed his commitment to ensuring that these reforms do not add a penny to our deficit. He reminded us that effective health reform is essential to restoring our long-term fiscal health and securing a stronger future for our children. In short, he did everything he needed to do.

“But, the success of health care reform will ultimately depend upon leaders who choose to work on behalf of the American people towards that finish line and engage in a serious debate. Calculated, false, and outrageous attacks for political gain must end. And those who continue to stand in the way of reform have a choice to make. They can either join in this historic effort – or they can continue to stand against it, with no real plan of their own. But we will not allow them to be a roadblock to the change that American workers, families, and businesses urgently need.

“Despite months of distractions and outright lies from opponents of health reform, Congress is closer than ever to enacting reforms that will transform our health care system from one that works for insurance companies into one that works for the American people.

“The House bill meets the principles President Obama laid out tonight. The America’s Affordable Health Choices Act lowers health costs for families, businesses and the government, ensures that Americans cannot be denied coverage or become bankrupt because they get sick, protects and expands people’s choices of doctors and health plans, creates competition and accountability to keep insurance companies honest, and provides access to affordable health care for all.

“Tonight the President left no doubts that meaningful health insurance reform will be transformative for our families, our economy and our country. The time for Congress to act is now.”

The three committees, which have been working together on health insurance reform, have now each approved health care legislation. H.R. 3200 is expected to be considered by the full House in September.

For more information on the America’s Affordable Health Choices Act, click here.

EXPOSING DECEPTIVE CAMPAIGN OF FEAR AND MISINFORMATION

Some of the myths, falsehoods and misinformation being aggressively peddled by Republicans and opponents of health insurance reform include:

Boehner Peddles “Baseless” end of life myth. Claim that House Dem bill pushes suicide is “nonsense.” House Republican Leader John Boehner continues to get his facts all wrong on the House Democratic health reform bill.  This time, the non-partisan FactCheck.org labeled his claim that the House bill encourages euthanasia, “baseless.” According to FactCheck.org: “Our inboxes have exploded recently with worried queries from readers who have heard that the House’s proposed health care bill, H.R. 3200, contains a provision that would require that ailing seniors be pressed to consider suicide in order to save the taxpayers money on Medicare. Most messages mention that this clause appears on page 425 of the legislation…. The claim that the bill would "push suicide" is a falsehood…. At least two Republican leaders have echoed this end-of-life distortion. On July 23, Republican Rep. John Boehner of Ohio, the House minority leader, released a statement, along with Republican Policy Committee Chairman Thaddeus McCotter of Michigan, saying that the bill would encourage euthanasia.” [False Euthanasia Claims, FactCheck.org, July 29, 2009]

Republicans use “deceptive assaults” to stop health insurance reform.  “Republicans in Washington seem to be shifting into overdrive to keep a health system overhaul from passing Congress before the August recess. Yesterday, July 22, brought two more deceptive assaults (that we know of) on the pending bills, one from Minority Whip Eric Cantor and the other from the top GOP member of the House Immigration Subcommittee, Steve King of Iowa.” [Misleading GOP Health Care Claims, FactCheck.Org, July 23, 2009]

Cantor’s video “inflates” cost of bill by “more than 50%.” “Cantor’s is in the form of a video that accuses Obama and the Democrats of being in a “reckless rush” to finalize a reset of the system. “How much will it cost?” the narrator asks, as photos of House Democrats flash onscreen. “$1.6 trillion?” Actually, in a preliminary analysis released July 14 (and updated July 17), the Congressional Budget Office scored the House tri-committee group bill as costing a net $1.042 trillion. Cantor’s video inflates that number by more than 50 percent.” [Misleading GOP Health Care Claims, FactCheck.Org, July 23, 2009]

Cantor’s ad fails to mention there “is no Republican plan.” “In the sunny wrap-up to the ad, the narrator describes “the Republican plan”: “If you like what you have, you can keep it,” he says. “Access to an affordable basic coverage.” But there is no plan around which Republicans have coalesced. Back in May, some GOP lawmakers offered a bill that would have cut the tax deduction that employers get for offering their employees health insurance plans, and given workers tax credits instead. But there’s been little talk of the bill since then. And Missouri Republican Rep. Roy Blunt was tapped to head a GOP health care task force in February, which was charged “with crafting Republican solutions to increase Americans’ access to quality, affordable health care,” but which so far has produced no plan and seems unlikely to do so.” [Misleading GOP Health Care Claims, FactCheck.Org, July 23, 2009]

Employer Mandate Is Not A “Jobs Tax.”   Wonk Room: "If the Energy and Commerce compromise comes to pass, 87 percent of businesses would be exempt from the mandate, since they have a payroll of less than $500,000. Even before the compromise, 77 percent of businesses would have been unaffected by the mandate. The only small employers that will be affected by the full scope of the mandate are firms with few employees who are making a lot of money — law firms, for instance. And chances are, businesses of that sort already provide insurance. " http://wonkroom.thinkprogress.org/2009/07/30/wsj-job-tax/

Reform Won’t Ration Care.  The most common argument for why health reform will ration care focuses on Comparative Effectiveness Research (CER).  According to the Wonk Room, conservatives “argue that the Center for Medicare and Medicaid Services (CMS) could use the information to make coverage decisions for Medicare. And three, if the government uses the comparative research results to establish best practice guidelines, then doctors who don’t follow the guidelines but rather consider the individual needs of their patients, could be liable for malpractice claims…. the last two arguments fall apart on close scrutiny.  The government isn’t mandating that doctors adopt the results of CER and it is not rationing care. Each patient has his or her unique needs and the ultimate decision for how to proceed should be left to the doctor and the patient. Currently, approximately one-third of all treatments have never been proven to produce better outcomes; CER would provide doctors with unbiased information about the most effective treatments, help doctors and patients make better informed decisions, and improve the quality of care.”
http://wonkroom.thinkprogress.org/2009/06/19/republicans-offer-redundant-cer-amendments/
 
Republicans Opposed Medicare In 1960s By Warning Of Rationing, “Socialized Medicine.” Ronald Reagan: “[I]f you don’t [stop Medicare] and I don’t do it, one of these days you and I are going to spend our sunset yearstelling our children and our children’s children what it once was like in America when men were free.” [1961] Barry Goldwater: “Having given our pensioners their medical care in kind,why not food baskets, why not public housing accommodations, why not vacation resorts, why not a ration of cigarettes for those who smoke and of beer for those who drink.” [1964] Bob Dole: In 1996, while running for the Presidency, Dole openly bragged that he was one of 12 House members who voted against creating Medicare in 1965. “I was there, fighting the fight, voting against Medicare . . . because we knew it wouldn’t work in 1965.” [1965]
http://thinkprogress.org/2009/07/29/medicare-flashback/  

Republican claim about coverage for illegal immigrants, “not true.” “King claimed that this is what the Congressional Budget Office’s recent analysis of House health care legislation said. But it didn’t. His press release also said that the 5.6 million would be covered “in large part because the liberal proposal does not include any requirements to verify the citizenship or immigration status of those receiving taxpayer-funded health benefits.” That’s not true, either.” [Misleading GOP Health Care Claims, FactCheck.Org, July 23, 2009]

Canadian style health care? A “straw man argument,” based on opinion piece “riddled with errors.” “One ad claims that ‘Washington wants to bring Canadian-style health care to the U.S.’ But the health care bills moving through Congress don’t call for a single-payer system like Canada’s… Obama, too, has said repeatedly that he doesn’t back a conversion to a single-payer system…. But as we've said about other ads, all this sets up a straw man argument, criticizing Canada's health care system despite the fact that a purely government-run system isn't what's being seriously considered in Congress or being proposed by the president.” [Canadian Straw Man, Fact Check.org, June 17, 2009]

Insurance industry “cherry-picks facts” in fight again public option.  “Karen Ignagni, president of America's Health Insurance Plans (AHIP), invoked the statistic to argue against the creation of a government-run insurance option. But the polls are not that simple, and her assertion reveals how the industry's effort to defend its turf has led it to cherry-pick the facts.  The poll Ignagni was citing actually undercuts her position: By 72 to 20 percent, Americans favor the creation of a public plan, the June survey by the New York Times and CBS News found. People also said that they thought government would do a better job than private insurers of holding down health-care costs and providing coverage.” [Health Insurance Industry Spins Data in Fight Against Public Plan, Washington Post, July 22, 2009]

Gingrich claims on cost and taxes of health care plan simply “not the case”.  “As for Gingrich’s twittered claim that the legislation would increase taxes on “virtually everyone,” that’s not the case. The proposal would increase taxes on those with adjusted gross incomes above $280,000 a year or $350,000 a year for couples. That’s not a whole lot of people. The nonpartisan Tax Policy Center projected a little less than 2.2 million households (1.4 percent of all households) would face higher taxes under the proposal. The surtax for those upper-income folks would start at 1 percent and go up to 5.4 percent with top incomes over $1 million. (This New York Times post explains how the surtax would work.)” [Tax-and-Spend Twittering, FactCheck.org, July 15, 2009]

Republicans use “misleading” facts when analyzing health care.  “A new ad from Conservatives for Patients' Rights says that a public health insurance plan now being proposed in Congress “could crush all your other choices, driving them out of existence, resulting in 119 million off their current insurance coverage.”   That's misleading. The 119 million figure comes from an analysis of a plan that would mirror Medicare and be open to every individual and business that wanted it. But that's not the type of public plan President Obama has proposed. Nor is such a plan gaining acceptance on Capitol Hill.” [More Health Care Scare, FactCheck.org, June 11, 2009]

Investor's Business Daily is “perpetuating misinformation” on health care legislation, “page 16 doesn’t allow private insurance.” “Jennifer Tolbert, the (Kaiser Family Foundation) foundation's principal policy analyst, told us that Page 16 doesn't outlaw private insurance.  “There will be individual policies available, but people will buy those policies through the national health insurance exchange,” she said.  The House bill allows for existing policies to be grandfathered in, so that people who currently have individual health insurance policies will not lose coverage. The line the editorial refers to is a clause that says the health insurance companies cannot enroll new people into the old plans.” [The Truth-O-Meter Says: Private health insurance not banned on page 16 of the House bill, Politifact, July 22, 2009]

Rove “wrong”, “false,” “distorting” facts.  “He (Rove) said, “The Lewin Group estimates 70 percent of people with private insurance — 120 million Americans — will quickly lose what they now get from private companies and be forced onto the government-run rolls as businesses decide it is more cost-effective for them to drop coverage.” That's wrong. The report said that people would choose to leave private insurance if given a cheaper option, but the report provided smaller numbers for other options.  The debate in Congress over what a public option will look like is fierce and ongoing. So Rove is picking the worst-case scenario and then distorting the cause and effects. We rate Rove's statement False.” [The Truth-O-Meter Says: Rove's op-ed distorts health study, Politifact, June 12, 2009]

120 million deprived of health care is “not correct,” Pence’s statement “false.”  “But there's a hitch: We'll grant that Congress could come up with a Medicare-style plan and open it to everyone, but it doesn't seem likely. Pence appears to be picking the worst number he can choose. And he doesn't mention the fact that under the scenario laid out by the Lewin Group, people would still have health care coverage and their premiums reduced by 30 to 40 percent. He says the government would “deprive” people of health insurance, when actually the scenario is that they would choose a different option. Finally, we have to include a caveat about the Lewin Group. The group says it operates with editorial independence, but it is a subsidiary of UnitedHealth Group, which also offers private health insurance.” [120 million “deprived” of health care is not correct, Politifact, May 19, 2009]

End of life claim, “pants on fire” “outright distortion,” Republicans “spreading a ridiculous falsehood.”  “Republicans have found many reasons to oppose the Democrats' health care proposal, but this is one of the oddest.  McCaughey incorrectly states that the bill would require Medicare patients to have these counseling sessions and she is suggesting that the government is somehow trying to interfere with a very personal decision. And her claim that the sessions would "tell [seniors] how to end their life sooner" is an outright distortion. Rather, the sessions are an option for elderly patients who want to learn more about living wills, health care proxies and other forms of end-of-life planning. McCaughey isn't just wrong, she's spreading a ridiculous falsehood.” [McCaughey claims end-of-life counseling will be required for Medicare patients, PolitiFact, July 16, 2009]

Lewin Group, frequently cited by GOP, “wholly owned” by “one of the nation’s largest insurers.”  “Generally left unsaid amid all the citations is that the Lewin Group is wholly owned by UnitedHealth Group, one of the nation's largest insurers.  More specifically, the Lewin Group is part of Ingenix, a UnitedHealth subsidiary that was accused by the New York attorney general and the American Medical Association, a physician's group, of helping insurers shift medical expenses to consumers by distributing skewed data. Ingenix supplied its parent company and other insurers with data that allegedly understated the “usual and customary” doctor fees that insurers use to determine how much they will reimburse consumers for out-of-network care.” [Research Firm Cited by GOP Is Owned by Health Insurer, Washington Post, July 22, 2009]

Republicans “break previous promise” to provide health care bill.  “GOP Rep. Roy Blunt has now said Republicans won’t offer a health care bill of their own, breaking a previous promise. Worse, it turns out Blunt is chair of something called the “House GOP Health Care Solutions Group.” Blunt’s quote went up online late yesterday evening: “Our bill is never going to get to the floor, so why confuse the focus? We clearly have principles; we could have language, but why start diverting attention from this really bad piece of work they’ve got to whatever we’re offering right now?” That’s a pretty stark admission that Republicans won’t introduce their own bill solely because they think it’s better politics to keep the focus on the Democrats. It gets better. Head over to the House GOP Health Care Solutions Group’s Web site, and you’ll find prominent video of Blunt vowing the GOP is “drafting our own legislation.”” [Leader Of GOP Health Care “Solutions Group” Says GOP Won’t Offer Health Care Bill, Washington Post’s Plum Line, July 23, 2009]

Americans support need to “pay for the cost of health care reform.”  “A proposal has been made to raise taxes on those who earn more than $250,000 a year to pay for the cost of health care reform. Do you favor or oppose raising taxes on those who earn more than $250,000 a year to pay for the cost of health care reform?  48% Favor; 44% Oppose; 8% Not sure.  Another recent poll found that 60% support taxing the wealthy for reform.  So if, as Nelson says, “tax” is a four letter word, the public doesn’t appear to think of it as an epithet when it’s applied to the wealthy in service of health care reform. What’s hard to understand is this reflexive belief that majorities must think the way conservatives do.” [Despite Centrist Claim, People Support Taxing Rich On Health Care, Washington Post’s Plum Line, July 17, 2009]

“Very important progress on health insurance reform has been made today that should be encouraging to everyone who believes reform is a priority for our country.  I commend Chairman Waxman and the members of the Energy and Commerce Committee for coming to an agreement to move the process forward that will allow the full House of Representatives to consider comprehensive health insurance reform in September. In the coming weeks, we will work to reconcile different versions of the bill that reflect all the hard work that our three committees have completed. I am confident that when Congress returns, we will pass a bill that will deliver the real reforms the American people want and deserve: lower costs, more choices of doctors and health plans, and access to quality, affordable health care for all.”  

The Education and Labor Committee passed the legislation on July 17. For more information, click here.

“This analysis is proof that our bill will meet President Obama’s direction to build on what works in our current system and fix what’s broken,” said U.S. Reps. Henry A. Waxman (D-CA), Charles Rangel (D-NY) and George Miller (D-CA), the Chairman of the House Committees on Energy and Commerce, Ways and Means and Education and Labor. “It reinforces that we are on track to delivering reforms that will reduce costs for American consumers and businesses, ensure access to quality, affordable health insurance for all and give Americans the peace of mind of knowing their coverage can never again be denied or taken away.”

The analysis confirms that provisions in H.R. 3200, such as the individual and employer responsibility requirements, retaining the tax benefit for employer-sponsored insurance, and the targeted income-related structure of affordability credits would result in dramatically increased coverage without crowding out private insurance.

The analysis specifically refutes estimates released by the Lewin Group, a research firm funded by one of the nation’s largest insurance companies, that significantly exaggerate the number of Americans who would enter into the public health insurance option.

Some key excerpts from the CBO letter:

INCREASE IN EMPLOYER SPONSORED INSURANCE COVERAGE. “We estimate that about 12 million people who would not be enrolled in an employment-based plan under current law would be covered by one in 2016, largely because the mandate for individuals to be insured would increase workers’ demand for insurance coverage through their employer.”

MEDICAID COVERAGE DOES NOT CROWD OUT PRIVATE HEALTH INSURANCE. “CBO does not anticipate a substantial shift from private insurance to Medicaid. Specifically, we estimate that about 1 million people who would otherwise have employment-based insurance or individually purchased coverage would end up enrolling in Medicaid in 2016.”

CBO REFUTES THE LEWIN ESTIMATE OF INFLATED PUBLIC OPTION ENROLLMENT AND CONFIRMS THAT THE PRIVATE PLANS WOULD BE DOMINANT IN MARKETPLACE. “For several reasons, we anticipate that our estimate of the number of enrollees in the public plan would be substantially smaller than the Lewin Group’s, even if we assumed that all employers would have that option.”  [Note:  CBO projects only about 10-11 million individuals in the public option by 2019] 

WHILE THE CBO LETTER INDICATES THAT THEY ARE NOT CERTAIN OF THE HOUSE PROPOSAL’S OVERALL AFFECT ON PREMIUMS, THEY NAME SEVERAL FACTORS THAT THEY EXPECT WILL LEAD TO DECREASED COSTS FOR THE AVERAGE CONSUMER (E.G. ENCOURAGING HEALTHY CONSUMERS TO PURCHASE INSURANCE, REDUCING THE “COST SHIFT” OF THE UNINSURED, AND REFORMS TO MEDICARE). "The resulting pool of enrollees would be somewhat healthier, on average, than is the pool of enrollees in employment-based insurance today; as a consequence, the average cost of covering those enrollees would be several percent lower than under current law (holding other factors equal).”

“The proposal would ultimately reduce the uninsured population by roughly two-thirds, which would greatly attenuate the pressure to shift costs that arises today when uncompensated or undercompensated care is provided to people who lack health insurance. One recent estimate indicates that hospitals provided about $35 billion in such care in 2008—an amount that would grow under current law but would be expected to decline considerably under the proposal.”

“In addition to proposed changes in Medicare’s payment rates, the proposal would also alter some of Medicare’s payment methods—or at least test such changes—which might ultimately reduce private insurance costs to a limited degree… To the extent that future steps to implement such changes in a more aggressive way also changed how doctors treated privately insured patients, some benefits could “spill over” to the private sector.”

CREATING MORE CHOICES FOR WORKER.  “Increasing the availability of health insurance…might also encourage other workers to take jobs that better match their skills, because they would not have to stay in less desirable jobs solely to maintain their health insurance.”

For more information on the bill, including bill text, summary, information on revenue provisions, and fact sheets on the reform provisions in the bill, click here. 

“This fulfills the strong commitment of the President and House leadership to enact health reform on a deficit-neutral basis,” said Chairman Henry A. Waxman, Chairman Charles B. Rangel, and Chairman George Miller.  “The reforms included in this legislation will help control health care costs and expand access to quality, affordable coverage to all Americans in a fiscally-responsible manner.”

The estimates also cover important reinvestments in Medicare and Medicaid, including phasing in the closing of the “donut” hole in the Medicare drug benefit.  The bill’s long-term reform of Medicare’s physician fee schedule to eliminate the potential 21 percent cut in fees, and put payments on a sustainable basis for the future, will cost about $245 billion.  Those costs, however, are not included in the net calculations above, as they will be absorbed under the upcoming statutory “pay go” legislation that is pending in the House.  

“Health care reform is moving forward. This legislation will reduce costs that are crushing workers, families and businesses alike and it will ensure that patients – not insurance companies – hold the power to make decisions about their care,” said U.S. Rep. George Miller (D-CA), the Chairman of the Committee. “These reforms will save jobs, create millions of new careers, improve the health of our workforce and help rebuild our nation’s middle class. Today’s vote is a monumental step forward in our journey to finally fix our broken health care system.”

“I am honored to have participated in the historic passage of America's Affordable Health Choices Act by the Education and Labor Committee,” said U.S. Rep. Rob Andrews (D-NJ), the Chairman of the House Subcommittee on Health, Employment, Labor, Pensions.  “Millions of Americans work hard, play by the rules, and take care of their families.  Yet they suffer from ever increasing health care costs and inadequate health insurance coverage.  Our work was done on their behalf. Our country is now one step closer to a better health care system that will create jobs, promote wellness, and reduce health care costs for all Americans.”

The legislation is consistent with President Obama’s overall goals of building on what works within the current health care system by strengthening employer-provided care, while fixing what is broken. According to the Congressional Budget Office, the bill will cover 97 percent of Americans by 2015, and two million more Americans will have employer-provided health plans by 2019.

H.R. 3200 will make remarkable changes in the way Americans access and receive health care. Among other things, it will establish a new health exchange that allows them to choose from either private insurers or a public health insurance option. Consumers will be protected from abusive and predatory tactics by insurance companies.  Individuals and small businesses will receive subsidies that make health care more affordable. The CBO estimates that 30 million Americans would choose to enter into the exchange, and that one-third – or 9 million – of those people would choose the public health insurance option.

In addition, the legislation strengthens Medicare and Medicaid and makes reforms to the health care delivery system that will help tame long-term costs.

Earlier this week, CBO issued a preliminary estimate of bill’s reforms at a net cost of $1 trillion over ten years. These reforms will be fully paid for through reforms to Medicare and Medicaid that will generate significant savings and a surcharge that will impact only the wealthiest 1.2 percent of all Americans, and only four percent of small businesses.  

The key principles of legislation include, among other things:

Increasing choice and competition. First, the bill will protect and improve consumers’ choices.

• If an individual likes their current plan, they will be able to keep it.
• For individuals who either aren’t currently covered, or wanted to enroll in a new health care plan, the proposal will establish a health care exchange where consumers can select from a menu of affordable, quality health care options: either a new public health insurance plan or a plan offered by private insurers. People will have similar choices that members of Congress have.
• This new marketplace will reduce costs, create competition that leads to better care for every American, and keep private insurers honest. Patients and doctors will have control over decisions about their health care, instead of insurance companies.

Giving Americans peace of mind. Second, the legislation will ensure that Americans have portable, secure health care plans – so that they won’t lose care if their employer drops their plan or they lose their job.

• Every American who receives coverage through the exchange will have a choice of plans that include quality health care benefits.  
• It will end increases in premiums or denials of care based on pre-existing conditions, race, or gender.
• The proposal will also eliminate co-pays for preventative care, cap out-of-pocket expenses, and end lifetime caps on benefits to protect every American from bankruptcy.

Improving quality of care for every American. Third, the legislation will ensure that Americans of all ages, from young children to retirees have access to greater quality of care by focusing on prevention, wellness, and strengthening programs that work.

• Guarantees that every child in America will have health care coverage that includes dental and vision benefits.
• Provides better preventive and wellness care. Every health care plan offered through the exchange will cover preventive care.
• Grows the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
• Strengthens Medicare and Medicaid so that seniors, people with disabilities, and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

Ensuring shared responsibility. Fourth, the bill will ensure that individuals, employers, and the federal government all share responsibility for a quality and affordable health care system.

• Employers who currently offer coverage will be able to continue offering coverage to workers. Employers who don’t currently offer coverage could choose to cover their workers or pay a penalty.
• All individuals would be required to get coverage, either through their employer or the exchange, or pay a penalty.
• The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.

Protecting consumers and reducing waste, fraud, and abuse. Fifth, the legislation will put the interests of consumers first, protect them from any problems in getting and keeping health care coverage, and reduce waste, fraud, and abuse.

• Provides complete transparency in plans in the health exchange so that consumers have the information they need to select the plan that best meets their needs.
• Establishes Consumer Advocacy Offices as part of the exchange in order to protect consumers, answer questions, and assist with any problems related to their plans.
• Identifies and eliminates waste, fraud, and abuse by simplifying paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers, and employers will all encounter a streamlined, less confusing, more consumer friendly system.

Over the past six months, the House Committees on Education and Labor, Ways and Means, and Energy and Commerce have been working together in an unprecedented way as one committee to develop health care reform legislation.

To view a complete summary of the legislation, click here.

View detailed fact sheets and what health care reform means for American families.

H.R. 3200 is supported by a diverse coalition of stakeholders, including the American Medical Association, the AARP, the Consumers Union, and many more.

"The President's proposal recognizes that community colleges can and should be a catalyst for our nation’s recovery. New data shows that jobs that require only an associate’s degree or a certificate are expected to grow faster in the next ten years than jobs that require a bachelor’s degree. We would be making a mistake if we missed this opportunity to adapt our community colleges to the rigors and demands of the 21st century economy we are working to rebuild. This proposal represents exactly the type of investment we’ll need to make if we’re serious about building a lasting economic recovery and leading the world in college graduates by 2020. Tomorrow I will introduce legislation that embraces this and other initiatives that will expand access to quality, affordable educational opportunities.

“Our community colleges have the potential to be much stronger than they are today. Too many institutions don’t have the resources they need to align their courses with the needs of local businesses and employers. Too many of their campuses are in need of serious repair. Too many students, from high school on, aren’t getting the basic skills they need to compete in high-wage jobs, in high-growth industries. And millions of Americans who have lost their jobs in this recession need access to affordable education and training programs that will help get back on their feet and back to work.

“For all of these reasons, President Obama’s proposal is a game-changer for our economy and our competitiveness. It will transform our community colleges into high-quality vessels for education and job training by driving partnerships between community colleges, local employers, and communities. And it will offer free, high-quality, online training courses to help prepare Americans of all ages, from high school and college students to displaced workers, for the careers of the future.” 

The House Committees on Education and Labor, Ways and Means, and Energy and Commerce have been working together in an unprecedented way as one committee to develop the proposal for health care reform. This week each of the three committees will be marking up the legislation, allowing for continued input from members of Congress and the American people.

“American families cannot afford for Washington to say ‘no’ once again to comprehensive health care reform,” said U.S. Rep. George Miller (D-CA), the Chairman of the House Education and Labor Committee. “We are proud to introduce legislation that meets the goals articulated by President Obama – to lower costs, preserve choice, and expand access to quality, affordable health care – while strengthening our economic and fiscal health. We will continue to work with our colleagues in the weeks ahead to deliver the fundamental reforms that the American people want, need and deserve.”

“Reforming America’s health care system to control costs and improve access to quality affordable care is not only the moral thing to do, it is also critical to our economic recovery and the long-term fiscal health of our nation,” said U.S. Rep. Charles B. Rangel (D-NY), the Chairman of the Ways and Means Committee.  “Health care costs are rising out of control, threatening the economic well-being of American families and businesses.  This innovative bill provides a uniquely American solution to control costs and put patients first without burdening future generations with debt.”

“Today we are taking another step forward towards fulfilling our commitment to deliver what the American people decisively voted for last November – access to affordable, quality health insurance for all Americans,” said U.S. Rep. Henry A. Waxman (D-CA), the Chairman of the Energy and Commerce Committee.  “This bill is among our highest legislative priorities this year.  We have taken great care to build on what we have that works and reform what doesn’t.  I look forward to working with my colleagues to refine the bill as it moves through the Committee process.  I am confident that we will succeed in enacting this landmark reform into law.”

“I’m pleased by the progress we’ve made on the America’s Affordable Health Choices Act.  Across the political spectrum – from liberal to conservative with moderates in between – everyone knows health care is a major part of our current economic crisis,” said U.S. Rep. John Dingell (D-MI), the Chairman Emeritus of the Energy and Commerce Committee. “If left unfixed, our health care crisis will cause the next great economic catastrophe.  We can’t afford to let medical costs continue to rise.  We can’t afford to leave people in a system that looks to recruit the healthy and leave the sick uninsured, underinsured or uncertain about their insurance.  The current broken health care system will not fix itself and the people who made billions from it have no reason to change their ways unless we make them.  The bill will address many of the problems we’ve heard from Americans whether they live in rural or urban communities, or are employed by small businesses and large factories.  What we know now is that we must get something done.”

“I am proud to join with my colleagues to introduce America's Affordable Health Choices Act.  This bill meets President Obama's call for health reform that provides coverage for all, promotes delivery system reforms, and controls costs,” said U.S. Rep. Pete Stark (D-CA), the Chairman of the Ways and Means Subcommittee on Health. “Our committee will begin markup this week and have a bill for members to approve before the August recess.”

“People have talked about the need for health care reform for decades, but today that talk is being converted into action,” said U.S. Rep. Frank Pallone, Jr. (D-NJ) the Chairman of Energy and Commerce Subcommittee on Health. “This plan will produce historic change but making history does not come easily. It's taken a lot of hard work and we have more work to do. This is a giant step forward that puts affordable and quality health care within reach of every American and puts our country back on track to fiscal sustainability.”

“Today we are pleased to announce a plan designed to free financial waste within our health care system and get costs under control. This effort ensures that Americans receive better care for their dollar and paves the way for economic growth,” said U.S. Rep. Rob Andrews (D-NJ), the Chairman of the Health, Employment, Labor and Pensions Subcommittee. “While government, businesses and insured Americans continue to bear the heavy financial burden for those who cannot afford coverage, limiting costs will free up the resources necessary to revitalize our economy, put Americans back to work, and expand health care to millions of struggling uninsured Americans.”

The key principles of legislation include, among other things:

Increasing choice and competition. First, the bill will protect and improve consumers’ choices.

• If an individual likes their current plan, they will be able to keep it.
• For individuals who either aren’t currently covered, or wanted to enroll in a new health care plan, the proposal will establish a health care exchange where consumers can select from a menu of affordable, quality health care options: either a new public health insurance plan or a plan offered by private insurers. People will have similar choices that members of Congress have.
• This new marketplace will reduce costs, create competition that leads to better care for every American, and keep private insurers honest. Patients and doctors will have control over decisions about their health care, instead of insurance companies.

Giving Americans peace of mind. Second, the legislation will ensure that Americans have portable, secure health care plans – so that they won’t lose care if their employer drops their plan or they lose their job.

• Every American who receives coverage through the exchange will have a plan that includes standardized, comprehensive and quality health care benefits.  
• It will end increases in premiums or denials of care based on pre-existing conditions, age, race, or gender.
• The proposal will also eliminate co-pays for preventative care, cap out-of-pocket expenses, and guarantee catastrophic coverage that protects every American from bankruptcy.

Improving quality of care for every American. Third, the legislation will ensure that Americans of all ages, from young children to retirees have access to greater quality of care by focusing on prevention, wellness, and strengthening programs that work.

• Guarantees that every child in America will have health care coverage that includes dental and vision benefits.
• Provides better preventative and wellness care. Every health care plan offered through the exchange will cover preventative care.
• Grows the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
• Strengthens Medicare and Medicaid so that seniors and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

Ensuring shared responsibility. Fourth, the bill will ensure that individuals, employers, and the federal government all share responsibility for a quality and affordable health care system.

• Employers who currently offer coverage will be able to continue offering coverage to workers. Employers who don’t currently offer coverage could choose to cover their workers or pay a penalty.
• All individuals would be required to get coverage, either through their employer or the exchange, or pay a penalty.
• The federal government will provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.

Protecting consumers and reducing waste, fraud, and abuse. Fifth, the legislation will put the interests of consumers first, protect them from any problems in getting and keeping health care coverage, and reduce waste, fraud, and abuse.

• Provides complete transparency in plans in the health exchange so that consumers have the clear, complete information needed to select the plan that best meets their needs.
• Establishes Consumer Advocacy Offices as part of the exchange in order to protect consumers, answer questions, and assist with any problems related to their plans.
• Will identify and eliminate waste, fraud, and abuse by simplifying paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers, and employers will all encounter a streamlined, less confusing, more consumer friendly system.

To view detailed fact sheets and more information on what the health care reform discussion draft means for American families, click here.

“The provisions in this bill will drive energy costs down for consumers and families in the long run and will create millions of clean energy jobs that cannot be shipped overseas,” Miller added. “And, in a very important step, under our bill American workers will be able to take advantage of opportunities that will help them transition into the new sustainable careers of the future.”
 
As chairman of the Education and Labor Committee, Miller wrote into the bill significant provisions to ensure workers affected by climate change policy have access to health care coverage, income support, and employment services so they can transition into green economy jobs.

Among other provisions to assist workers in transition, eligible workers impacted by the new energy policy would:

•    Receive income support equal to 70 percent of their income for up to 156 weeks;
•    Receive an 80 percent credit toward their monthly health care premiums;
•    Have access to job training opportunities, including on-the-job training programs, as well as other support services; and
•    Receive job search allowances and relocation assistance, up to $1,500 for each.

The discussion draft will provide significant relief to small businesses, which spend 18 percent more on health coverage, on average, than larger employers. Among other things, the draft includes targeted support to help small businesses ensure that their workers get coverage, and requires employers to share responsibility, along with individuals and the government.  

A new survey of small business owners in 16 states, released at today’s hearing, found that 81 percent of small business owners support a health exchange and that 66 percent of small businesses are willing to share responsibility for paying for it.

“A system requiring an employer contribution, with appropriate levels of tax credits, sliding scales and exclusions, will give small businesses the relief they need, potentially saving as much as $855 billion over the next 10 years, reducing lost wages by up to $339 billion and minimizing job losses by 72%,” said John Arensmeyer, Founder and CEO of the Small Business Majority. The committee’s draft is “workable,” he explained, “and if properly designed can produce substantial benefits for small businesses.

“Our firm faces health insurance premium expenditures that would add 12-13 percent to our payroll expenses in order to provide health insurance for our workers,” said ReShonda Young, who manages her family’s transportation and contracting business in Waterloo, Iowa. “The contribution level in the bill – even without the small business tax credit – would reduce our contribution amount by one third, to 8 percent of payroll. And the insurance package would actually cover our health care costs, with no preexisting conditions. This is a tremendous improvement over our current options.”

Contrary to what some critics argue, these requirements would not “place a tax on employment, leading to fewer jobs,” explained Dr. Jacob Hacker, an economist at the University of California, Berkeley. “By lowering the cost of care and requiring that all firms eventually contribute to the cost of coverage, the legislation would encourage employers to continue to provide health insurance.”

The health exchange established by the draft would allow people to comparison-shop for quality, affordable, patient-centered care in a transparent, user-friendly marketplace. By creating a public health insurance option to compete alongside private insurers, the draft would lower costs for everyone and ensure that all plans operate honestly and in the best interests of consumers.

“We believe the draft is a plan that would at long last ensure access to affordable, quality, “peace of mind” health insurance for every American,” said William Vaughan, Senior Health Policy Analyst for the Consumers Union.

“We are pleased that your draft bill demonstrates your commitment to ensuring that patients, consumers and their families have a strong voice and role to play in a reformed health care system,” said Fran Visco, President of the National Breast Cancer Coalition.”

Ron Pollack, the Executive Director of Families USA explained how the draft will meet the needs of all consumers: “For American consumers who believe the current health insurance system works well for them—the House bill protects you. For American consumers who believe that the current health insurance system is like that house in the real estate ads coined a “handy-man’s special”—that is, it needs some leaks fixed, perhaps an addition, a little  re-modeling, but it holds great promise—the U.S. House of Representatives provides a toolbox to get the improvements done.”

For more information on the Tri-Committee Discussion Draft, click here. To view a statement of support for the draft issued by the White House, click here.

To view all of the testimonies from today’s hearing, click here.

Over the past several months House Committees on Education and Labor, Ways and Means, and Energy and Commerce have been working together as one committee – an unprecedented approach – to develop one proposal for health care reform. In releasing their discussion draft today, the chairmen reiterated that they will continue to seek the input of all members and stakeholders during hearings and markups in the coming weeks.
 
“Today marks a historic moment in America’s urgent quest to fix our broken health insurance system,” said U.S. Rep. George Miller (D-CA), the Chairman of the Education and Labor Committee. “Our discussion draft is the first step in delivering on the fundamental change that President Obama has called for, and that families and businesses need, by building a truly American solution to reduce costs, offer real choice, and guarantee affordable, quality health care for all.”

“President Obama issued a call to action to reform our nation’s health care system and the House Committees have answered in an unprecedented way, working as one to produce a draft that will help control costs, preserve and expand coverage and strengthen Medicare and Medicaid,” said U.S. Rep. Charles B. Rangel (D-NY), the Chairman of the Ways and Means Committee Chairman.  “In the coming weeks, we will continue working with our colleagues and stakeholders to move this draft forward so we can create a new day in American health care that will benefit our nation for generations to come.”

“This draft sets out a very practical and uniquely American proposal,” said U.S. Rep. Henry A. Waxman (D-CA), the Chairman of the Energy and Commerce Committee.  “It fulfills President Obama’s commitment to provide quality, affordable health care for all.  Nothing is more important to the long term health of the American people.”

“We are beginning an important process that I am confident will make history. The discussion draft is the first step towards creating a distinctly American Solution to our health care crisis. This bill includes a public option, which will provide the American people with a real choice,” said U.S. Rep. John Dingell (D-MI), the Chairman Emeritus of the Energy and Commerce Committee. This public option will lower costs and establish consumer protections that private companies have refused to commit to. The cooperation between Chairmen Miller, Rangel and Waxman is unprecedented and it is my pleasure to be working with them. We are committed to working with all the members in writing a bill that will provide quality, affordable care for all but also prevent the next great economic crisis we face.”

"We are not going to have economic growth until our health care system is fixed. Nearly a fifth of our economy is spent on health care, and while our world competitors continue to offer more efficient care, America lags behind,” said U.S. Rep. Rob Andrews (D-NJ), the Chairman of the Health, Employment, Labor and Pensions Subcommittee. “Insured Americans bear the heavy financial burden for those who cannot afford coverage and millions of struggling families cannot meet the rising costs. This plan is about freeing financial waste within our system and getting more value for our dollar so that we can afford to cover the 46 million uninsured Americans and freeing up money to be invested toward out nation’s economic growth.”

"Today's draft is the result of cooperation between members of the House.  The bill provides affordable, quality health care for all," said U.S. Rep. Pete Stark (D-CA), the Chairman of the Ways and Means Subcommittee on Health. "The discussion draft builds on what works.  It keeps employer-sponsored insurance, makes market reforms, and limits catastrophic costs.  The draft improves the Medicare program; eliminating co-pays for preventive care and the 'donut hole.'"

"While this country has the best medical care in the world, fewer and fewer people are able to access it and more and more people can't afford it," said U.S. Rep. Frank Pallone, Jr. (D-NJ) the Chairman of Energy and Commerce Subcommittee on Health. "Today we are taking a big step towards historic health care reform for all Americans. History is not often made in a day and it certainly won't be made without continued hard work, but this plan is a big step on a truly meaningful issue. A new day for health care is now closer in sight."

The key principles of the House Democratic discussion draft for health care include, among other things:

• If an individual likes their current plan, they would be able to keep it.
• For individuals who either aren’t currently covered, or wanted to enroll in a new health care plan, the proposal would establishes a health care exchange where consumers can select from a menu of affordable, quality health care options: either a new public health insurance plan or a plan offered by private insurers. People will have similar choices that Members of Congress have.
• This new marketplace would reduce costs, create competition that leads to better care for every American, and keep private insurers honest. Patients and doctors would have control over decisions about their health care, instead of insurance companies.

Giving Americans peace of mind. Second, the proposal would ensure that Americans have portable, secure health care plans – so that they wouldn’t lose care if their employer drops their plan or they lose their job.

• Every American who receives coverage through the exchange will have a plan that includes standardized, comprehensive and quality health care benefits.  
• It would end increases in premiums or denials of care based on pre-existing conditions, age, race or gender.
• The proposal would also eliminate co-pays for preventative care, cap out-of-pocket expenses and guarantee catastrophic coverage that protects every American from bankruptcy.

Improving quality of care for every American. Third, the proposal would ensure that Americans of all ages, from young children to retirees have access to greater quality of care by focusing on prevention, wellness and strengthening programs that work.

• Guarantees that every child in America will have health care coverage that includes dental and vision benefits.
• Provides better preventative and wellness care. Every health care plan offered through the exchange would cover preventative care.
• Grows the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
• Strengthens Medicare and Medicaid so that seniors and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

Ensuring shared responsibility. Fourth, the draft would ensure that individuals, employers and the federal government all share responsibility for a quality and affordable health care system.

• Employers who currently offer coverage would be able to continue offering coverage to workers. Employers who don’t currently offer coverage could choose to pay for their workers to gain health care coverage through the exchange or pay a penalty.
• All individuals would be required to get coverage, either through their employer or the exchange, or pay a penalty.
• The federal government would provide affordability credits, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.

Protecting consumers and reduces waste, fraud and abuse. Fifth, the proposal would put the interests of consumers first, protect them from any problems in getting and keeping health care coverage, and reduce waste, fraud and abuse.

• Provides complete transparency in plans in the health exchange so that consumers have the clear, complete information needed to select the plan that best meets their needs.
• Establishes Consumer Advocacy Offices as part of the exchange to protect consumers, answer questions and assist with any problems related to their plans.
• Would identify and eliminate waste, fraud and abuse by simplifying paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers and employers would all encounter a streamlined, less confusing, more consumer friendly system.

To view a complete summary of the discussion draft, click here.

To view detailed fact sheets and more information on what the health care reform discussion draft means for American families, click here.