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111TH CONGRESS
1st Session

REPT. 111-299

HOUSE OF REPRESENTATIVES

Part 1

DISSENTING VIEWS

[To accompany H.R. 3200]

The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 3200) to provide affordable, quality health care for all
Americans and reduce the growth in health care spending, and for
other purposes, having considered the same, report favorably there-
on with an amendment and recommend that the bill as amended
do pass.

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Changes in Existing Law Made by the Bill, as Reported

Dissenting Views

Appendix A-Text of Motion to Instruct the Chairman on H.R. 3200

AMENDMENT

748

1167

1183

The amendment is as follows:

Strike all after the enacting clause (other than sections 321 and
322, title IV of division A, subtitle A of title I of division B, and
title VIII of division B) and insert the following:

SECTION 1. SHORT TITLE; TABLE OF DIVISIONS, TITLES, AND SUBTITLES.

(a) SHORT TITLE.-This Act may be cited as the "America's Affordable Health
Choices Act of 2009".

(b) TABLE OF DIVISIONS, TITLES, AND SUBTITLES.-This Act is divided into divi-
sions, titles, and subtitles as follows:

DIVISION A-AFFORDABLE HEALTH CARE CHOICES

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TITLE IV-AMENDMENTS TO INTERNAL REVENUE CODE OF 1986

Subtitle A―Shared Responsibility

PART 1-INDIVIDUAL RESPONSIBILITY

Sec. 401. Tax on individuals without acceptable health care coverage.

Sec. 411. Election to satisfy health coverage participation requirements.
Sec. 412. Responsibilities of nonelecting employers.

Subtitle B-Credit for Small Business Employee Health Coverage Expenses

Sec. 421. Credit for small business employee health coverage expenses.

Subtitle C-Disclosures To Carry Out Health Insurance Exchange Subsidies

Sec. 431. Disclosures to carry out health insurance exchange subsidies.

Subtitle D-Other Revenue Provisions

Sec. 441. Surcharge on high income individuals.

Sec. 442. Delay in application of worldwide allocation of interest.

PART 2-PREVENTION OF TAX AVOIDANCE

Sec. 451. Limitation on treaty benefits for certain deductible payments.
Sec. 452. Codification of economic substance doctrine.

Sec. 453. Penalties for underpayments.

(c) GENERAL DEFINITIONS.-Except as otherwise provided, in this division:
(1) ACCEPTABLE COVERAGE.-The term “acceptable coverage” has the meaning

given such term in section 202(d)(2).

(2) BASIC PLAN.-The term “basic plan” has the meaning given such term in

section 203(c).

(3) COMMISSIONER.-The term "Commissioner" means the Health Choices

Commissioner established under section 141.

(4) COST-SHARING.-The term “cost-sharing" includes deductibles, coinsurance,

copayments, and similar charges but does not include premiums or any network

payment differential for covered services or spending for non-covered services.

(5) DEPENDENT.-The term "dependent" has the meaning given such term by

the Commissioner and includes a spouse.

(6) EMPLOYMENT-BASED HEALTH PLAN.-The term "employment-based health

plan"-

(A) means a group health plan (as defined in section 733(a)(1) of the Em-

ployee Retirement Income Security Act of 1974); and
(B) includes such a plan that is the following:

(i) FEDERAL, STATE, AND TRIBAL GOVERNMENTAL PLANS.-A govern-

mental plan (as defined in section 3(32) of the Employee Retirement In-

come Security Act of 1974), including a health benefits plan offered

under chapter 89 of title 5, United States Code.

(ii) CHURCH PLANS.-A church plan (as defined in section 3(33) of the

Employee Retirement Income Security Act of 1974).

(7) ENHANCED PLAN.-The term "enhanced plan" has the meaning given such

term in section 203(c).

(8) ESSENTIAL BENEFITS PACKAGE.-The term "essential benefits package" is

defined in section 122(a).

(9) FAMILY.-The term “family” means an individual and includes the individ-
ual's dependents.

(10) FEDERAL POVERTY LEVEL; FPL.-The terms "Federal poverty level" and

"FPL" have the meaning given the term "poverty line" in section 673(2) of the

Community Services Block Grant Act (42 U.S.C. 9902(2)), including any revision

required by such section.

(11) HEALTH BENEFITS PLAN.-The terms "health benefits plan" means health

insurance coverage and an employment-based health plan and includes the pub-
lic health insurance option and cooperatives under subtitle D of title II.

(12) HEALTH INSURANCE COVERAGE; HEALTH INSURANCE ISSUER.-The terms
"health insurance coverage" and "health insurance issuer" have the meanings
given such terms in section 2791 of the Public Health Service Act.

(13) HEALTH INSURANCE EXCHANGE.-The term "Health Insurance Exchange"
means the Health Insurance Exchange established under section 201.

(14) MEDICAID.-The term "Medicaid" means a State plan under title XIX of
the Social Security Act (whether or not the plan is operating under a waiver
under section 1115 of such Act).

(15) MEDICARE.-The term "Medicare" means the health insurance programs

under title XVIII of the Social Security Act.

(16) PLAN SPONSOR.-The term "plan sponsor" has the meaning given such

term in section 3(16)(B) of the Employee Retirement Income Security Act of

1974.

(17) PLAN YEAR.-The term "plan year" means-

(A) with respect to an employment-based health plan, a plan year as

specified under such plan; or

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