AMENDMENT: An amendment to the Waxman amendment in the nature of a substitute offered by Mr. payment for Medicare Advantage plans. DISPOSITION: NOT AGREED TO by a roll call vote of 27 yeas to 31 nays. BILL: MOTION: COMMITTEE ON ENERGY AND COMMERCE – 111TH CONGRESS ROLL CALL VOTE # 106 H.R. 3200, the "America's Affordable Health Choices Act of 2009". A Motion by Mr. Dingell to order H.R. 3200 favorably reported to the House, amended. (Final Passage) DISPOSITION: AGREED TO by a roll call vote of 31 yeas to 28 nays. COMMITTEE OVERSIGHT FINDINGS AND RECOMMENDATIONS In compliance with clause 3(c)(1) of rule XIII and clause 2(b)(1) of rule X of the Rules of the House of Representatives, the Committee's oversight findings and recommendations are reflected in the body of this report. NEW BUDGET AUTHORITY AND CONGRESSIONAL BUDGET OFFICE ESTIMATE With respect to the requirements of clause 3(c)(2) of House rule XIII and section 308(a) of the Congressional Budget Act of 1974 and with respect to requirements of clause 3(c)(3) of House rule XIII and section 402 of the Congressional Budget Act of 1974, the Committee anticipates that a ČBO cost estimate letter on H.R. 3200 will address these issues when the bill proceeds to consideration on the House floor. CBO is unable to provide a cost estimate prior to the reconciliation of the versions of the bill as amended and reported by the three committees of jurisdiction. STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES In accordance with clause 3(c) of House rule XIII, the Committee finds that the goal of H.R. 3200 is to increase access to affordable quality health coverage and contain costs. CONSTITUTIONAL AUTHORITY STATEMENT Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House of Representatives, the Committee finds that the constitutional authority for H.R. 3200 is provided in clauses 1, 3, and 18 of Article I, section 8 of the United States Constitution. EARMARKS AND TAX AND TARIFF BENEFITS H.R. 3200 does not contain any congressional earmarks, limited tax benefits, or limited tariff benefits as defined in clause 9 of rule XXI of the Rules of the House of Representatives. ADVISORY COMMITTEE STATEMENT The Committee finds that the legislation establishes or authorizes the establishment of advisory committees within the definition of 5 U.S.C. App., Section 5(b). Section 123 of the bill establishes a Health Benefits Advisory Committee. The Committee finds this committee is needed to make recommendations on covered benefits and essential, enhanced, and premium plans. Section 1191 establishes a Telehealth Advisory Committee. The Committee finds this committee is needed to advise the Secretary of Health and Human Services on policies of the Centers for Medicare and Medicaid Services regarding telehealth services. Section 1401 establishes a Comparative Effectiveness Research Commission, which the Committee finds is necessary to oversee and evaluate the activities of the Center for Comparative Effectiveness Research established by the bill. In addition, section 2261 establishes an Advisory Committee on Health Workforce Evaluation and Assessment. The Committee finds this entity is needed to make recommendations to the Secretary of Health and Human Services regarding classifications of the health workforce; standardized methodologies and procedures to enumerate the health workforce; the supply, diversity, and geo graphic distribution of the health workforce; retention of the health workforce; and policies to carry out these recommendations. Section 2310 establishes a Task Force on Clinical Preventive Services, which the Committee finds is necessary to assist the Secretary of Health and Human Services in the review of scientific evidence related to costs, benefits, effectiveness, and appropriateness of clinical preventive services, gaps in such services, and other issues relating to clinical preventive services. Section 2310 also establishes a Task Force on Community Preventive Services, which the Committee finds is necessary to assist the Secretary of Health and Human Services in the review of scientific evidence related to costs, benefits, effectiveness, and appropriateness of community preventive services, gaps in such services, and other issues relating to community preventive services. Section 2552 establishes the Interagency Pain Research Coordinating Committee. The Committee finds this entity is needed to coordinate all efforts within the Department of Health and Human Services and other federal agencies that relate to pain research. APPLICABILITY OF LAW TO THE LEGISLATIVE BRANCH Section 102(b)(3) of Public Law 104-1, the Congressional Accountability Act, requires a description of the application of this bill to the legislative branch. The Committee has determined that the bill would apply to the legislative branch and its employees in the same way it would apply to employers and employees in the private sector. FEDERAL MANDATES STATEMENT Section 423 of the Congressional Budget and Impoundment Act (as amended by section 101(a)(2) of the Unfunded Mandates Reform Act, P.L. 104-4) requires a statement of whether the provisions of the reported bill include unfunded mandates. The Committee anticipates that this issue will be addressed in a CBO cost estimate letter for the bill when it proceeds to consideration on the House floor. COMMITTEE COST ESTIMATE Clause 3(d) of rule XIII of the Rules of the House of Representatives requires an estimate and comparison of the costs that would be incurred in carrying out H.R. 3200. The Committee anticipates that a CBO cost estimate letter will address these issues when the bill proceeds to consideration on the House floor. SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION Sec. 1. Short Title; Table of Divisions, Titles, and Subtitles The short title may be cited as the America's Affordable Health Choices Act of 2009. The section also provides a table of contents for the divisions, titles, and subtitles of the bill. This Act is divided into divisions, titles, and subtitles as follows: DIVISION A-AFFORDABLE HEALTH CARE CHOICES Sec. 100. Purpose; Table of Contents of Division; General Definitions Purpose The purpose of this division is to provide affordable, quality health care for all Americans and reduce the growth in health care spending. This division achieves this purpose by building on what works in today's health care system, while repairing the aspects that are broken by: Enacting strong insurance market reforms; • Creating a new Health Insurance Exchange, with a public health insurance option alongside private plans; • Including sliding scale affordability credits; and Initiating shared responsibility among workers, employers, and the government. This division institutes health delivery system reforms both to increase quality and to reduce growth in health spending so that health care becomes more affordable for businesses, families, and government. General Definitions (Created within this Act) • Acceptable Coverage.-a qualified health benefit plan coverage, coverage under a grandfathered health insurance coverage or current group health plan, Medicare Part A, Medicaid, Military Health System, Veteran's Health Care Program (VA), and other coverage the Secretary of HHS in coordination with the Health Choices Commissioner sees fit. • Basic Plan.—a plan that offers the essential benefits package's minimum requirements to be a qualified health benefits plan approximately 70% of the actuarial value of the benefits provided. • 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. Employment-Based Health Plan.-the term given to group health plans (as defined in section 733(a)(1) of ERISA as an employee welfare benefit plan to the extent that plan provides medical care to employees or their dependents, either directly, through insurance or otherwise)—and is comprised of federal and state government plans, tribal plans and church plans. • Enhanced Plan.-a plan that offers, in addition to the level of benefits under a basic plan, a lower level of cost-sharing equivalent to approximately 85% of the actuarial value of the benefits provided. • Essential Benefits Package.-health benefits coverage, consistent with the standards set forth by the Secretary no later than 18 months after enactment of this Act. • Health Benefits Plan.-health insurance coverage and a group health plan, including the public health insurance option. • Health Insurance Exchange.-created by this bill to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option. |