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The proposed America's Affordable Health Choices Act of 2009 (or HR 3200) was an unsuccessful bill introduced in the U.S. House of Representatives on July 14, 2009. The bill was introduced during the first session of the 111th Congress as part of an effort of the Democratic Party leadership to enact health care reform. The bill was not approved by the House, but was superseded by a similar bill, the proposed Affordable Health Care for America Act (HR 3962), which was passed by the House in November 2009, by a margin of 220-215 votes but later abandoned. A similar bill to HR 3200, called the "Affordable Health Choices Act" (HR 1679)), was introduced in the Senate on September 17, 2009. It too was unsuccessful as the Senate approved instead another proposal called the "Patient Protection and Affordable Care Act". According to the Congressional Budget Office, HR 3200 included tax increases and spending cuts that reduce the net increase in the federal deficit to 1% of 2008 tax revenues. The CBO director subsequently noted that, in terms of total National Health Expenditure, non-governmental spending will increase as coverage expands. The bill was originally sponsored by Representatives John Dingell, Charles Rangel, Henry Waxman, George Miller, Pete Stark, Frank Pallone, and Robert Andrews. The 1017 page PDF version of the bill〔(H.R. 3200 (RH) ), as introduced in the House, PDF, TXT or XML via GPO's FDsys〕 is the first of three health care reform-related legislative proposals expected from the Democratic congressional leadership.〔Marianne Kolbasuk McGee (Health Care Overhaul Bill Calls For Online Enrollment ) InformationWeek June 10, 2009〕 Votes in the U.S. House of Representatives on this bill and on the United States National Health Care Act, an alternative that would establish a national, universal single-payer health insurance, were previously expected in September 2009 and again in October 2009, before the actual November 2009 vote took place. ==Elements of the bill== The summary of the bill includes the following elements, among others:〔(America's Affordable Health Choices Act of 2009 - Summary ), Congressional Research Service, THOMAS〕 #Establishes a mandate to purchase private insurance for most individuals with an income above poverty level. #Creates a mechanism to enforce the mandate in a sliding scale tax on those who do not purchase health insurance for most legal United States residents with an income above poverty level.〔HR 3200, Division A, Title IV, Subtitle A, Part 1, Section 401 amends Section 59B of the Internal Revenue Tax Code. Paragraph (c) of Sec. 59B, lists as its exceptions dependents, non-resident aliens, individuals residing outside of the US, and those with a religious conscience exemption. Paragraph (a) of Sec. 59B, states those without insurance will be charged a 2.5% tax up to the average cost of an insurance premium.〕 #Prohibits pre-existing condition exclusions. #Requires adjusted community rating, guaranteed issue, and guaranteed renewal of individual and small group health insurance that: ''limits'' age rating variation of premiums to 2:1 (200 percent), ''prohibits'' gender and health status rating variation of premiums, ''allows'' variation of premiums by geographic area and family (vs. individual) enrollment. #Prohibits cancellation of coverage except for evidence of fraud. #Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family. #Requires Health and Human Services to create a non-subsidized public health insurance plan with pricing based on private industry averages. Three optional levels of coverage are to be offered by the plan which must set premiums at a level sufficient to fully finance the costs of the health benefits the administrative costs related to operating the plan.〔s:H.R. 3200/Division A/Title II/Subtitle B〕 #Establishes a Health Insurance Exchange (HIE) within a proposed Health Choices Administration, to provide a market place for insurers to sell qualifying plans on a public web site.〔s:H.R. 3200/Division A/Title II/Subtitle A〕 #Requires the creation of a risk equalization pool that will allow qualifying plans to minimize the impact of adverse selection of enrollees among the plans.〔 #Provides a tax credit for low-income individuals and families to help pay insurance premiums. #Requires employers with payroll costs over $500,000 to provide health insurance that meets the minimum standard of coverage allowed in the HIE. #Provides for a tax on employers that do not provide the required health insurance. #Provides for a tax on couples with adjusted joint gross income exceeding $350,000 (80% of this figure for single people) #Reduces Medicare payments to hospitals with excessive re-admissions. #Further expands Medicaid eligibility and scope of covered preventive services, for lower-income individuals and families. #Increases Medicaid payments to physicians for primary care. #Provides for a phased-in elimination of the Medicare Part D coverage gap and requires drug manufactures to discount and/or rebate additional qualifying drugs originally excluded from the plan. #Requires the Secretary of Health and Human Services (HHS) to develop quality measures for the delivery of health care services in the United States. #Establishes the Health Benefits Advisory Committee chaired by the Surgeon General of the United States. #Prioritizes any eventual implementation of best practices in the delivery of health care. #Establishes a National Prevention and Wellness Strategy along with appropriations for its trust fund. #Outlines Administrative standards that reduces costs and improves service, including the ability for Administrators to determine an accurate total financial estimate at the point of service as well as enabling real time electronic transfer of funds to take place if possible (mirrors (currently existing laws )).〔(Health Care Misinformation Does Not Further Debate ), The Durango Herald, 16 August 2009〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「America's Affordable Health Choices Act of 2009」の詳細全文を読む スポンサード リンク
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