congress-mongodb

<bill session="111" type="h" number="3590" updated="2011-01-29T17:44:07-05:00"> <state datetime="2010-03-23">ENACTED:SIGNED</state> <status><enacted datetime="2010-03-23" /></status> <introduced datetime="2009-09-17"/> <titles> <title type="popular" as="">Health care reform bill</title> <title type="short" as="introduced">Service Members Home Ownership Tax Act of 2009</title> <title type="short" as="passed house">Patient Protection and Affordable Care Act</title> <title type="short" as="passed house">Service Members Home Ownership Tax Act of 2009</title> <title type="short" as="passed house">Biologics Price Competition and Innovation Act of 2009</title> <title type="short" as="passed house">Catalyst to Better Diabetes Care Act of 2009</title> <title type="short" as="passed house">CLASS Act</title> <title type="short" as="passed house">Community Living Assistance Services and Supports Act</title> <title type="short" as="passed house">Congenital Heart Futures Act</title> <title type="short" as="passed house">Cures Acceleration Network Act of 2009</title> <title type="short" as="passed house">EARLY Act</title> <title type="short" as="passed house">Elder Justice Act of 2009</title> <title type="short" as="passed house">ENHANCED Act of 2009</title> <title type="short" as="passed house">Establishing a Network of Health-Advancing National Centers of Excellence for Depression Act of 2009</title> <title type="short" as="passed house">Young Women's Breast Health Education and Awareness Requires Learning Young Act of 2009</title> <title type="short" as="passed senate">Patient Protection and Affordable Care Act</title> <title type="short" as="passed senate">Biologics Price Competition and Innovation Act of 2009</title> <title type="short" as="passed senate">Catalyst to Better Diabetes Care Act of 2009</title> <title type="short" as="passed senate">CLASS Act</title> <title type="short" as="passed senate">Community Living Assistance Services and Supports Act</title> <title type="short" as="passed senate">Congenital Heart Futures Act</title> <title type="short" as="passed senate">Cures Acceleration Network Act of 2009</title> <title type="short" as="passed senate">EARLY Act</title> <title type="short" as="passed senate">Elder Justice Act of 2009</title> <title type="short" as="passed senate">ENHANCED Act of 2009</title> <title type="short" as="passed senate">Establishing a Network of Health-Advancing National Centers of Excellence for Depression Act of 2009</title> <title type="short" as="passed senate">Young Women's Breast Health Education and Awareness Requires Learning Young Act of 2009</title> <title type="short" as="enacted">Patient Protection and Affordable Care Act</title> <title type="short" as="enacted">Biologics Price Competition and Innovation Act of 2009</title> <title type="short" as="enacted">Catalyst to Better Diabetes Care Act of 2009</title> <title type="short" as="enacted">CLASS Act</title> <title type="short" as="enacted">Community Living Assistance Services and Supports Act</title> <title type="short" as="enacted">Congenital Heart Futures Act</title> <title type="short" as="enacted">Cures Acceleration Network Act of 2009</title> <title type="short" as="enacted">EARLY Act</title> <title type="short" as="enacted">Elder Justice Act of 2009</title> <title type="short" as="enacted">ENHANCED Act of 2009</title> <title type="short" as="enacted">Establishing a Network of Health-Advancing National Centers of Excellence for Depression Act of 2009</title> <title type="short" as="enacted">Young Women's Breast Health Education and Awareness Requires Learning Young Act of 2009</title> <title type="official" as="introduced">To amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes.</title> <title type="official" as="amended by senate">An act entitled The Patient Protection and Affordable Care Act.</title> </titles> <sponsor id="400333"/> <cosponsors> <cosponsor id="400133" joined="2009-10-06"/> <cosponsor id="400263" joined="2009-10-06"/> <cosponsor id="400092" joined="2009-09-17"/> <cosponsor id="400209" joined="2009-09-17"/> <cosponsor id="400282" joined="2009-10-06"/> <cosponsor id="400403" joined="2009-09-17"/> <cosponsor id="412305" joined="2009-10-06"/> <cosponsor id="400647" joined="2009-09-17"/> <cosponsor id="412318" joined="2009-10-06"/> <cosponsor id="400323" joined="2009-09-17"/> <cosponsor id="400377" joined="2009-09-17"/> <cosponsor id="400355" joined="2009-09-17"/> <cosponsor id="400262" joined="2009-09-17"/> <cosponsor id="400387" joined="2009-09-17"/> <cosponsor id="412300" joined="2009-10-07"/> <cosponsor id="400051" joined="2009-09-17"/> <cosponsor id="412193" joined="2009-10-06"/> <cosponsor id="412199" joined="2009-10-06"/> <cosponsor id="400395" joined="2009-09-17"/> <cosponsor id="400087" joined="2009-09-17"/> <cosponsor id="412211" joined="2009-09-17"/> <cosponsor id="400270" joined="2009-09-17"/> <cosponsor id="412240" joined="2009-09-17"/> <cosponsor id="400653" joined="2009-10-06"/> <cosponsor id="400111" joined="2009-09-17"/> <cosponsor id="400021" joined="2009-09-17"/> <cosponsor id="400125" joined="2009-09-17"/> <cosponsor id="400415" joined="2009-09-17"/> <cosponsor id="400093" joined="2009-09-17"/> <cosponsor id="400291" joined="2009-09-17"/> <cosponsor id="400641" joined="2009-09-17"/> <cosponsor id="400033" joined="2009-09-17"/> <cosponsor id="400218" joined="2009-09-17"/> <cosponsor id="400240" joined="2009-09-17"/> <cosponsor id="400024" joined="2009-09-17"/> <cosponsor id="400238" joined="2009-09-17"/> <cosponsor id="400163" joined="2009-10-06"/> <cosponsor id="400233" joined="2009-09-17"/> <cosponsor id="400321" joined="2009-10-06"/> <cosponsor id="400309" joined="2009-09-17"/> </cosponsors> <actions> <action datetime="2009-09-17"><text>Referred to the House Committee on Ways and Means.</text></action> <action datetime="2009-10-07T14:35:00-04:00"><text>Mr. Blumenauer moved to suspend the rules and pass the bill.</text></action> <action datetime="2009-10-07T14:35:00-04:00"><text>Considered under suspension of the rules.</text><reference label="consideration" ref="CR H10550-10554"/></action> <action datetime="2009-10-07T14:35:00-04:00"><text>DEBATE - The House proceeded with forty minutes of debate on H.R. 3590.</text></action> <action datetime="2009-10-07T15:02:00-04:00"><text>At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.</text></action> <action datetime="2009-10-08T12:08:00-04:00"><text>Considered as unfinished business.</text><reference label="consideration" ref="CR H11126-11127"/></action> <vote how="roll" type="vote" roll="768" datetime="2009-10-08T12:15:00-04:00" where="h" result="pass" suspension="1" state="PASS_OVER:HOUSE"><text>On motion to suspend the rules and pass the bill Agreed to by the Yeas and Nays: (2/3 required): 416 - 0 (Roll no. 768). (text: CR 10/7/2009 H10550)</text></vote> <action datetime="2009-10-08T12:15:00-04:00"><text>Motion to reconsider laid on the table Agreed to without objection.</text></action> <action datetime="2009-10-08"><text>Received in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time.</text></action> <calendar under="General Orders" number="175" datetime="2009-10-13" calendar="Senate Legislative" ><text>Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 175.</text></calendar> <action datetime="2009-11-19"><text>Motion to proceed to consideration of measure made in Senate.</text><reference label="consideration" ref="CR S11578"/></action> <action datetime="2009-11-19"><text>Cloture motion on the motion to proceed to the bill presented in Senate.</text><reference label="consideration" ref="CR S11578"/><reference label="text" ref="CR S11578"/></action> <action datetime="2009-11-20"><text>Motion to proceed to consideration of measure considered in Senate.</text><reference label="consideration" ref="CR S11826-11879, S11888-11903"/></action> <action datetime="2009-11-21"><text>Motion to proceed to consideration of measure considered in Senate.</text><reference label="consideration" ref="CR S11907-11967"/></action> <action datetime="2009-11-21"><text>Cloture on the motion to proceed to the bill invoked in Senate by Yea-Nay Vote. 60 - 39. Record Vote Number: 353.</text><reference label="consideration" ref="CR S11967"/><reference label="text" ref="CR S11967"/></action> <action datetime="2009-11-21"><text>Motion to proceed to consideration of measure agreed to in Senate by Unanimous Consent.</text></action> <action datetime="2009-11-21"><text>Measure laid before Senate by motion.</text><reference label="consideration" ref="CR S11967"/></action> <action datetime="2009-11-30"><text>Considered by Senate.</text><reference label="consideration" ref="CR S11985-12005"/></action> <action datetime="2009-11-30"><text>Motion by Senator McCain to commit to Senate Committee on Finance with instructions made in Senate.</text><reference label="consideration" ref="CR S11997-12005"/><reference label="text" ref="CR S11997"/></action> <action datetime="2009-12-01"><text>Considered by Senate.</text><reference label="consideration" ref="CR S12021-12031, S12033-12066"/></action> <action datetime="2009-12-02"><text>Considered by Senate.</text><reference label="consideration" ref="CR S12094-12106, S12106-12152"/></action> <action datetime="2009-12-03"><text>Considered by Senate.</text><reference label="consideration" ref="CR S12265-12300, S12300-12317"/></action> <action datetime="2009-12-03"><text>Motion by Senator McCain to commit to Senate Committee on Finance under the order of 12/2/2009, not having achieved 60 votes in the affirmative, the motion was rejected in Senate by Yea-Nay Vote. 42 - 58. Record Vote Number: 358.</text><reference label="consideration" ref="CR S12265, S12293-12294"/></action> <action datetime="2009-12-03"><text>Motion by Senator McCain to commit to Senate Committee on Finance under the order of 12/2/2009, not having achieved 60 votes in the affirmative, the motion was withdrawn in Senate.</text><reference label="consideration" ref="CR S12294"/></action> <action datetime="2009-12-03"><text>Motion by Senator Hatch to commit to Senate Committee on Finance with instructions made in Senate.</text><reference label="consideration" ref="CR S12306-12317"/></action> <action datetime="2009-12-04"><text>Considered by Senate.</text><reference label="consideration" ref="CR S12356-12408"/></action> <action datetime="2009-12-04"><text>Motion by Senator Hatch to commit to Senate Committee on Finance under the order of 12/4/2009, not having achieved 60 votes in the affirmative, the motion was rejected in Senate by Yea-Nay Vote. 41 - 57. Record Vote Number: 362.</text><reference label="consideration" ref="CR S12356, S12396-12397"/></action> <action datetime="2009-12-04"><text>Motion by Senator Hatch to commit to Senate Committee on Finance under the order of 12/4/2009, not having achieved 60 votes in the affirmative, the motion was withdrawn in Senate.</text><reference label="consideration" ref="CR S12397"/></action> <action datetime="2009-12-04"><text>Motion by Senator Johanns to commit to Senate Committee on Finance with instructions made in Senate.</text><reference label="consideration" ref="CR S12397"/></action> <action datetime="2009-12-05"><text>Considered by Senate. By Unanimous Consent.</text><reference label="consideration" ref="CR S12462-12516"/></action> <action datetime="2009-12-05"><text>Motion by Senator Johanns to commit to Senate Committee on Finance under the order of 12/5/2009, not having achieved 60 votes in the affirmative, the motion was rejected in Senate by Yea-Nay Vote. 41 - 53. Record Vote Number: 364.</text><reference label="consideration" ref="CR S12462, S12496"/></action> <action datetime="2009-12-05"><text>Motion by Senator Johanns to commit to Senate Committee on Finance under the order of 12/5/2009, not having achieved 60 votes in the affirmative, the motion was withdrawn in Senate.</text><reference label="consideration" ref="CR S12496"/></action> <action datetime="2009-12-06"><text>Considered by Senate.</text><reference label="consideration" ref="CR S12524-12552"/></action> <action datetime="2009-12-07"><text>Considered by Senate.</text><reference label="consideration" ref="CR S12565-12613"/></action> <action datetime="2009-12-07"><text>Motion by Senator McCain to commit to Senate Committee on Finance with instructions made in Senate.</text><reference label="consideration" ref="CR S12603-12609"/><reference label="text" ref="CR S12603-12604"/></action> <action datetime="2009-12-08"><text>Considered by Senate.</text><reference label="consideration" ref="CR S12648-12664, S12664-12699"/></action> <action datetime="2009-12-08"><text>Motion by Senator McCain to commit to Senate Committee on Finance, under the order of 12/8/2009, not having achieved 60 votes in the affirmative, the motion was rejected in Senate by Yea-Nay Vote. 42 - 57. Record Vote Number: 370.</text><reference label="consideration" ref="CR S12648, S12684"/></action> <action datetime="2009-12-08"><text>Motion by Senator McCain to commit to Senate Committee on Finance, under the order of 12/8/2009, not having achieved 60 votes in the affirmative, the motion was withdrawn in Senate.</text><reference label="consideration" ref="CR S12648, S12684"/></action> <action datetime="2009-12-08"><text>Motion by Senator Crapo to commit to Senate Committee on Finance with instructions made in Senate.</text><reference label="consideration" ref="CR S12685-12686"/><reference label="text" ref="CR S12685"/></action> <action datetime="2009-12-09"><text>Considered by Senate.</text><reference label="consideration" ref="CR S12745-12791, S12791-12799"/></action> <action datetime="2009-12-10"><text>Considered by Senate.</text><reference label="consideration" ref="CR S12836-12876"/></action> <action datetime="2009-12-13"><text>Considered by Senate.</text><reference label="consideration" ref="CR S13131-13132"/></action> <action datetime="2009-12-13"><text>Cloture motion on the Crapo motion to commit presented in Senate.</text><reference label="consideration" ref="CR S13131-13132"/><reference label="text" ref="CR S13132"/></action> <action datetime="2009-12-14"><text>Cloture motion on the Crapo motion to commit withdrawn by unanimous consent in Senate.</text></action> <action datetime="2009-12-15"><text>Considered by Senate.</text><reference label="consideration" ref="CR S13205-13219, S13219-13242"/></action> <action datetime="2009-12-15"><text>Motion by Senator Crapo to commit to Senate Committee on Finance under the order of 12/14/2009, not having achieved 60 votes in the affirmative, the motion was rejected in Senate by Yea-Nay Vote. 45 - 54. Record Vote Number: 376.</text><reference label="consideration" ref="CR S13205, S13237-13238"/></action> <action datetime="2009-12-15"><text>Motion by Senator Crapo to commit to Senate Committee on Finance under the order of 12/14/2009, not having achieved 60 votes in the affirmative, the motion was withdrawn in Senate.</text></action> <action datetime="2009-12-15"><text>Motion by Senator Hutchison to commit to Senate Committee on Finance with instructions made in Senate.</text><reference label="consideration" ref="CR S13239-13242"/><reference label="text" ref="CR S13239"/></action> <action datetime="2009-12-16"><text>Considered by Senate.</text><reference label="consideration" ref="CR S13280-13295"/></action> <action datetime="2009-12-16"><text>Motion by Senator Hutchison to commit to Senate Committee on Finance tabled in Senate by Yea-Nay Vote. 56 - 41. Record Vote Number: 379.</text><reference label="consideration" ref="CR S13280, S13295"/></action> <action datetime="2009-12-17"><text>Motion to proceed to consideration of measure made in Senate.</text><reference label="consideration" ref="CR S13376"/></action> <action datetime="2009-12-17"><text>Cloture motion on the motion to proceed to the measure presented in Senate.</text><reference label="consideration" ref="CR S13376"/><reference label="text" ref="CR S13376"/></action> <action datetime="2009-12-17"><text>Motion to proceed to consideration of measure withdrawn in Senate.</text><reference label="consideration" ref="CR S13376"/></action> <action datetime="2009-12-19"><text>Considered by Senate.</text><reference label="consideration" ref="CR S13477-13489"/></action> <action datetime="2009-12-19"><text>Cloture motion on the motion to proceed rendered moot in Senate.</text><reference label="consideration" ref="CR S13477-13478"/><reference label="text" ref="CR S13477-13478"/></action> <action datetime="2009-12-19"><text>Cloture motion the bill presented in Senate.</text><reference label="consideration" ref="CR S13478"/><reference label="text" ref="CR S13478"/></action> <action datetime="2009-12-19"><text>Motion by Senator Reid to commit to Senate Committee on Finance with instructions that the Committee report back with the following amendment (SA 3280) made in Senate.</text><reference label="consideration" ref="CR S13478"/></action> <action datetime="2009-12-20"><text>Considered by Senate.</text><reference label="consideration" ref="CR S13558-13628"/></action> <action datetime="2009-12-21"><text>Considered by Senate.</text><reference label="consideration" ref="CR S13640-13646, S13647-13660, S13661-13695"/></action> <action datetime="2009-12-21"><text>Motion by Senator Reid to commit to Senate Committee on Finance with instructions that the Committee report back with the following amendment (SA 3280) fell when cloture was invoked on amendment SA 3276 in Senate.</text><reference label="consideration" ref="CR S13640"/></action> <action datetime="2009-12-22"><text>Considered by Senate.</text><reference label="consideration" ref="CR S13714-13744, S13745-13751"/></action> <action datetime="2009-12-23"><text>Considered by Senate.</text><reference label="consideration" ref="CR S13796-13866"/></action> <action datetime="2009-12-23"><text>Cloture invoked in Senate by Yea-Nay Vote. 60 - 39. Record Vote Number: 395.</text></action> <action datetime="2009-12-24"><text>Considered by Senate.</text><reference label="consideration" ref="CR S13890-14132"/></action> <vote how="roll" type="vote2" roll="396" datetime="2009-12-24" where="s" result="pass" state="PASS_BACK:SENATE"><text>Passed Senate with an amendment and an amendment to the Title by Yea-Nay Vote. 60 - 39. Record Vote Number: 396.</text><reference label="text" ref="CR S13890-142124"/></vote> <action datetime="2009-12-24"><text>Measure amended in Senate by unanimous consent after passage by Unanimous Consent.</text></action> <action datetime="2009-12-24"><text>Senate ordered measure printed as passed.</text></action> <action datetime="2009-12-29"><text>Message on Senate action sent to the House.</text></action> <action datetime="2010-03-21T22:31:00-04:00"><text>Mr. Spratt moved that the House agree to the Senate amendments.</text><reference label="consideration" ref="CR H1854-1890, S1891-2153"/></action> <action datetime="2010-03-21T22:31:00-04:00"><text>The previous question was ordered pursuant to the rule.</text></action> <vote how="roll" type="pingpong" roll="165" datetime="2010-03-21T22:48:00-04:00" where="h" result="pass" state="PASSED:BILL"><text>On motion that the House agree to the Senate amendments Agreed to by recorded vote: 219 - 212 (Roll no. 165).</text><reference label="text as House agrees to Senate amendments" ref="CR H1920-2152"/></vote> <action datetime="2010-03-21T22:48:00-04:00"><text>Motion to reconsider laid on the table Agreed to without objection.</text></action> <topresident datetime="2010-03-21" ><text>Cleared for White House.</text></topresident> <topresident datetime="2010-03-22" ><text>Presented to President.</text></topresident> <signed datetime="2010-03-23" ><text>Signed by President.</text></signed> <enacted number="111-148" type="public" datetime="2010-03-23" state="ENACTED:SIGNED"><text>Became Public Law No: 111-148.</text></enacted> </actions> <committees> <committee code="HSWM" name="House Ways and Means" activity="Referral" /> </committees> <relatedbills> <bill relation="unknown" session="111" type="hc" number="254" /> <bill relation="unknown" session="111" type="hr" number="1203" /> <bill relation="unknown" session="111" type="h" number="3780" /> <bill relation="unknown" session="111" type="h" number="4872" /> <bill relation="unknown" session="111" type="s" number="1728" /> <bill relation="unknown" session="111" type="s" number="1790" /> </relatedbills> <subjects> <term name="Taxation"/> <term name="Abortion"/> <term name="Administrative law and regulatory procedures"/> <term name="Adoption and foster care"/> <term name="Advisory bodies"/> <term name="Aging"/> <term name="Alaska"/> <term name="Allied health services"/> <term name="Appropriations"/> <term name="Budget process"/> <term name="Cancer"/> <term name="Cardiovascular and respiratory health"/> <term name="Child health"/> <term name="Civil actions and liability"/> <term name="Comprehensive health care"/> <term name="Congressional oversight"/> <term name="Criminal procedure and sentencing"/> <term name="Dental care"/> <term name="Department of Health and Human Services"/> <term name="Department of Labor"/> <term name="Digestive and metabolic diseases"/> <term name="Diplomacy, foreign officials, Americans abroad"/> <term name="Disability and health-based discrimination"/> <term name="Disability and paralysis"/> <term name="Disaster relief and insurance"/> <term name="Education of the disadvantaged"/> <term name="Emergency medical services and trauma care"/> <term name="Employee benefits and pensions"/> <term name="Executive agency funding and structure"/> <term name="Family planning and birth control"/> <term name="Federal preemption"/> <term name="Food industry and services"/> <term name="Food supply, safety, and labeling"/> <term name="Fraud offenses and financial crimes"/> <term name="General health and health care finance matters"/> <term name="Government employee pay, benefits, personnel management"/> <term name="Government information and archives"/> <term name="Government investigations"/> <term name="Government trust funds"/> <term name="HIV-AIDS"/> <term name="Hawaii"/> <term name="Health care costs and insurance"/> <term name="Health care coverage and access"/> <term name="Health care quality"/> <term name="Health facilities and institutions"/> <term name="Health information and medical records"/> <term name="Health personnel"/> <term name="Health programs administration and funding"/> <term name="Health promotion and preventive care"/> <term name="Health technology, devices, supplies"/> <term name="Hearing, speech, and vision care"/> <term name="Higher education"/> <term name="Home and outpatient care"/> <term name="Hospital care"/> <term name="Housing finance and home ownership"/> <term name="Income tax credits"/> <term name="Income tax deductions"/> <term name="Income tax exclusion"/> <term name="Income tax rates"/> <term name="Indian social and development programs"/> <term name="Insurance industry and regulation"/> <term name="Intelligence activities, surveillance, classified information"/> <term name="Law enforcement administration and funding"/> <term name="Long-term, rehabilitative, and terminal care"/> <term name="Manufacturing"/> <term name="Medicaid"/> <term name="Medical education"/> <term name="Medical ethics"/> <term name="Medical research"/> <term name="Medical tests and diagnostic methods"/> <term name="Medicare"/> <term name="Mental health"/> <term name="Military medicine"/> <term name="Military personnel and dependents"/> <term name="Minority health"/> <term name="Nebraska"/> <term name="Nursing"/> <term name="Nutrition and diet"/> <term name="Performance measurement"/> <term name="Physical fitness and lifestyle"/> <term name="Poverty and welfare assistance"/> <term name="Prescription drugs"/> <term name="Rural conditions and development"/> <term name="Sales and excise taxes"/> <term name="Self-employed"/> <term name="Sex and reproductive health"/> <term name="Sexually transmitted diseases"/> <term name="Small business"/> <term name="Social security and elderly assistance"/> <term name="Social work, volunteer service, charitable organizations"/> <term name="Student aid and college costs"/> <term name="Surgery and anesthesia"/> <term name="Tax administration and collection, taxpayers"/> <term name="U.S. Sentencing Commission"/> <term name="User charges and fees"/> <term name="Veterans' medical care"/> <term name="Women's health"/> </subjects> <amendments> <amendment number="s2786"/> <amendment number="s2787"/> <amendment number="s2788"/> <amendment number="s2789"/> <amendment number="s2790"/> <amendment number="s2791"/> <amendment number="s2792"/> <amendment number="s2793"/> <amendment number="s2794"/> <amendment number="s2795"/> <amendment number="s2798"/> <amendment number="s2799"/> <amendment number="s2800"/> <amendment number="s2801"/> <amendment number="s2802"/> <amendment number="s2803"/> <amendment number="s2804"/> <amendment number="s2805"/> <amendment number="s2806"/> <amendment number="s2807"/> <amendment number="s2808"/> <amendment number="s2809"/> <amendment number="s2810"/> <amendment number="s2811"/> <amendment number="s2812"/> <amendment number="s2813"/> <amendment number="s2814"/> <amendment number="s2815"/> <amendment number="s2816"/> <amendment number="s2817"/> <amendment number="s2818"/> <amendment number="s2819"/> <amendment number="s2820"/> <amendment number="s2821"/> <amendment number="s2822"/> <amendment number="s2823"/> <amendment number="s2824"/> <amendment number="s2825"/> <amendment number="s2826"/> <amendment number="s2827"/> <amendment number="s2828"/> <amendment number="s2829"/> <amendment number="s2830"/> <amendment number="s2831"/> <amendment number="s2832"/> <amendment number="s2833"/> <amendment number="s2834"/> <amendment number="s2835"/> <amendment number="s2836"/> <amendment number="s2837"/> <amendment number="s2838"/> <amendment number="s2839"/> <amendment number="s2840"/> <amendment number="s2841"/> <amendment number="s2842"/> <amendment number="s2843"/> <amendment number="s2844"/> <amendment number="s2845"/> <amendment number="s2846"/> <amendment number="s2847"/> <amendment number="s2848"/> <amendment number="s2849"/> <amendment number="s2850"/> <amendment number="s2851"/> <amendment number="s2852"/> <amendment number="s2853"/> <amendment number="s2854"/> <amendment number="s2855"/> <amendment number="s2856"/> <amendment number="s2857"/> <amendment number="s2858"/> <amendment number="s2859"/> <amendment number="s2860"/> <amendment number="s2861"/> <amendment number="s2862"/> <amendment number="s2863"/> <amendment number="s2864"/> <amendment number="s2865"/> <amendment number="s2866"/> <amendment number="s2867"/> <amendment number="s2868"/> <amendment number="s2869"/> <amendment number="s2870"/> <amendment number="s2871"/> <amendment number="s2872"/> <amendment number="s2873"/> <amendment number="s2874"/> <amendment number="s2875"/> <amendment number="s2876"/> <amendment number="s2877"/> <amendment number="s2878"/> <amendment number="s2879"/> <amendment number="s2880"/> <amendment number="s2881"/> <amendment number="s2882"/> <amendment number="s2883"/> <amendment number="s2884"/> <amendment number="s2885"/> <amendment number="s2886"/> <amendment number="s2887"/> <amendment number="s2888"/> <amendment number="s2889"/> <amendment number="s2890"/> <amendment number="s2891"/> <amendment number="s2892"/> <amendment number="s2893"/> <amendment number="s2894"/> <amendment number="s2895"/> <amendment number="s2896"/> <amendment number="s2897"/> <amendment number="s2898"/> <amendment number="s2899"/> <amendment number="s2900"/> <amendment number="s2901"/> <amendment number="s2902"/> <amendment number="s2903"/> <amendment number="s2904"/> <amendment number="s2905"/> <amendment number="s2906"/> <amendment number="s2907"/> <amendment number="s2908"/> <amendment number="s2909"/> <amendment number="s2910"/> <amendment number="s2911"/> <amendment number="s2912"/> <amendment number="s2913"/> <amendment number="s2914"/> <amendment number="s2915"/> <amendment number="s2916"/> <amendment number="s2917"/> <amendment number="s2918"/> <amendment number="s2919"/> <amendment number="s2920"/> <amendment number="s2921"/> <amendment 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number="s3282"/> <amendment number="s3283"/> <amendment number="s3284"/> <amendment number="s3285"/> <amendment number="s3286"/> <amendment number="s3287"/> <amendment number="s3288"/> <amendment number="s3289"/> <amendment number="s3290"/> <amendment number="s3291"/> <amendment number="s3292"/> <amendment number="s3293"/> <amendment number="s3294"/> <amendment number="s3295"/> <amendment number="s3296"/> <amendment number="s3297"/> <amendment number="s3298"/> </amendments> <summary> 3/23/2010--Public Law. (This measure has not been amended since it was passed by the Senate on December 24, 2009. The summary of that version is repeated here.) Patient Protection and Affordable Care Act - Title I: Quality, Affordable Health Care for All Americans - Subtitle A: Immediate Improvements in Health Care Coverage for All Americans - (Sec. 1001, as modified by Sec. 10101) Amends the Public Health Service Act to prohibit a health plan ("health plan” under this subtitle excludes any “grandfathered health plan” as defined in section 1251) from establishing lifetime limits or annual limits on the dollar value of benefits for any participant or beneficiary after January 1, 2014. Permits a restricted annual limit for plan years beginning prior to January 1, 2014. Declares that a health plan shall not be prevented from placing annual or lifetime per-beneficiary limits on covered benefits that are not essential health benefits to the extent that such limits are otherwise permitted. Prohibits a health plan from rescinding coverage of an enrollee except in the case of fraud or intentional misrepresentation of material fact. Requires health plans to provide coverage for, and to not impose any cost sharing requirements for: (1) specified preventive items or services; (2) recommended immunizations; and (3) recommended preventive care and screenings for women and children. Requires a health plan that provides dependent coverage of children to make such coverage available for an unmarried, adult child until the child turns 26 years of age. Requires the Secretary of Health and Human Services (HHS) to develop standards for health plans (including grandfathered health plans) to provide an accurate summary of benefits and coverage explanation. Directs each such health plan, prior to any enrollment restriction, to provide such a summary of benefits and coverage explanation to: (1) the applicant at the time of application; (2) an enrollee prior to the time of enrollment or re-enrollment; and (3) a policy or certificate holder at the time of issuance of the policy or delivery of the certificate. Requires group health plans to comply with requirements relating to the prohibition against discrimination in favor of highly compensated individuals. Requires the Secretary to develop reporting requirements for health plans on benefits or reimbursement structures that: (1) improve health outcomes; (2) prevent hospital readmissions; (3) improve patient safety and reduce medical errors; and (4) promote wellness and health. Requires a health plan (including a grandfathered health plan) to: (1) submit to the Secretary a report concerning the ratio of the incurred loss (or incurred claims) plus the loss adjustment expense (or change in contract reserves) to earned premiums; and (2) provide an annual rebate to each enrollee if the ratio of the amount of premium revenue expended by the issuer on reimbursement for clinical services provided to enrollees and activities that improve health care quality to the total amount of premium revenue for the plan year is less than a 85% for large group markets or 80% for small group or individual markets. Requires each U.S. hospital to establish and make public a list of its standard charges for items and services. Requires a health plan to implement an effective process for appeals of coverage determinations and claims. Sets forth requirements for health plans related to: (1) designation of a primary care provider; (2) coverage of emergency services; and (3) elimination of referral requirements for obstetrical or gynecological care. (Sec. 1002) Requires the Secretary to award grants to states for offices of health insurance consumer assistance or health insurance ombudsman programs. (Sec. 1003, as modified by Sec. 10101) Requires the Secretary to establish a process for the annual review of unreasonable increases in premiums for health insurance coverage. (Sec. 1004) Makes this subtitle effective for plan years beginning six months after enactment of this Act, with certain exceptions. Subtitle B: Immediate Actions to Preserve and Expand Coverage - (Sec. 1101) Requires the Secretary to establish a temporary high risk health insurance pool program to provide health insurance coverage to eligible individuals with a preexisting condition. Terminates such coverage on January 1, 2014, and provides for a transition to an American Health Benefit Exchange (Exchange). (Sec. 1102, as modified by Sec. 10102) Requires the Secretary to establish a temporary reinsurance program to provide reimbursement to participating employment-based plans for a portion of the cost of providing health insurance coverage to early retirees before January 1, 2014. (Sec. 1103, as modified by Sec. 10102) Requires the Secretary to establish a mechanism, including an Internet website, through which a resident of, or small business in, any state may identify affordable health insurance coverage options in that state. (Sec. 1104) Sets forth provisions governing electronic health care transactions. Establishes penalties for health plans failing to comply with requirements. (Sec. 1105) Makes this subtitle effective on the date of enactment of this Act. Subtitle C: Quality Health Insurance Coverage for All Americans - Part I: Health Insurance Market Reforms - (Sec. 1201, as modified by Sec. 10103) Prohibits a health plan ("health plan” under this subtitle excludes any “grandfathered health plan” as defined in section 1251) from: (1) imposing any preexisting condition exclusion; or (2) discriminating on the basis of any health status-related factor. Allows premium rates to vary only by individual or family coverage, rating area, age, or tobacco use. Requires health plans in a state to: (1) accept every employer and individual in the state that applies for coverage; and (2) renew or continue coverage at the option of the plan sponsor or the individual, as applicable. Prohibits a health plan from establishing individual eligibility rules based on health status-related factors, including medical condition, claims experience, receipt of health care, medical history, genetic information, and evidence of insurability. Sets forth provisions governing wellness programs under the health plan, including allowing cost variances for coverage for participation in such a program. Prohibits a health plan from discriminating with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable state law. Requires health plans that offer health insurance coverage in the individual or small group market to ensure that such coverage includes the essential health benefits package. Requires a group health plan to ensure that any annual cost-sharing imposed under the plan does not exceed specified limitations. Prohibits a health plan from: (1) applying any waiting period for coverage that exceeds 90 days; or (2) discriminating against individual participation in clinical trials with respect to treatment of cancer or any other life-threatening disease or condition. Part II: Other Provisions - (Sec. 1251, as modified by Sec. 10103) Provides that nothing in this Act shall be construed to require that an individual terminate coverage under a group health plan or health insurance coverage in which such individual was enrolled on the date of enactment of this Act. Allows family members of individuals currently enrolled in a plan to enroll in such plan or coverage if such enrollment was permitted under the terms of the plan. Allows new employees and their families to enroll in a group health plan that provides coverage on the date of enactment of this Act. Defines a "grandfathered health plan" as a group health plan or health insurance coverage in which an individual was enrolled on the date of enactment of this Act. States that this subtitle and subtitle A shall not apply to: (1) a group health plan or health insurance coverage in which an individual was enrolled on the date of enactment of this Act, regardless of whether the individual renews such coverage after such date of enactment; (2) an existing group health plan that enrolls new employees under this section; and (3) health insurance coverage maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers that was ratified before the date of enactment of this Act until the date on which the last of the collective bargaining agreements relating to the coverage terminates. Applies provisions related to uniform coverage documents and medical loss ratios to grandfathered health plans for plan years beginning after enactment of this Act. (Sec. 1252) Requires uniform application of standards or requirements adopted by states to all health plans in each applicable insurance market. (Sec. 1253, as added by Sec. 10103) Directs the Secretary of Labor to prepare an annual report on self-insured group health plans and self-insured employers. (Sec. 1254, as added by Sec. 10103) Requires the HHS Secretary to conduct a study of the fully-insured and self-insured group health plan markets related to financial solvency and the effect of insurance market reforms. (Sec. 1255, as modified by Sec. 10103) Sets forth effective dates f