H.R. 3590, the "Patient Protection and Affordable Care Act"

The nation’s historic health reform legislation, commonly referred to as the Affordable Care Act, is the consolidation of H.R. 3590, the Patient Protection and Affordable Care Act, P.L. 111-148, as amended by H.R. 4872, the Health Care and Education Reconciliation Act, P.L. 111-152. 

The Congressional Budget Office estimates that the Affordable Care Act will reduce the number of Americans without health insurance coverage by 32 million by 2019, increasing the percentage of insured non-elderly Americans from 83% to 94%.  The Affordable Care Act accomplishes this by establishing a mandate for most residents of the United States to obtain health insurance; setting up insurance exchanges through which certain individuals and families can receive federal subsidies to substantially reduce the cost of purchasing that coverage; and significantly expanding eligibility for Medicaid.

Below are a number of documents that summarize how the legislation will benefit Americans.  For more detaileds on how the legislation will improve the quality of care for every American, strengthen Medicare and Medicaid, and control costs, visit this page to download a series of fact sheets.

• Summary of Health Care Reform Legislation

• What Health Insurance Reform Does for You

• Benefits of Health Care Reform in Each Congressional District

• Common questions and answers in the Health Reform Q&A

• Learn about the Immediate Benefits of Health Insurance Reform

• Timeline for Implementation of Health Care Reform

• Health Care Reform Benefits: Infographic

On June 28, 2012, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act.

Legislative History

In the first session of the 111th Congress, the Subcommittee on Health held five days of oversight hearings focused on making health care work for American families.  The Committee on Energy and Commerce and the Subcommittee on Health also held three days of legislative hearings on a discussion draft of comprehensive health reform legislation.

On July 14, 2009, Rep. John Dingell of Michigan introduced H.R. 3200, America’s Affordable Health Choices Act.  On July 31, 2009, the Committee ordered H.R. 3200 favorably reported to the House, amended, by a roll call vote of 31 - 28.  The Committee subsequently met in open markup session on September 23, 2009, to consider and adopt additional amendments.

No further action was taken on H.R. 3200 in the 111th Congress.  The bill was superseded first by H.R. 3962, and then later by H.R. 3590. 

On October 29, 2009, Rep. Dingell introduced H.R. 3962, the Affordable Health Care for America Act.  On November 7, 2009, the House passed H.R. 3962 by a roll call vote of 220 - 215.  H.R. 3962 was eventually superseded by H.R. 3590.  (In the second session of the 111th Congress, the Senate amended H.R. 3962 as the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which became Public Law 111-192.) 

On March 21, 2010, the House took up H.R. 3590, the Patient Protection and Affordable Care Act, as passed by the U.S. Senate.  The House passed H.R. 3590 by a roll call vote of 219 - 212, clearing the measure for the White House.  On March 23, 2010, H.R. 3590 was signed into law by the President and became Public Law 111-148.

At the same time, the House considered H.R. 4872, the Health Care and Education Reconciliation Act, which amended financing and revenue provisions of the Patient Protection and Affordable Care Act.  The House passed H.R. 4872 on March 21, 2010, by a roll call vote of 220 – 211 and again, as amended by the Senate, on March 25, 2010, by a roll call vote of 220 - 207.  On March 30, 2010, H.R. 4872 was signed into law by the President and became Public Law 111-152.

Press Releases

• Rep. Waxman's Statement on the Supreme Court’s Decision on the Affordable Care Act (June 28, 2012)
• Supreme Court Amicus Brief on the Affordable Care Act's Medicaid Provision (February 17, 2012)
• Supreme Court Amicus Brief on the Affordable Care Act's Minimum Coverage Provision (January 13, 2012)
• District by District Impact of Republican Medicare Plan and Medicaid Cuts (June 2011)
• District by District and Metro Area Analysis of the Impact of Repealing Health Reform (January 18, 2011)
• Historic Health Reform Approved (March 21, 2010)
• Committee Chairmen's Statement Regarding the Impact of Health Care Reform on TRICARE (March 21, 2010)
• Chairman Waxman's Statement Before the Committee on Rules (March 20, 2010)
• Tri-Committee Chairmen Joint Statement on Introduction of Health Reform Bill to Provide Quality, Affordable Health Care for All Americans (March 18, 2010)

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