It all began with HR 3200. Five years ago today, the House of Representatives officially released the bill that would later become the Affordable Care Act. Later that year, the Senate released its companion bill and the election of Sen. Scott Brown would mean that the House would have to scrap a presumed negotiation bill and pass the Senate version. However, at the time- HR 3200 was the only player in the game. A quick reminder on what it contained:
- A Public Health Insurance Option: required HHS to create three different public plans based on market averages.
- A national Health Insurance Exchange: As opposed to what exists today- that each state may run their own Marketplace, HR 3200 had the federal government run a national Marketplace.
- Medicaid expansion: The bill expanded Medicaid to 150% of federal poverty rather than the Affordable Care Act’s 133%.
- Employer mandate: The employer mandate included in the bill was a requirement for all employers with an annual payroll over $500,000 to provide health coverage to employees and to provide a minimum set of benefits and cover a minimum percent of the cost. The bill taxed certain employers that do not provide coverage.
- Pay for: A large portion of the bill was paid for through a tax on high earning individuals and families.
CBO initially estimated that this bill would reduce the number of uninsured by 37 million by 2019 and cost $239 billion over the ten year period.
The bill passed the House in November of 2009 by a margin of 220-215.