House Bill: The Affordable Health Care for America Act (passed Nov. 7, 2009) |
Senate Bill: The Patient Protection and Affordable Care Act (passed Dec. 24, 2009) |
Requires most U.S. citizens and legal residents to have health insurance. Penalty for not having coverage is a flat fee or percentage of income. Exemptions granted to those with financial hardships, religious obligations, American Indians, those without coverage for less than three months, undocumented immigrants and incarcerated individuals. |
Requires most individuals to have health insurance. Penalty for not having coverage is a percentage of your income. Exemptions granted for those with financial hardships and religious obligations. |
Insurance exchange through which individuals can buy insurance is state-based, with separate exchanges for businesses and individuals. |
Business and individuals participate in the same national insurance exchange. |
Expands Medicaid to 133% of poverty level. |
Expands Medicaid to 150% of poverty level. |
Employers with fewer than 50 employees are exempt from penalties. Employers with more than 200 employees must automatically enroll all employees (though they can opt-out). |
Employer penalty exemption is based on payroll amount, not number of employees, with employers with annual payrolls less than $500,000 totally exempt. |
No public plan option, but each state insurance exchange must include at least two multi-state exchanges. |
Public plan option is available through the insurance exchange, but must meet the same requirements as private plans in terms of benefit levels, provider networks, consumer protections, and cost-sharing. |
Require guarantee issue and renewability and allow rating variation based only on age (limited to 3 to 1 ratio), premium rating area, family composition, and tobacco use (limited to 1.5. to 1 ratio). |
Require guarantee issue and renewability; allow rating variation based only on age (limited to 2 to 1 ratio), premium rating area, and family enrollment. |
Temporary high-risk pool to cover those who are difficult to cover will take effect within 90 days after enactment and last until Jan. 1, 2014. |
Temporary high-risk pool to cover those who are difficult to cover will take effect Jan. 1, 2010 and last until the national insurance exchange is established. |
Dependent coverage for children will be provided until age 26. |
Dependent coverage for children will be provided until age 27. |
Create a Web site to help consumers navigate health care choices and develop uniform policy presentation standards. |
Develop uniform marketing and policy presentation standards. |
CLASS Act national long term care program |
CLASS Act national long term care program |
Effective date for most provisions is Jan. 1, 2014. |
Effective date for most provisions is Jan. 1, 2013. |