When was the affordable care act passed by congress

The Fair Labor Standards Act of is amended by inserting after section 18A as added by section the following:. The Secretary shall make such determination on the basis of the National Compensation Survey published by the Bureau of Labor Statistics. Unless specifically provided for otherwise, the definitions contained in section of the Public Health Service Act 42 U.

Not later than 30 days after the date of enactment of this Act, the Secretary of Health and Human Services shall publish on the Internet website of the Department of Health and Human Services, a list of all of the authorities provided to the Secretary under this Act and the amendments made by this Act. Notwithstanding any other provision of this Act, the Secretary of Health and Human Services shall not promulgate any regulation that No individual, company, business, nonprofit entity, or health insurance issuer offering group or individual health insurance coverage shall be required to participate in any Federal health insurance program created under this Act or any amendments made by this Act , or in any Federal health insurance program expanded by this Act or any such amendments , and there shall be no penalty or fine imposed upon any such issuer for choosing not to participate in such programs.

The enforcement mechanisms provided for and available under such title VI, title IX, section , or such Age Discrimination Act shall apply for purposes of violations of this subsection. The Fair Labor Standards Act of is amended by inserting after section 18B as added by section the following:.

The rights and remedies in this section may not be waived by any agreement, policy, form, or condition of employment. The Inspector General of the Department of Health and Human Services shall have oversight authority with respect to the administration and implementation of this title as it relates to such Department. F by transferring such section as amended by this paragraph to appear at the end of section as added by section 4 ;.

D by transferring such section as amended by this paragraph to appear at the end of section as added by section 4 ;. C by redesignating such section as amended by this paragraph as section and transferring such section to appear after section as added by section 5 ;.

C by redesignating subsections b through e as subsections a through d , respectively; and. Such medical assistance shall be provided subject to the requirements of section , without regard to whether a State otherwise has elected the option to provide medical assistance through coverage under that section, unless an individual described in subclause VIII of subsection a 10 A i is also an individual for whom, under subparagraph B of section a 2 , the State may not require enrollment in benchmark coverage described in subsection b 1 of section or benchmark equivalent coverage described in subsection b 2 of that section.

A State that offers health benefits coverage to only parents or only nonpregnant childless adults described in the preceding sentence shall not be considered to be an expansion State. A State may elect to phase-in the extension of eligibility for medical assistance to such individuals based on income, so long as the State does not extend such eligibility to individuals described in such subclause with higher income before making individuals described in such subclause with lower income eligible for medical assistance.

A Section a 10 of such Act 42 U. B Section l 2 C of such Act 42 U. C Section a of such Act 42 U. D Section f 4 of such Act 42 U. E Section a 1 B of such Act 42 U. Upon submission of such a certification to the Secretary, the requirement under paragraph 1 shall not apply to the State with respect to any remaining portion of the period described in the preceding sentence.

A Section a of such Act 42 U. B Section f 4 of such Act 42 U. C Section e of such Act 42 U. A State shall establish income eligibility thresholds for populations to be eligible for medical assistance under the State plan or a waiver of the plan using modified gross income and household income that are not less than the effective income eligibility levels that applied under the State plan or waiver on the date of enactment of the Patient Protection and Affordable Care Act.

For purposes of complying with the maintenance of effort requirements under subsection gg during the transition to modified gross income and household income, a State shall, working with the Secretary, establish an equivalent income test that ensures individuals eligible for medical assistance under the State plan or under a waiver of the plan on the date of enactment of the Patient Protection and Affordable Care Act, do not lose coverage under the State plan or under a waiver of the plan.

The Secretary may waive such provisions of this title and title XXI as are necessary to ensure that States establish income and eligibility determination systems that protect beneficiaries. To the extent practicable, the State shall use the same methodologies and procedures for purposes of making such determinations as the State used on the date of enactment of the Patient Protection and Affordable Care Act. The Secretary shall ensure that the income eligibility thresholds proposed to be established using modified gross income and household income, including under the eligibility category established under subsection a 10 A ii XX , and the methodologies and procedures proposed to be used to determine income eligibility, will not result in children who would have been eligible for medical assistance under the State plan or under a waiver of the plan on the date of enactment of the Patient Protection and Affordable Care Act no longer being eligible for such assistance.

Section of the Social Security Act 42 U. Stafford Disaster Relief and Emergency Assistance Act and determined as a result of such disaster that every county or parish in the State warrant individual and public assistance or public assistance from the Federal Government under such Act and for which The increase in the enhanced FMAP under the preceding sentence shall not apply with respect to determining the payment to a State under subsection a 1 for expenditures described in subparagraph D iv , paragraphs 8 , 9 , 11 of subsection c , or clause 4 of the first sentence of section b.

The preceding sentence shall not be construed as preventing a State during such period from A by redesignating subparagraphs E through L as subparagraphs F through M , respectively; and.

B by redesignating the new subparagraph to be added by such section to section a 3 of the Social Security Act as a new subparagraph H. Nothing in this subparagraph shall be construed as changing State law requirements applicable to a birth attendant. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature.

B Section u 1 D v of such Act 42 U. Section a of the Social Security Act 42 U. Such models may include the provision of vouchers, direct cash payments, or use of a fiscal agent to assist in obtaining services. A achieve a more consistent administration of policies and procedures across programs in relation to the provision of such services; and.

In the 20 years since those recommendations were made, Congress has never acted on the report. In fact, for many, it has gotten far worse. This disparity continues even though, on average, it is estimated that Medicaid dollars can support nearly 3 elderly individuals and adults with physical disabilities in home and community-based services for every individual in a nursing home. Although every State has chosen to provide certain services under home and community-based waivers, these services are unevenly available within and across States, and reach a small percentage of eligible individuals.

The Secretary shall adjust such payment reduction for a calendar quarter to the extent the Secretary determines, based upon subsequent utilization and other data, that the reduction for such quarter was greater or less than the amount of payment reduction that should have been made. Such a disallowance is not subject to a reconsideration under section d. The Secretary shall implement a smoothing process for average manufacturer prices. Such process shall be similar to the smoothing process used in determining the average sales price of a drug or biological under section A.

Such term does not include a pharmacy that dispenses prescription medications to patients primarily through the mail, nursing home pharmacies, long-term care facility pharmacies, hospital pharmacies, clinics, charitable or not-for-profit pharmacies, government pharmacies, or pharmacy benefit managers.

The aggregate amount awarded by the Secretary for grants and contracts for the development, testing, and validation of emerging and innovative evidence-based measures under such program shall equal the aggregate amount awarded by the Secretary for grants under section A b 4 A.

Funds appropriated under this subsection shall remain available until expended. Such regulations shall be effective as of July 1, , and shall prohibit payments to States under section of the Social Security Act for any amounts expended for providing medical assistance for health care-acquired conditions specified in the regulations.

The regulations shall ensure that the prohibition on payment for health care-acquired conditions shall not result in a loss of access to care or services for Medicaid beneficiaries. Payments made to a designated provider, a team of health care professionals operating with such a provider, or a health team for such services shall be treated as medical assistance for purposes of section a , except that, during the first 8 fiscal year quarters that the State plan amendment is in effect, the Federal medical assistance percentage applicable to such payments shall be equal to 90 percent.

Such methodology for determining payment A planning grant awarded to a State under this paragraph shall remain available until expended. When appropriate and feasible, a designated provider shall use health information technology in providing the State with such information. A IN GENERAL- The Secretary shall enter into a contract with an independent entity or organization to conduct an evaluation and assessment of the States that have elected the option to provide coordinated care through a health home for Medicaid beneficiaries with chronic conditions under section of the Social Security Act as added by subsection a for the purpose of determining the effect of such option on reducing hospital admissions, emergency room visits, and admissions to skilled nursing facilities.

A State selected to participate in the demonstration project may target the demonstration project to particular categories of beneficiaries, beneficiaries with particular diagnoses, or particular geographic regions of the State, but the Secretary shall insure that, as a whole, the demonstration project is, to the greatest extent possible, representative of the demographic and geographic composition of Medicaid beneficiaries nationally.

The Secretary may modify the episodes of care as well as the services to be included in the bundled payments prior to or after approving the project. The Secretary may also vary such factors among the different States participating in the demonstration project. States shall ensure that Medicaid beneficiaries are not liable for any additional cost sharing than if their care had not been subject to payment under the demonstration project. The Secretary shall select not more than 5 States to participate in the demonstration project.

The Secretary may establish an annual cap on incentive payments for an accountable care organization. This mechanism shall commence before the third day of the inpatient stay. States participating in the demonstration project may manage the provision of services for the stabilization of medical emergency conditions through utilization review, authorization, or management practices, or the application of medical necessity and appropriateness criteria applicable to behavioral health.

In selecting State applications for the demonstration project, the Secretary shall seek to achieve an appropriate national balance in the geographic distribution of such projects.

As a condition of receiving payment, a State shall collect and report information, as determined necessary by the Secretary, for the purposes of providing Federal oversight and conducting an evaluation under subsection f 1.

A An assessment of access to inpatient mental health services under the Medicaid program; average lengths of inpatient stays; and emergency room visits. C An assessment of the impact of the demonstration project on the costs of the full range of mental health services including inpatient, emergency and ambulatory care.

D An analysis of the percentage of consumers with Medicaid coverage who are admitted to inpatient facilities as a result of the demonstration project as compared to those admitted to these same facilities through other means. E A recommendation regarding whether the demonstration project should be continued after December 31, , and expanded on a national basis.

MACPAC shall include in the annual report required under paragraph 1 D a description of all such areas or problems identified with respect to the period addressed in the report. Responsibility for analysis of and recommendations to change Medicare policy regarding Medicare beneficiaries, including Medicare beneficiaries who are dually eligible for Medicare and Medicaid, shall rest with MedPAC.

Such membership shall also include representatives of children, pregnant women, the elderly, individuals with disabilities, caregivers, and dual eligible individuals, current or former representatives of State agencies responsible for administering Medicaid, and current or former representatives of State agencies responsible for administering CHIP. Responsibility for analysis of and recommendations to change Medicare policy regarding Medicare beneficiaries, including Medicare beneficiaries who are dually eligible for Medicare and Medicaid, shall rest with the Commission.

Responsibility for analysis of and recommendations to change Medicaid policy regarding Medicaid beneficiaries, including Medicaid beneficiaries who are dually eligible for Medicare and Medicaid, shall rest with MACPAC.

The plan shall include provisions for the Secretary to monitor implementation of the plan and conduct continued oversight of the program, including through submission by the entity of regular reports to the Secretary.

The Secretary may provide the technical assistance directly or through grants, contracts, or cooperative agreements. The evaluation shall include Such requirements shall, to the greatest extent practicable, be consistent with the requirements applicable to eligible entities that are States and shall require an Indian Tribe or consortium , Tribal Organization, or Urban Indian Organization to The Secretary shall specify the requirements for such an organization to apply for and conduct the program which shall, to the greatest extent practicable, be consistent with the requirements applicable to eligible entities that are States and shall require the organization to The Secretary may carry out such activities directly, or through grants, cooperative agreements, or contracts.

The report required under this paragraph shall include Any funds that are not expended by the eligible entity during the period in which the funds are available under the preceding sentence may be used for grants to nonprofit organizations under subsection h 2 B. Activities under this paragraph shall include conducting and supporting the following:. B Epidemiological studies to address the frequency and natural history of the conditions and the differences among racial and ethnic groups with respect to the conditions.

E Information and education programs for health care professionals and the public, which may include a coordinated national campaign to increase the awareness and knowledge of postpartum conditions. Activities under such a national campaign may II educating new mothers and their families about postpartum conditions to promote earlier diagnosis and treatment; and.

III ensuring that such education includes complete information concerning postpartum conditions, including its symptoms, methods of coping with the illness, and treatment resources. A SENSE OF CONGRESS- It is the sense of Congress that the Director of the National Institute of Mental Health may conduct a nationally representative longitudinal study during the period of fiscal years through of the relative mental health consequences for women of resolving a pregnancy intended and unintended in various ways, including carrying the pregnancy to term and parenting the child, carrying the pregnancy to term and placing the child for adoption, miscarriage, and having an abortion.

This study may assess the incidence, timing, magnitude, and duration of the immediate and long-term mental health consequences positive or negative of these pregnancy outcomes. B REPORT- Subject to the completion of the study under subsection a , beginning not later than 5 years after the date of the enactment of this Act, and periodically thereafter for the duration of the study, such Director may prepare and submit to the Congress reports on the findings of the study. The Secretary may allow such projects to include the following:.

Such education may include B REPORT- Not later than 2 years after the date of the enactment of this Act, the Secretary shall complete the study required by subparagraph A and submit a report to the Congress on the results of such study. The Secretary also shall use any amounts from the allotments of States that submit applications under this section for a fiscal year that remain unexpended as of the end of the period in which the allotments are available for expenditure under paragraph 3 for awarding grants under this paragraph.

An entity awarded a grant under this paragraph shall agree to participate in a rigorous Federal evaluation of the activities carried out with grant funds. In carrying out such functions, the Secretary shall collaborate with a variety of entities that have expertise in the prevention of teen pregnancy, HIV and sexually transmitted infections, healthy relationships, financial literacy, and other topics addressed through the personal responsibility education programs.

Amounts appropriated under this subsection shall remain available until expended. Such measures shall be selected from the measures specified under subsection b 3 B viii. Such measures shall be adjusted for factors such as age, sex, race, severity of illness, and other factors that the Secretary determines appropriate.

Such performance period shall begin and end prior to the beginning of such fiscal year. The Secretary shall make such reductions for all hospitals in the fiscal year involved, regardless of whether or not the hospital has been determined by the Secretary to have earned a value-based incentive payment under paragraph 6 for such fiscal year.

The Secretary shall ensure that such process provides for resolution of such appeals in a timely manner. Such process shall include the auditing of a number of randomly selected hospitals sufficient to ensure validity of the reporting program under this clause as a whole and shall provide a hospital with an opportunity to appeal the validation of measures reported by such hospital. The Secretary shall seek input from such stakeholders in determining the type of information that is useful and the formats that best facilitate the use of the information.

Such study shall include an analysis of the impact of such program on Such study shall include an analysis B REPORT- Not later than January 1, , the Secretary of Health and Human Services shall submit to Congress a report containing the results of the study conducted under subparagraph A , together with recommendations for such legislation and administrative action as the Secretary determines appropriate.

The Secretary shall ensure that such hospitals are representative of the spectrum of such hospitals that participate in the Medicare program. D REPORT- Not later than 18 months after the completion of the demonstration program under this paragraph, the Secretary shall submit to Congress a report on the demonstration program together with Such integration shall consist of the following:. Such review shall be conducted on an expedited basis. Such data shall be submitted in a form and manner, and at a time, specified by the Secretary for purposes of this subparagraph.

Such procedures shall ensure that a long-term care hospital has the opportunity to review the data that is to be made public with respect to the hospital prior to such data being made public. Such procedures shall ensure that a rehabilitation facility has the opportunity to review the data that is to be made public with respect to the facility prior to such data being made public.

Such procedures shall ensure that a hospice program has the opportunity to review the data that is to be made public with respect to the hospice program prior to such data being made public. Such procedures shall ensure that a hospital described in section d 1 B v has the opportunity to review the data that is to be made public with respect to the hospital prior to such data being made public.

A The ongoing development, selection, and modification process for measures including under section of the Social Security Act 42 U. C The structure of value-based payment adjustments, including the determination of thresholds or improvements in quality that would substantiate a payment adjustment, the size of such payments, and the sources of funding for the value-based bonus payments.

D Methods for the public disclosure of information on the performance of skilled nursing facilities. B consider experience with such demonstrations that the Secretary determines are relevant to the value-based purchasing program described in paragraph 1. Such payment modifier shall be separate from the geographic adjustment factors established under subsection e. Such measures shall be risk adjusted as determined appropriate by the Secretary.

On or after January 1, , the Secretary may apply this subsection to eligible professionals as defined in subsection k 3 B as the Secretary determines appropriate.

In making the determination under the preceding sentence, the Secretary may take into account the amount of growth in expenditures per individual for a physician compared to the amount of such growth for other physicians.

Such study shall include an analysis of how such policies could impact quality of patient care, patient safety, and spending under the Medicare program. Such common quality measures shall be measures identified by the Secretary under section A or B of the Social Security Act or endorsed under section of such Act. Any such update shall include a review of short- and long-term goals. X any other Federal agencies and departments with activities relating to improving health care quality and safety, as determined by the President.

In identifying such gaps and existing quality measures that need improvement, the Secretary shall take into consideration In developing such measures, the Administrator shall consult with the Director of the Agency for Healthcare Research and Quality. Of the amounts appropriated under the preceding sentence in a fiscal year, not less than 50 percent of such amounts shall be used pursuant to subsection e of section A of the Social Security Act, as added by subsection b , with respect to programs under such Act.

Amounts appropriated under this subsection for a fiscal year shall remain available until expended. Such process shall include the following:. Amounts transferred under the preceding sentence shall remain available until expended. The Secretary shall ensure that such collection, aggregation, and analysis systems span an increasingly broad range of patient populations, providers, and geographic areas over time.

The Secretary shall provide standards for the protection of the security and privacy of patient data. Such non-Federal matching funds may be provided directly or through donations from public or private entities and may be in cash or in-kind, fairly evaluated, including plant, equipment, or services.

Such information shall be tailored to respond to the differing needs of hospitals and other institutional health care providers, physicians and other clinicians, patients, consumers, researchers, policymakers, States, and other stakeholders, as the Secretary may specify. The purpose of the CMI is to test innovative payment and service delivery models to reduce program expenditures under the applicable titles while preserving or enhancing the quality of care furnished to individuals under such titles.

In selecting such models, the Secretary shall give preference to models that also improve the coordination, quality, and efficiency of health care services furnished to applicable individuals defined in paragraph 4 A.

The CMI shall use open door forums or other mechanisms to seek input from interested parties. The models selected under the preceding sentence may include the models described in subparagraph B. Such termination may occur at any time after such testing has begun and before completion of the testing.

Such evaluation shall include an analysis of Each such report shall describe the models tested under subsection b , including the number of individuals described in subsection a 4 A i and of individuals described in subsection a 4 A ii participating in such models and payments made under applicable titles for services on behalf of such individuals, any models chosen for expansion under subsection c , and the results from evaluations under subsection b 4.

In addition, each such report shall provide such recommendations as the Secretary determines are appropriate for legislative action to facilitate the development and expansion of successful payment models. Under such program At a minimum, the ACO shall have at least 5, such beneficiaries assigned to it under subsection c in order to be eligible to participate in the ACO program.

Such data may include care transitions across health care settings, including hospital discharge planning and post-hospital discharge follow-up by ACO professionals, as the Secretary determines appropriate.

The Secretary shall seek to improve the quality of care furnished by ACOs over time by specifying higher standards, new measures, or both for purposes of assessing such quality of care. The incentive payments described in the preceding sentence shall not be taken into consideration when calculating any payments otherwise made under subsection d.

The Secretary shall determine the appropriate percent described in the preceding sentence to account for normal variation in expenditures under this title, based upon the number of Medicare fee-for-service beneficiaries assigned to an ACO. Such benchmark shall be adjusted for beneficiary characteristics and such other factors as the Secretary determines appropriate and updated by the projected absolute amount of growth in national per capita expenditures for parts A and B services under the original Medicare fee-for-service program, as estimated by the Secretary.

Such benchmark shall be reset at the start of each agreement period. The Secretary shall establish limits on the total amount of shared savings that may be paid to an ACO under this paragraph. In selecting conditions under the preceding sentence, the Secretary shall take into consideration the following factors:. Such requirements shall ensure that applicable beneficiaries have an adequate choice of providers of services and suppliers under the pilot program.

Such payment methods may include bundled payments and bids from entities for episodes of care. The Secretary shall make payments to the entity for services covered under this section. Quality measures established under the preceding sentence shall include measures of the following:.

Such consultation shall include consideration of innovative methods of implementing bundled payments in hospitals described in the preceding sentence, taking into consideration any difficulties in doing so as a result of the low volume of services provided by such hospitals. The entity shall report on quality measures in such form, manner, and frequency as specified by the Secretary, which may be for the group, for providers of services and suppliers, or both and report to the Secretary in a form, manner, and frequency as specified by the Secretary such data as the Secretary determines appropriate to monitor and evaluate the demonstration program.

Such spending targets shall be determined on a per capita basis. Such spending targets shall include a risk corridor that takes into account normal variation in expenditures for items and services covered under parts A and B furnished to such beneficiaries with the size of the corridor being related to the number of applicable beneficiaries furnished services by each independence at home medical practice.

The spending targets may also be adjusted for other factors as the Secretary determines appropriate. An incentive payment for such year shall be equal to a portion as determined by the Secretary of the amount by which actual expenditures including incentive payments under this paragraph for applicable beneficiaries under parts A and B for such year are estimated to be less than 5 percent less than the estimated spending target for such year, as determined under paragraph 1.

Enrollment in the demonstration program shall be voluntary. An agreement with an independence at home medical practice under the demonstration program may cover not more than a 3-year period. Such report shall include an analysis of the demonstration program on coordination of care, expenditures under this title, applicable beneficiary access to services, and the quality of health care services provided to applicable beneficiaries.

Amounts transferred under this subsection for a fiscal year shall be available until expended. In expanding such applicable conditions, the Secretary shall seek the endorsement described in subparagraph A ii I but may apply such measures without such an endorsement in the case of a specified area or medical topic determined appropriate by the Secretary for which a feasible and practical measure has not been endorsed by the entity with a contract under section a as long as due consideration is given to measures that have been endorsed or adopted by a consensus organization identified by the Secretary.

Insofar as the discharge relates to an applicable condition for which there is an endorsed measure described in subparagraph A ii I , such time period such as 30 days shall be consistent with the time period specified for such measure.

The Secretary may also make other information determined appropriate by the Secretary available on such website. B An appropriate community-based organization that provides care transition services under this section across a continuum of care through arrangements with subsection d hospitals as so defined to furnish the services described in subsection c 2 B i and whose governing body includes sufficient representation of multiple health care stakeholders including consumers.

A participate in a program administered by the Administration on Aging to provide concurrent care transitions interventions with multiple hospitals and practitioners; or. Section d of the Social Security Act 42 U. Such analysis shall include an evaluation of the following:. Such adjustments shall be made without regard to adjustments made pursuant to clauses i and ii and shall be made in a budget neutral manner.

Section g 5 of the Social Security Act 42 U. Such attestation shall be subject to section of title 18, United States Code. Materials submitted under the preceding sentence shall include a certification by an accountant on behalf of the pharmacy or the submission of tax returns filed by the pharmacy during the relevant periods, as requested by the Secretary. Read more. The Affordable Care Act states an individual is eligible for a tax credit if he or she enrolls in an insurance plan through "an Exchange established by the State.

At issue in King v. Burwell was whether the ACA permitted the IRS to interpret the law in this way and grant tax credits to individuals who purchased their health insurance from the federal health insurance exchange in addition to the state exchanges.

If tax subsidies were not available for insurance plans purchased through federal exchange, an estimated 6. This federal lawsuit was filed in Florida , with 26 states, two individuals, and an independent organization named as plaintiffs. The lawsuit challenged the Affordable Care Act on the grounds that the individual health insurance mandate exceeded Congress ' authority to regulate interstate commerce under the Commerce Clause of Article I and did not fall within its power to tax.

The complaint further alleged that the Act violated the Tenth Amendment by compelling states to follow federal regulations—under the ACA, states would have lost federal Medicaid funding had they not expanded their Medicaid programs. The Affordable Care Act had mandated that insurance plans must cover certain essential benefits—which HHS later interpreted to include contraceptive coverage. Employers that didn't provide this benefit in their health insurance plan would face hefty fines.

Two family-owned companies—Hobby Lobby and Conestoga Wood Specialty—challenged the contraception mandate in court. They sought exemptions from coverage of four different contraceptives—two emergency morning after pills and two intrauterine devices IUDs —on the basis that those contraceptives were forms of abortion according to their religious beliefs. On July 30, , the House voted to in favor of a resolution to file a lawsuit against the Obama administration.

The lawsuit challenged the administration's delay of the ACA's employer mandate and its payment of subsidies to insurers for providing a reduced cost burden to low-income consumers under the law.

Boehner claimed the executive branch "changed the healthcare law without a vote of Congress" by delaying the employer mandate and violated Article I of the Constitution by using unappropriated funds to make payments to insurers. Sixteen of these measures were ultimately enacted and signed into law by former President Barack Obama D ; these bills made bipartisan changes such as delaying the 40 percent excise tax on high-cost health plans and amending definitions.

Four of the bills that passed the House would have repealed the law in its entirety had they been enacted; only one made it to President Obama's desk, HR The passage of HR , the Restoring Americans' Healthcare Freedom Act , marked the first time a measure to repeal major portions of the law had passed both the House and the U.

President Obama vetoed the bill. Both bills were reconciliation bills that proposed modifying the budgetary and fiscal provisions of the ACA. Ultimately, the Senate did not pass the bill. Trump offered his full support for the legislation. The bill was a reconciliation bill, meaning it would have impacted the budgetary and fiscal provisions of the ACA, and did not contain a provision to repeal the law in its entirety.

It proposed repealing the tax penalties on individuals for not maintaining health coverage and on employers for not offering coverage. The ACA's income-based tax credits for purchasing insurance would have ended, as would have the enhanced federal funding for states that expanded Medicaid.

The bill contained its own system of tax credits, based on age rather than income, and a penalty in the form of increased premiums for individuals who did not maintain continuous coverage. After two canceled votes in March, the House reintroduced the measure on April 6, On April 13, House Republicans added a new amendment to the American Health Care Act in an attempt to unite the party behind the bill, allowing states to opt out of some of the bill's provisions.

These two amendments garnered enough votes from moderate and conservative Republicans to pass the bill on May 4, , by a vote of On June 22, , the U. The bill was a reconciliation bill that proposed modifying the budgetary and fiscal provisions of the Patient Protection and Affordable Care Act ACA , also known as Obamacare.

For detailed information on the BCRA, click here. During the last week of July, the Senate voted on three major proposals to repeal and replace the ACA. A procedural vote on the BCRA was rejected by a vote of A proposal to repeal the ACA and delay the effective date for two years to provide time for a replacement bill failed by a vote of The final major amendment—the "skinny bill"—was rejected by a vote. It contained the provisions to repeal the requirements for individuals to enroll in health insurance and for employers to offer it, among other provisions.

On January 6, , the U. House of Representatives voted in favor of a bill to repeal parts of the Affordable Care Act , also known as "Obamacare," and to end federal funding for Planned Parenthood over the next year. President Barack Obama vetoed the measure on January 8, stating that the legislation would have caused harm "to the health and financial security of millions of Americans.

The bill, HR , was widely expected to be vetoed by the president and, according to The Hill , was viewed as more of a symbolic move for the Republican Party to show voters "how they would govern if they win back the White House in November. The bill would have ended the expansion of Medicaid and federal subsidies for people buying health insurance on the new exchanges. These changes would have taken place in , and Republicans say they would have used the two years in between to implement a replacement of the law.

Beginning early on during congressional debate over the Affordable Care Act, 10 legislative referrals and citizen initiatives appeared seeking to stop implementation of the act in eight states. Most of these ballot measures proposed an amendment to the state's constitution declaring that citizens of the respective state could not be compelled to purchase health insurance or be fined for not doing so.

Some measures, however, instead chose to focus on prohibiting the state's government from establishing a health insurance exchange. This particular tactic was used so as to gain additional legal leverage before the courts by making available the argument that the federal law violated state constitutions.

Another aspect of this strategy was to demonstrate public disapproval of the bill by having such constitutional changes be decided by voters rather than state legislators. This effort was not universally successful, however, because voters in some states refused to approve these constitutional amendments.

The following is a list of states that saw such constitutional amendments on their ballots since Successful measures are indicated with a a. The link below is to the most recent stories in a Google news search for the terms Affordable Care Act.

These results are automatically generated from Google. Ballotpedia does not curate or endorse these articles. Obamacare overview - Google News. Healthcare policy in the United States. Federal policy on healthcare, Ballotpedia features , encyclopedic articles written and curated by our professional staff of editors, writers, and researchers. Click here to contact our editorial staff, and click here to report an error.

Click here to contact us for media inquiries, and please donate here to support our continued expansion. Share this page Follow Ballotpedia. What's on your ballot? Jump to: navigation , search. The Affordable Care Act passed the Senate along party lines on December 24, , and passed the House on March 21, Thirty-four House Democrats voted in opposition.

As of November , a total of 36 states and Washington, D. President Donald Trump 's main healthcare policy initiative has been working to fulfill his campaign promise to repeal and replace the ACA.

He expressed support for the House and Senate bills that proposed modifying parts of the ACA, but as of November , Congress had not passed a bill.

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How many GOP senators voted to repeal Obamacare? Obama healthcare signature. Any inconsistencies are attributable to the original source. Categories : Pages with broken file links Federalism tracking Federalism legislation Federal issues, Obama administration Federal issues, healthcare Healthcare laws and lawsuits Past administration federal policy pages Federal legislation.

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This section-by-section analysis includes a description of those provisions within the description of the section that was amended.

ProQuest Legislative Insight A federal legislative history database containing compilations of digital full-text publications relevant to enacted U. Includes legislative histories for public laws from the 1st Congress to the current Congress. ProQuest Congressional U. Congressional publications and information of particular importance to legislative history research. Publications include: bills, hearings, committee reports, the Congressional Record, the U.

Statutes at Large, the U. Code, the Code of Federal Regulations, the Federal Register, compiled legislative histories, Congressional Research Service CRS reports, campaign contribution and financial information, voting record information, and congressional news sources. See the "Content Coverage Chart" link for dates of coverage and update schedule. Regulations and Guidance from the U. Department of Labor DOL. Gluck; Ezekiel J. Emanuel Call Number: KF A A2 Noble; Michael M.

Maddigan Call Number: KF Health Care Reform: Law and Practice. A A15 Legal Practice Implications of the U. Mitchell; Ferd H. Mitchell Call Number: KF A15 L