The U.S. House of Representatives House Committees on Education and Labor, Ways and Means, and Energy and Commerce have prepared and introduced H.R. 3200, the "Affordable Health Choices Act", much anticipated health reform legislation.

Some major points in the 1000-plus page bill are below. The bill has exceptions for certain provisions and specific definitions for certain terms, so this is a generalized overview:

Insurance Reform and Access
--Qualified health benefits plans may not impose any coverage denials on pre-existing conditions, including rate increases for pre-existing conditions, gender or occupation. Insurers will be prevented from selectively refusing to renew coverage.
--"Grandfathered" coverage--an individual may keep one's own current doctor and plan.
--Mental health and substance abuse disorder benefits must be covered, and at parity with other coverage.
--Required core set of benefits must include inpatient hospital services, outpatient hospital services, physician and other health professional services, equipment and supplies related to physician services, preventive services, maternity services, prescription drugs, rehabilitative and habilitative services, well baby and well child visits and oral health, vision, and hearing services for children.
--There must be fair marketing standards and fair appeals and grievance mechanisms for qualified health benefit plans. Plans must explain coverage in plain language, for consumers' informed choices.
--Establishment of a Health Insurance Exchange for choice among a variety of programs, and establishment of a public health insurance option to compete with private insurers.
--Standardized benefit packages in order to comparison shop; small plans and national plans to have the same opportunity to offer coverage.

Individual Costs

--No deductibles for preventative care, an annual cap on out of pocket expenses, no lifetime limits on insurance company payments.
--Group rates out of a national pool for those who purchase their own plan.
--A Premium Plus plan with options to purchase coverage for additional health care benefits.
--Affordability credits available for people purchasing through the Exchange, assisting people with incomes up to 400% of the federal poverty level ($43,000 for individuals or $88,000 for families of four) and then a sliding scale basis.

Shared Responsibility

--Those individuals who do not choose basic coverage will be penalized based on 2.5 percent of income. However, there will be hardship waivers on criteria including affordability and religious objections.

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