Instruct: Given a question, retrieve documents that can help answer the question.
Query: When was the America's Healthy Future Act first proposed?
The America's Healthy Future Act () was a law proposed by Democratic Senator Max Baucus of Montana, who chairs the Senate Finance Committee, on September 16, 2009.[1][2][3] It is also colloquially known as the Baucus Health Bill,[4] the Baucus Health Plan,[5] or BaucusCare.[6] Baucus initially publicly released a 223-page summary of the proposal.[2] It started going through the Senate mark-up process on September 22.[7] That amendment process finished Oct. 2, and was passed by the Finance Committee on October 13 by a 14 to 9 vote,.[8][9] An October CBO report stated that enacting the proposal would, on net, end up reducing the federal deficit by $81 billion over the 2010–2019 period.[10]
The U.S. Chamber of Commerce sent a letter to Baucus and Ranking Republican Member Chuck Grassley that labeled the proposal "unacceptable in many areas" while still "the most balanced health reform proposal to be marked up by Congress to date". The group highlighted the proposed tax on high-value insurance plans as unacceptable.[40] Michael D. Tanner, a CATO Institute senior fellow, criticized several aspects of the proposal such as the health care materials tax, which he said "will result in higher health care costs that will be passed on to consumers", and the individual mandate, which he labeled "heavily punitive".[41]
According to the San Francisco Chronicle, the proposal was "much-anticipated" and it represented the only attempt by a Senate committee to reach bipartisan compromise.[1] McClatchy Newspapers has also called the proposal "closely watched".[34] After its release, the proposal divided Congressional Democrats and attracted no support at all from Congressional Republicans according to National Public Radio health correspondent Julie Rovner.[29]
The proposal specifies the creation of health insurance cooperatives, which would be member-controlled, non-profit forms of health insurance that would compete with private insurers. It does not include a public insurance plan. The co-operatives would receive $6 billion in federal funding in 2012 to start off, but they would operate independently after that point.[4] The introduction of the co-ops is intended to drive health care costs downward.[1]
During 2009, the Gang of Six consisted of six members of the Senate Finance Committee of the 111th United States Congress who attempted to negotiate a compromise to pass a health care reform bill. Among the bills under consideration at the time were 
the United States National Health Care Act,
the America's Affordable Health Choices Act of 2009,
the Healthy Americans Act (Wyden–Bennett), and
the America’s Healthy Future Act (Baucus plan).
The day after Baucus made his proposal, President Barack Obama referred to the plan during a speech at the University of Maryland. He declined to endorse Baucus's plan directly, but he criticized the opponents of his broader goals in health care reform. The crowd of left-leaning college students booed at the mention of Baucus' proposal and cheered at Obama's other comments.[38]
This article is part of a series onHealthcare reform in the United States of America History Debate Legislation Preceding Social Security Amendments of 1965 EMTALA (1986) HIPAA (1996) Medicare Modernization Act (2003) PSQIA (2005) Superseded Affordable Health Care for America (H.R. 3962) America's Affordable Health Choices (H.R. 3200) Baucus Health Bill (S. 1796) Proposed American Health Care Act (2017) United States National Health Care Act (2009, H.R. 676) Healthy Americans Act (2007, 2009) Health Security Act (H.R. 3600) Latest enacted Affordable Care Act (H.R. 3590) Health Care and Education Reconciliation Act (H.R. 4872) Reforms Obama administration proposals Public opinion Reform advocacy groups Rationing Insurance coverage Systems Free market Health insurance exchange Nationalized insurance Publicly-funded Single-payer Canadian vs. American Two-tier Universal Third-party payment models All-payer rate setting Capitation Fee-for-service Global payment United Statesportal Health careportalvt
This article is part of a series onHealthcare reform in the United States of America History Debate Legislation Preceding Social Security Amendments of 1965 EMTALA (1986) HIPAA (1996) Medicare Modernization Act (2003) PSQIA (2005) Superseded Affordable Health Care for America (H.R. 3962) America's Affordable Health Choices (H.R. 3200) Baucus Health Bill (S. 1796) Proposed American Health Care Act (2017) United States National Health Care Act (2009, H.R. 676) Healthy Americans Act (2007, 2009) Health Security Act (H.R. 3600) Latest enacted Affordable Care Act (H.R. 3590) Health Care and Education Reconciliation Act (H.R. 4872) Reforms Obama administration proposals Public opinion Reform advocacy groups Rationing Insurance coverage Systems Free market Health insurance exchange Nationalized insurance Publicly-funded Single-payer Canadian vs. American Two-tier Universal Third-party payment models All-payer rate setting Capitation Fee-for-service Global payment United Statesportal Health careportalvt
Additionally, a small portion of funds would come from a new cap imposed on Flexible Spending Accounts (FSAs), pre-tax health benefits that enable millions of Americans to manage their out-of-pocket health care costs. Americans Healthy Future Act would impose a $2,500 limit on contributions to FSAs. Unfortunately, 7 million Americans have FSAs above $2,500, and those with the highest out-of-pocket health care costs- the sickest – would be hit the hardest by the restrictions.[25]
Before the proposal was made, President Barack Obama publicly promised that he would not support a plan that would cost more than $900 billion over the next ten years. He also said that a plan could not add to the federal deficit, with every bit of new spending completely offset.[12] The Baucus proposal stalled in the committee in August 2009 due to the town hall meetings faced by members of Congress, in which many opponents attended.[8]
On October 13, the Senate Finance Committee made their final vote on the Baucus proposal. The committee passed its bill 14 to 9. All Republicans voted no with the exception of Sen. Olympia Snowe. She later commented, "When history calls, history calls." The San Francisco Chronicle referred to her vote as "a coup" for Baucus, coming after criticism from his fellow Democrats for making too many compromises.[8][9] Snowe, as well as some moderate Democratic members of the committee, have vowed that they will drop their support for the Baucus plan if a 'public option' is added at any point.[8]
The AARP has not objected to the cuts to future Medicare spending in the proposal. Charles Kahn, president of the Federation of American Hospitals, has called the proposal "the right thing to do." The Washington Post has labeled the possible changes as "designed to be relatively painless".[24] The National Council of La Raza opposes the measures in the proposal that require individuals to prove their citizenship status before receiving coverage. The group has created a campaign to leave Senators voice mail messages about the issue.[42]
On September 29, the Finance Committee rejected two amendments to add a public plan to Baucus' proposal. Senator Jay Rockefeller's amendment was rejected 15 to 8, with five Democrats (Baucus, Kent Conrad, Blanche Lincoln, Tom Carper, Bill Nelson) and all Republicans voting no. Senator Chuck Schumer's amendment was defeated 13 to 10, with three Democrats (Baucus, Conrad, Lincoln) and all Republicans voting no.[35]
Baucus played a key role in facilitating the recent agreement between the Obama administration and the Pharmaceutical Research and Manufacturers of America in which the group promised a $80 billion reduction in Medicare drug prices over ten years. The administration then promised in return not to make any more financial demands on the group in the future. On Sept. 25, Democratic Sen. Bill Nelson of Florida created an amendment to reverse the deal. The Committee voted 13–10 to reject the amendment.[27]
The bill proposed by Max Baucus, the America’s Healthy Future Act, which uses health insurance cooperatives, was estimated by the Congressional Budget Office to cost $829 billion over ten years, and because of the increase in taxes of $210 billion over 10 years on premium insurance plans with high benefits, would lead to a reduction in the deficit of $81 billion. It would expand coverage to 94 percent of all eligible Americans.
The editors of National Review criticized the plan, arguing that "his proposal resorts to the same kinds of arbitrary fee cuts, taxes, and regulatory payment-control schemes that have been tried many times before and have never worked."[45] The Weekly Standard also ran an article blasting the proposal and stating that it would increase the cost of health insurance premiums through controls such as making individuals buy more comprehensive insurance than they would otherwise want.[46] The Wall Street Journal editorialized that Baucus' plan, a "Rube Goldberg proposal", would eventually lead to a total government takeover of the health care industry.[6]
Both the House health care reform bill (HR 3200) and the Senate Health, Education, Labor and Pensions Committee's bill (S 1679) have a public plan. Baucus' proposal does not.[27] The Health, Education, Labor and Pensions Committee is considered to be more liberal than the Finance Committee.[12] According to Norman Ornstein of the American Enterprise Institute, a conservative think tank, the Health Committee's proposal and the House bill would both lead to budget deficits, in contrast to the Baucus plan, which would reduce the debt. Ornstein has argued that this is an important advantage for the Baucus plan.[29] Howard Dean has stated that the majority of Senate Democrats support a more liberal plan.[33] If it reaches the Senate floor, Baucus' proposal will have to be amalgamated with the Health Committee's proposal.[34]
On September 24, the CBO re-evaluated the proposal, taking into account the changes created by the Senate Committee. The CBO stated that the proposal would bring in $23 billion in the first ten years.[27] Specifically, the Committee decreased the penalties for avoiding buying insurance, expanded the subsidies, and lowered the excise tax on high end insurance plans.[28] A CBO report issued on October 7 stated that enacting the proposal would, on net, end up reducing the federal deficit by $81 billion over the 2010–2019 period.[10] That report prompted praise from White House Press Secretary Robert Gibbs and from Senate Majority Leader Harry Reid, Dem. from Nevada, who called the scoring a "landmark occasion". Senate Minority Leader Mitch McConnell, Rep. from Kentucky, criticized the numbers as misleading given that the Baucus proposal would not come into effect for about another five years.[29]
, The Bottom Line (Committee for a Responsible Federal Budget) from the Kaiser Family Foundation
The proposal also creates an individual mandate that requires people to either buy insurance or pay a penalty. Those with incomes below three times the federal poverty level would receive subsidies to purchase their plans. For a family of four, $66,150 would be the dividing line. The penalty would be up to $950 per person or $3,800 per family each year. These measures would come into effect for all American residents in 2013.[4] According to Politico:
According to Sen. Olympia Snowe, the cost of the average employer-provided insurance plan will rise to nearly $31,000 in several years if no health care reform measures are done.[8]
Other funds come a reduction in future Medicare spending, which would be over $400 billion in the next decade. Specifically, payments under the Medicare Advantage system would be decreased by $113 billion in the next decade. The so-called 'doughnut hole' in prescription drug coverage would be closed. In the long term, the proposal would set up an independent commission that could alter payments further.[24]
The Finance Committee also rejected, by 14–9, an amendment removing the individual mandate from the proposal. Republican Sen. Jim Bunning of Kentucky proposed the change, which he said would remove an 'un-American' requirement. Baucus labeled the amendment "mortally wounding" to the health care system set forth in the proposal.[27]
Health care reform debate in the United States History of health care reform in the United States Affordable Health Care for America Act Wyden-Bennett Act Max Baucus#Health care reform
Although the proposal does not establish an employer mandate, which would have required firms to provide insurance for their workers or pay a penalty, the proposal requires businesses with more than fifty employees to pay fees going towards the aforementioned subsidies. The maximum possible fee would either be $400 per full-time employee or the average cost of the subsidies a firm's employee's take in multiplied by the number of those receiving them. The proposal forbids insurance companies from restricting coverage based on 'pre-existing conditions'. The insurance premiums can take into account tobacco use, age, family size, and geographic location.[4] Insurance companies would also be forbidden from setting up lifetime or annual caps that specify a maximum amount of care that customers can receive.[20]