What portion of the Affordable Care Act originated in the House?

Question

The Patient Protection and Affordable Care Act, aka Obamacare was declared constitutional by the Supreme Court of the United States. In Justice Roberts opinion, he declared that the individual mandate to buy health insurance was not a constitutional exercise of the Commerce Clause, but was a constitutional exercise of Congress's power to Tax & Spend:

The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax. Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.

All revenue raising bills must originate in the House of Representatives.

All Bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with Amendments as on other Bills.

What portion of the Affordable Care Act originated in the House?

Answer 1

No portion of the Affordable Care Act (ACA) was passed in the House.

You can check the Library of Congress's Thomas database. There were 7 versions of Bill Number H.R.3590 for the 111th Congress. The 3rd one on the list, is the version passed by the house, and placed on the Senate calendar. The final version, ultimately passed into law essentially stripped all the text from the House bill and inserted the text of the ACA.

3). Service Members Home Ownership Tax Act of 2009 (Placed on Calendar Senate -PCS)

An Act To amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes.

7). Patient Protection and Affordable Care Act (Enrolled Bill [Final as Passed Both House and Senate] - ENR)

An Act Entitled The Patient Protection and Affordable Care Act.

The only text that the ACA shares with the House bill is the number (H.R. 3590), and the default template that appears at the start of all bills passed by Congress.

Answer 2

The House passed a bill called HR 3590, the Service Members Home Ownership Tax Act of 2009, which had nothing to do with healthcare. And then the Senate put their version of the ACA as an amendment to that bill.

EDIT: The House bill and the Senats bill were pretty similar, but if you want to know their differences, there's a pretty comprehensive listing of the differences here: www.nytimes.com/interactive/2009/11/19/us/politics/1119-plan-comparison.html

There were basically three major changes between the two bills:

1. Some moderate Democrats in the Senate like Joe Lieberman were against the public option (because they thought it would weaken the private insurance market), so the Senate bill removed the federal public option that was in the House bill, although it did give states the choice to create their own public options (which is how Vermont was able to institute its single-payer healthcare plan).

2. The House bill included the Stupak amendment, which prohibited any Federal subsidies being used to buy insurance policies that covered abortion (although you could still attach a rider to your policy that would cover it). But a lot of pro-choice Senators found that too restrictive, because it might have led insurance companies to simply decide not to offer any policies at all that cover abortion. So the Senate bill said that people receiving Federal subsidies COULD buy insurance that covered abortion, they would just have to segregate the funds, i.e. write one check with their own money to pay for the abortion part of the insurance, and write another check paying for the non-abortion part of the insurance using the Federal subsidies.

3. The Senate bill added a tax on Cadillac health plans, i.e. insurance policies that offered really generous benefits, to help pay for the cost of the bill.

Note that you shouldn't assume that whatever was in the Senate bill is now the law of the land. You see, after the Senate bill was passed by the Senate, Ted Kennedy died, and the Democrats lost their filibuster-proof majority in the Senate when Republican Scott Brown replaced Ted Kennedy. So the only way to make Obamacare into law was for the House to pass the Senate bill. But the House didn't like some of the things that were in the Senate bill, so what they did was pass the Senate bill, which then became law, but then they passed a new bill to make changes to the Senate bill, through a process known as budget reconciliation which bypasses the filibuster. The new bill passed through reconciliation made two significant changes:

1. It weakened the individual mandate and the enforcement of the mandate, since House Democrats were less supportive of the mandate now that the public option had been removed.

2. It delayed the tax on Cadillac health plans (I don't remember the time period of the delay), since House Democrats were reluctant to impose a tax that would have impacted a lot of union workers.

There was also one other significant change relative to the Senate bill, although it was not passed legislatively: Bart Stupak and his fellow pro-life Democrats in the house didn't like the changes the Senate had made to the abortion provision, because they argued that money was fungible, so even if you wrote two separate checks, the government would still be paying for your abortion coverage, because by paying for some of your healthcare expenses, it would leave you with more money to pay for abortion coverage. So as the price of agreeing to pass the Senate bill, those House members got President Obama to issue an executive order stating that no Federal money could be used to pay for abortion coverage, just like the Stupak amendment in the House bill said.