Today House Democratic leaders unveiled the Affordable Health Care for America Act (H.R. 3962), which builds on the legislation approved by three House committees this summer.   The massive, almost 2000-page bill includes a wide range of provisions designed to expand access to health insurance, improve health care quality, and reduce health care costs. Notably, Congressional leaders decided to include a public health insurance option to compete with private health plans, with payment rates based on negotiations between the HHS Secretary and providers (rather than using Medicare rates). Other mechanisms to expand access to insurance include market reforms, an insurance purchasing exchange, premium subsidies, an expansion of Medicaid, and mandates for employers to contribute to workers’ health care costs and individuals to purchase insurance (or pay a penalty). The bill also includes scores of provisions that would impact Medicare reimbursement to providers, such as: bundled payments for acute and post-acute provider; payment reforms to discourage preventable hospital readmissions; reduced payments to Medicare Advantage plans; reduced market basket updates; “productivity adjustments” that reduce rate updates for certain Medicare providers; restrictions on specialty hospitals; and reductions in payment rates for home health and imaging services, among others. Many other reforms could impact a range of providers and manufacturers, such as expanded comparative effectiveness research, new nursing home transparency rules, expanded disclosure requirements regarding financial relationships between manufacturers and providers, numerous fraud and abuse provisions, Part D drug payment provisions, expanded drug rebates, and new payment policies for biosimilar biological products. The Congressional Budget Office analysis of the bill is expected to be released later today,  and House leaders hope to bring the bill to the House floor for a vote next week. Senate leaders still have not released their combined health reform package, although that document also is likely to be released shortly in hopes of Senate consideration by Thanksgiving. Differences between bills approved by the House and Senate ultimately would need to be reconciled before a final bill could be send to the President for his signature. In a related development, today House leaders also released H.R. 3961, the Medicare Physician Payment Reform Act of 2009, which would provide a permanent fix to the physician fee schedule through a free-standing bill, rather than using the health reform bill as the legislative vehicle to avert an upcoming 21.5 percent cut in physician fee schedule payments.