Home > 107th Congressional Bills > H.R. 677 (ih) To amend title 49, United States Code, relating to inspection of commercial motor vehicles entering the United States along the United States-Mexico border, and for other purposes. [Introduced in House] ...H.R. 677 (ih) To amend title 49, United States Code, relating to inspection of commercial motor vehicles entering the United States along the United States-Mexico border, and for other purposes. [Introduced in House] ...
108th CONGRESS
1st Session
H. R. 676
To provide for comprehensive health insurance coverage for all United
States residents, and for other purposes.
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IN THE HOUSE OF REPRESENTATIVES
February 11, 2003
Mr. Conyers (for himself, Mr. McDermott, Mr. Kucinich, Mrs.
Christensen, Mr. Scott of Virginia, Ms. Lee, Ms. Norton, Mr. Davis of
Illinois, Mr. Owens, Mr. Jackson of Illinois, Mr. Hinchey, Mr. Payne,
Mr. Cummings, Ms. Kilpatrick, Mr. Hastings of Florida, Mr. Fattah, Mr.
Grijalva, Mr. Towns, Mr. Lewis of Georgia, Mr. Gutierrez, Mr. Thompson
of Mississippi, Ms. Carson of Indiana, Mr. Pastor, Ms. Woolsey, Mr.
Clay, and Mr. Rangel) introduced the following bill; which was referred
to the Committee on Energy and Commerce, and in addition to the
Committees on Ways and Means, Resources, and Veterans' Affairs, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
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A BILL
To provide for comprehensive health insurance coverage for all United
States residents, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``United States
National Health Insurance Act (or the Expanded and Improved Medicare
for All Act)''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions and terms.
TITLE I--ELIGIBILITY AND BENEFITS
Sec. 101. Eligibility and registration.
Sec. 102. Benefits and portability.
Sec. 103. Qualification of participating providers.
Sec. 104. Prohibition against duplicating coverage.
TITLE II--FINANCES
Subtitle A--Budgeting and Payments
Sec. 201. Budgeting process.
Sec. 202. Payment of providers and health care clinicians.
Sec. 203. Payment for long-term care.
Sec. 204. Mental health services.
Sec. 205. Payment for prescription medications, medical supplies, and
medically necessary assistive equipment.
Sec. 206. Consultation in establishing reimbursement levels.
Subtitle B--Funding
Sec. 211. Overview: funding the USNHI Program.
Sec. 212. Appropriations for existing programs for uninsured and
indigent.
TITLE III--ADMINISTRATION
Sec. 301. Public administration; appointment of Director.
Sec. 302. Quality and cost control.
Sec. 303. Regional and State administration; employment of displaced
clerical workers.
Sec. 304. Confidential Electronic Patient Record System.
Sec. 305. National Board of Universal Quality and Access.
TITLE IV--ADDITIONAL PROVISIONS
Sec. 401. Treatment of VA and IHS health programs.
Sec. 402. Public health and prevention.
Sec. 403. Reduction in health disparities.
TITLE V--EFFECTIVE DATE
Sec. 501. Effective date.
SEC. 2. DEFINITIONS AND TERMS.
In this Act:
(1) USNHI program; program.--The terms ``USNHI Program''
and ``Program'' mean the program of benefits provided under
this Act and, unless the context otherwise requires, the
Secretary with respect to functions relating to carrying out
such program.
(2) National board of universal quality and access.--The
term ``National Board of Universal Quality and Access'' means
such Board established under section 305.
(3) Regional office.--The term ``regional office'' means a
regional office established under section 303.
(4) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(5) Director.--The term ``Director'' means, in relation to
the Program, the Director appointed under section 301.
TITLE I--ELIGIBILITY AND BENEFITS
SEC. 101. ELIGIBILITY AND REGISTRATION.
(a) In General.--All individuals residing in the United States
(including any territory of the United States) are covered under the
USNHI Program entitling them to a universal, best quality standard of
care. Each such individual shall receive a card with a unique number in
the mail. An individual's social security number shall not be used for
purposes of registration under this section.
(b) Registration.--Individuals and families shall receive a United
States National Health Insurance Card in the mail, after filling out a
United States National Health Insurance application form at a health
care provider. Such application form shall be no more than 2 pages
long.
(c) Presumption.--Individuals who present themselves for covered
services from a participating provider shall be presumed to be eligible
for benefits under this Act, but shall complete an application for
benefits in order to receive a United States National Health Insurance
Card and have payment made for such benefits.
SEC. 102. BENEFITS AND PORTABILITY.
(a) In General.--The health insurance benefits under this Act cover
all medically necessary services, including--
(1) primary care and prevention;
(2) inpatient care;
(3) outpatient care;
(4) emergency care;
(5) prescription drugs;
(6) durable medical equipment;
(7) long term care;
(8) mental health services;
(9) the full scope of dental services (other than cosmetic
dentistry);
(10) substance abuse treatment services;
(11) chiropractic services; and
(12) basic vision care and vision correction (other than
laser vision correction for cosmetic purposes).
(b) Portability.--Such benefits are available through any licensed
health care clinician anywhere in the United States that is legally
qualified to provide the benefits.
(c) No Cost-Sharing.--No deductibles, copayments, coinsurance, or
other cost-sharing shall be imposed with respect to covered benefits.
SEC. 103. QUALIFICATION OF PARTICIPATING PROVIDERS.
(a) Requirement To Be Public or Non-Profit.--
(1) In general.--No institution may be a participating
provider unless it is a public or not-for-profit institution.
(2) Conversion of investor-owned providers.--Investor-owned
providers of care opting to participate shall be required to
convert to not-for-profit status.
(3) Compensation for conversion.--The owners of such
investor-owned providers shall be compensated for the actual
appraised value of converted facilities used in the delivery of
care.
(4) Funding.--There are authorized to be appropriated from
the Treasury such sums as are necessary to compensate investor-
owned providers as provided for under paragraph (3).
(5) Requirements.--The conversion to a not-for-profit
health care system shall take place over a 15-year period,
through the sale of US Treasury Bonds. Payment for conversions
under paragraph (3) shall not be made for loss of business
profits, but may be made only for costs associated with the
conversion of real property and equipment.
(b) Quality Standards.--
(1) In general.--Health care delivery facilities must meet
regional and State quality and licensing guidelines as a
condition of participation under such program, including
guidelines regarding safe staffing and quality of care.
(2) Licensure requirements.--Participating clinicians must
be licensed in their State of practice and meet the quality
standards for their area of care. No clinician whose license is
under suspension or who is under disciplinary action in any
State may be a participating provider.
(c) Participation of Health Maintenance Organizations.--
(1) In general.--Non-profit health maintenance
organizations that actually deliver care in their own
facilities and employ clinicians on a salaried basis may
participate in the program and receive global budgets or
capitation payments as specified in section 202.
(2) Exclusion of certain health maintenance
organizations.--Other health maintenance organizations,
including those which principally contract to pay for services
delivered by non-employees, shall be classified as insurance
plans. Such organizations shall not be participating providers,
and are subject to the regulations promulgated by reason of
section 104(a) (relating to prohibition against duplicating
coverage).
(d) Freedom of Choice.--Patients shall have free choice of
participating physicians and other clinicians, hospitals, and inpatient
care facilities.
SEC. 104. PROHIBITION AGAINST DUPLICATING COVERAGE.
(a) In General.--It is unlawful for a private health insurer to
sell health insurance coverage that duplicates the benefits provided
under this Act.
(b) Construction.--Nothing in this Act shall be construed as
prohibiting the sale of health insurance coverage for any additional
benefits not covered by this Act, such as for cosmetic surgery or other
services and items that are not medically necessary.
TITLE II--FINANCES
Subtitle A--Budgeting and Payments
SEC. 201. BUDGETING PROCESS.
(a) Establishment of Operating Budget and Capital Expenditures
Budget.--
(1) In general.--To carry out this Act there are
established on an annual basis consistent with this title--
(A) an operating budget;
(B) a capital expenditures budget;
(C) reimbursement levels for providers consistent
with subtitle B; and
(D) a health professional education budget,
including amounts for the continued funding of resident
physician training programs.
(2) Regional allocation.--After Congress appropriates
amounts for the annual budget for the USNHI Program, the
Director shall provide the regional offices with an annual
funding allotment to cover the costs of each region's
expenditures. Such allotment shall cover global budgets,
reimbursements to clinicians, and capital expenditures.
Regional offices may receive additional funds from the national
program at the discretion of the Director.
(b) Operating Budget.--The operating budget shall be used for--
(1) payment for services rendered by physicians and other
clinicians;
(2) global budgets for institutional providers;
(3) capitation payments for capitated groups; and
(4) administration of the Program.
(c) Capital Expenditures Budget.--The capital expenditures budget
shall be used for funds needed for--
(1) the construction or renovation of health facilities;
and
(2) for major equipment purchases.
(d) Prohibition Against Co-Mingling Operations and Capital
Improvement Funds.--It is prohibited to use funds under this Act that
are earmarked--
(1) for operations for capital expenditures; or
(2) for capital expenditures for operations.
SEC. 202. PAYMENT OF PROVIDERS AND HEALTH CARE CLINICIANS.
(a) Establishing Global Budgets; Monthly Lump Sum.--
(1) In general.--The USNHI Program, through its regional
offices, shall pay each hospital, nursing home, community or
migrant health center, home care agencies, or other
institutional provider or pre-paid group practice a monthly
lump sum to cover all operating expenses under a global budget.
(2) Establishment of global budgets.--The global budget of
a provider shall be set through negotiations between providers
and regional directors, but are subject to the approval of the
Director. The budget shall be negotiated annually, based on
past expenditures, projected changes in levels of services,
wages and input, costs, and proposed new and innovative
programs.
(b) Three Payment Options for Physicians and Certain Other Health
Professionals.--
(1) In general.--The Program shall pay physicians,
dentists, doctors of osteopathy, psychologists, chiropractors,
doctors of optometry, nurse practitioners, nurse midwives,
physicians' assistants, and other advanced practice clinicians as
licensed and regulated by the States by the following payment methods:
(A) Fee for service payment under paragraph (2).
(B) Salaried positions in institutions receiving
global budgets under paragraph (3).
(C) Salaried positions within group practices or
non-profit health maintenance organizations receiving
capitation payments under paragraph (4).
(2) Fee for service.--
(A) In general.--The Program shall negotiate a
simplified fee schedule with clinician representatives,
after close consultation with the National Board of
Universal Quality and Access and regional and State
directors.
(B) Considerations.--In establishing such schedule,
the Director shall take into consideration regional
differences in reimbursement, but strive for a uniform
national standard.
(C) Final guidelines.--The regional directors shall
be responsible for promulgating final guidelines to all
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