Summary: H.R.15041 — 93rd Congress (1973-1974)All Information (Except Text)

There is one summary for H.R.15041. Bill summaries are authored by CRS.

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Introduced in House (05/29/1974)

Health Care Insurance Act - Provides, under the Social Security Act, for medical, dental, and hospital care through a system of voluntary health insurance financed in whole for low-income groups through issuance of certificates, and in part for all other persons through allowance of tax credits.

Adds to the Social Security Act a new title entitled Federal Financing of Voluntary Health Insurance. Provides that, for the purpose of providing assistance on behalf of the individuals and their dependents whose income and resources are insufficient to meet the costs of necessary medical, dental, and hospital services, there is established a program of hospital, dental, and medical benefits for any eligible beneficiary and his dependents through the issuance of health insurance certificates, in full payment of allowable premium on a qualified health care insurance policy of his choice. Assets that health insurance certificates of entitlement will be redeemable by the carrier by payment from the Federal Health Insurance Redemption Fund.

Includes as eligible beneficiaries under this title any husband and wife both under age 65 and living together and any unmarried person under age 65 who is not a dependent beneficiary. Defines a dependent beneficiary as any child of an eligible beneficiary receiving more than 50 percent of his support from the eligible beneficiary, which child is under 21, or if a student, under age 23.

Provides that every individual who is an eligible beneficiary whose income results in no individual income tax liability during his base year, whose dependent beneficiaries have no such liability for their taxable years which end during his base year, and who is not eligible to receive military medical care, shall be eligible to receive a health insurance certificate of entitlement. Asserts that such certificates shall be applicable in full payment of allowable premiums for a qualified health care insurance policy or plan. Requires that such policy or plan shall provide protection for the eligible beneficiary and his dependent beneficiaries for a 12-month period beginning during his benefit year against the expenses of health care, including catastrophic expenses of illness.

Allows tax credits for health care insurance. Asserts that every individual who is an eligible beneficiary who has not elected, where eligible, to receive benefits under the provisions for fully-paid health care insurance for the low-income group and who is not eligible to receive military medical care, shall be allowed at his election a credit against his income tax liabliity for his taxable year which ends during his base year; or a health insurance certificate of entitlement acceptable by a qualified carrier in payment toward a premium, under a qualified health care insurance policy. Specifies the amount of the tax credit or the value to be assigned to the health insurance certificate on the basis of allowable premiums.

Provides that a health insurance certificate of entitlement means a certificate issued by the Secretary of Health, Education and Welfare upon application to him by an eligible beneficiary to apply toward payment of premium on a qualified health care insurance policy or plan.

Specifies that a qualified health care insurance policy or plan shall be a contractual agreement specifying benefits under a program offered by a qualified carrier which has been registered by a State Agency and which provides basic institutional and medical coverage and catastrophic expense coverage.

Declares that each such qualified health care insurance policy or plan shall be noncancellable and guaranteed renewable so long as the carrier continues to offer to the public one or more qualified health care insurance policies or plans, shall provide protection against the expense of health care without regard to any pre-existing conditions, and shall provide for payment under this title of usual and customary charges for services covered under the policy or plan.

Stipulates what cost shall be included under basic coverage and under catastrophic expense coverage. Establishes deductibles for each of the two types of coverage.

Creates a Health Insurance Advisory Board which shall consist of eleven persons including the Secretary of Health, Education, and Welfare and the Commissioner of the Internal Revenue Service. Directs that the remaining members, not otherwise in the employ of the Government, shall be appointed by the President, with the advice and consent of the Senate, without regard to the provisions of title 5, United States Code, governing appointment in the competitive service. Asserts that the Secretary of HEW shall serve as Chairman. Provides that the members shall be selected from the persons who are specifically qualified to serve on such Board by virtue of their education, training, or experience.

Provides that the Health Insurance Advisory Board shall perform such functions as: (1) prescribe such regulations as may be necessary to carry out the purposes and provisions of this Act; (2) establish minimum Federal standards for the use of State insurance departments in determining whether an insurance company and plan are qualified under this Act; (3) in consultation with carriers, providers of services, and consumers, plan and develop programs whose purposes are to provide for maintaining the quality of medical care; and (4) review the effectiveness of the tax credit program and file an annual report.

Grants the States the power to decide which carriers are qualified.

Forbids any Federal officer or employee to exercise any supervision or control over the practice of mediciene or dentistry or the manner in which medical or dental services are provided, or over the selection, tenure, or compensation of any officer or employee or any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.

Creates in the Treasury a trust fund to be known as the Federal Health Insurance Redemption Fund to consist in part of an amount equal to the aggregate amount of premiums paid under this title through the redemption of health insurance certificates.