Summary: H.R.13189 — 95th Congress (1977-1978)All Information (Except Text)

There is one summary for H.R.13189. Bill summaries are authored by CRS.

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Introduced in House (06/19/1978)

Comprehensive Health Care Insurance Act - Requires every employer to offer each of his employees and their families qualified health care insurance. States that such coverage shall be optional with the employee. Requires an employer to contribute to the cost of such coverage for the benefit of an electing employee and his family at least 65 percent of the premium, with the employee contributing the balance.

Establishes, for low-income employees, a program of certificates of entitlement or income tax credit in the amount by which the portion of the premium payable by such an employee exceeds the premium for which he would be liable under the program of health insurance for the unemployed or self-employed as established by this Act.

Authorizes the Attorney General to bring suit to compel an employer to comply with the provisions of this Act.

Stipulates that employers experiencing substantial increases in payroll cost due to the provisions of this Act will be entitled to a cash payment by the Secretary of Health, Education, and Welfare or a credit against income tax.

States that premiums for employee groups of one to 100 persons and self-employed persons shall not exceed 125 percent of the estimated average in the State of the annual premium for employee groups of more than 100 persons.

Sets forth a plan of health insurance providing hospital, medical, dental, and other health care services for non-employed and self-employed individuals and their families. Establishes, as a means of implementing such plan, a program of certificates of entitlement issued by the Secretary and credits against income tax for the premium for qualified health care insurance. States that the amount of Federal participation shall be related to the income of the individual or family, the Government to pay the full premium for those whose annual incomes are insufficient to create income tax liability, and to pay a gradually smaller proportion of the premium for others in relation to increasing amounts of income tax liability.

Provides qualified health care insurance for an individual or family with no tax liability for the base year.

Stipulates that the premium rate to be charged for a qualified health care insurance policy offered under such plan for any year shall in no case exceed 125 percent of the estimated average of premiums paid in the State for qualified health care insurance for groups of employees with more than 100 members.

Excludes from qualified health care insurance coverage payment for stipulated items, including: (1) personal comfort items; (2) eyeglasses, hearing aids, or orthopedic shoes; and (3) private room inpatient hospital accommodations.

Limits the aggregate amount of expenditures for catastrophic illness expenses.

Sets forth requirements which must be met by qualified health care insurance plans.

Establishes the Federal Health Insurance Redemption Fund. Authorizes appropriations to the fund of amounts equal to the aggregate amount of premiums paid under this Act. Requires carriers offering qualified health care insurance policies to participate in an assigned-risk pool which may be established in such State by the State insurance department or by such agency as may be authorized by the State.

Establishes a Health Insurance Advisory Board to: (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, review, and develop, where necessary, programs whose purposes are to provide for maintaining the quality of medical care; and (4) review the effectiveness of the program established by this Act.

Stipulates that individuals collecting unemployment compensation are eligible for coverage under this Act, unless covered through an employed member of his family.

Permits an income tax credit for premiums paid for qualified insurance plans under this Act.