Summary: H.R.4412 — 95th Congress (1977-1978)All Information (Except Text)

There is one summary for H.R.4412. Bill summaries are authored by CRS.

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Introduced in House (03/03/1977)

National Health Care Act - Title I: Findings and Declaration of Purpose - Expresses the finding of Congress that many Americans find it difficult to secure quality health care when they need it. Declares the purpose of the Act to be the improvement of the organization, delivery, and financing of health care for all citizens of the United States.

Title II: Provisions to Strengthen Health Planning - Directs the States, as part of their review of institutional health services, to designate unneeded services as surplus. States that surplus service shall be considered as though it has been denied a certificate-of-need. Establishes under the Secretary of Health, Education, and Welfare, a system of grants to reimburse health care institutions which incurred expenses in developing facilities which were later declared surplus. Authorizes State health planning and development agencies to establish a health data consortium to serve the common data needs of itself and specified groups including health care institutions, insurance companies underwriting health insurance plans, and Health Systems Agencies. Requires the Secretary to issue guidelines to be used in establishing certificate-of-need programs and in evaluating the need for new institutional health services.

Title III: Provisions to Encourage Comprehensive Ambulatory Health Care Centers - Authorizes grants for the construction and modernization of comprehensive ambulatory health care centers. Places priority upon the construction of such facilities located in densely populated areas where such facilities do not now exist. Directs that in order to participate in programs pursuant to this title the States must submit a plan which includes a listing of comprehensive ambulatory health care centers needed to provide adequate ambulatory health care services for patients residing in the State.

Title IV: Provisions to Assure a Coordinated National Health Policy - Requires the President to transmit to the Congress not later than July 1 of each year a health report setting forth the present status of the health care system of the Nation with an appraisal of trends and a review of the health programs and activities of the Federal, State and local governments.

Creates a Health Policy Board which shall study the Nation's health care programs and make recommendations to the President concerning such programs. Directs the Board to consult with other advisory bodies and representative groups in carrying out its responsibilities.

Directs all agencies of the Federal Government to include in every major action, statements regarding the effect of such action on the nation's health care.

Title V: Provisions to Make Comprehensive Health Care Insurance Available to All - Establishes minimum standard health care benefits. Specifies that such standard shall be 100 percent of specified examinations, X-rays and laboratory tests and 80 percent of specified hospital, surgical, professional, and ambulatory health care.

Prohibits, after a transitional period, any deductions by an employer for payments to an employee health care plan unless the plan offers coverage to the employees' family, the employer pays at least 50 percent of the plan's cost, and the plan provides the minimum health care benefits specified by this title. Allows an unlimited personal deduction for premiums paid by the taxpayer for a health care plan covering himself or his dependents which provides the minimum benefits specified by this Act.

Specifies such minimum health care benefits, including basic dental, maternal, child, family planning and mental health care, which must be extended by health plans in order to qualify for the income tax deductions provided by this Act. Requires that such plans provide an annual deductible of $100, with a carryover of any unused portion.

Prohibits the award of damages for the cost of remedial services for which a party is compensated under this Act, in any malpractice action arising out of the furnishing of services covered under a health care plan or under the Social Security Act.

Adds to the Social Security Act, "Title XXI - Grants to States for Qualified State Health Care Plans". Authorizes the appropriation of such funds as necessary to provide comprehensive health care insurance to needy individuals and families.

Allows individuals or families eligible for enrollment in the qualified State health care plan to elect coverage under an arrangement between the administering carrier and an approved health maintenance organization.

States that every resident individual or family who is not eligible to enroll in a qualified employee health care plan, who is enrolled in the supplementary medical insurance program for the aged and who meets the requirements concerning income, shall be eligible to enroll in the qualified State health care plan. Sets forth a formula for determining premium rates to be paid by participating individuals and families.

States that in the operation of a qualified State health care plan no charge for services rendered or supplies furnished by any hospital, skilled nursing facility, or home health agency shall be reimbursed to the extent that such charges exceed the rates approved by a State health care institution cost commission established pursuant to this Act. Makes it the duty of the Secretary of Health, Education, and Welfare to review the level of rates of institutional reimbursement approved by the commission for such categories of health care institutions as shall be established by the Secretary. Requires the Secretary to order a reduction in the level of rates approved for a given category of health care institution upon a determination that such rates are unjustifiably high.

Stipulates that each State must establish a health care benefits pool. Directs that the premiums collected pursuant to Title XXI, as introduced in this Act, be paid into the pool. Makes such pool available to pay claims and other specified expenses associated with the program.

Prohibits any class of individuals or families receiving all, or substantially all, of their medical care under a Federal program from receiving coverage under a qualified State health care plan unless the Federal Government provides payment as required by the Act.

Makes the State insurance commissioner responsible for assuring the establishment and regulation of a facility to underwrite or reinsure minimum standard health care benefits for individuals, families, and groups of less than 50 employees or members to whom such benefits would not otherwise be available.