Universal Health Insurance Act of 1991

Universal Health Insurance Act of 1991 - Adds a new title XXI to the Social Security Act entitled "Basic Health Insurance."

Provides, under title XXI, for: (1) the establishment of one or more service areas within each State to deliver health care services; (2) the establishment of benefit standards; (3) the selection of carriers through competitive bidding; and (4) outreach services. Directs the Secretary of Health and Human Services in establishing the benefit standards to include the types of coverage normally provided by health insurance plans, including maternity, prenatal, and postnatal care and catastrophic protection.

Provides that every U.S. national and lawfully admitted alien shall be eligible to enroll with a participating carrier.

Determines the annual premium for such insurance by the use of a formula which takes into account an individual's income and net assets so that such premium increases with one's wealth.

Provides that coverage under a title XXI plan shall: (1) be secondary in payment to any other insurance or benefit plan; and (2) not require any evidence of medical insurability or restrict coverage because of a preexisting condition or previous treatment. Provides a premium discount to enrollees who make little or no use of such insurance.

Authorizes appropriations to carry out new title XXI in an amount equal to: (1) 100 percent of the cigarette excise tax; and (2) such additional amounts as may be required. Requires such funds to be used for making payments to health insurance carriers for health insurance coverage contracted for by the Secretary under title XXI.

Amends the Internal Revenue Code to impose an additional tax on cigarettes.

Imposes an excise tax, of six percent of total wages paid, on employers who do not offer their employees a health plan meeting title XXI benefit standards.