Universal Health Care Act of 1991

Universal Health Care Act of 1991 - Amends the Social Security Act to add a new title XXI (National Health Insurance) to establish a national, single-payer health insurance program under which every U.S. citizen would be eligible for enrollment. Allows individuals to choose their own health care providers from among those providers participating in the program. Provides for comprehensive health care under the program with the following benefits provided without any payment of coinsurance or deductibles: (1) inpatient hospital services; (2) nursing facility services; (3) home health services; (4) hospice care; (5) medical care; (6) prescription drugs and biologicals; (7) preventive health services; (8) home and community-based services; (9) mental health care; and (10) such other medical or health care items or services as the Secretary of Health and Human Services determines to be appropriate.

Incorporates into the National Health Care program various practice guidelines and trust fund administrative provisions under the Medicare program (title XVIII of the Social Security Act) as well as Medicare-related provisions in titles XI and II (Old Age, Survivors and Disability Insurance) (OASDI) of the Act, including those provisions relating to outcomes of research and peer review under title XI and administration of OASDI and Medicare trust funds under title II.

Outlines provisions regarding payments to providers. Provides monthly payments to hospitals and nursing homes on the basis of prospective global budgets established annually after review by the State advisory board and approval by the designated government agency. Provides payment to physicians and other health care professionals according to fee schedules established by the Secretary and adjusted by geographic region. Provides payment for health care (including hospice care) furnished outside of a hospital or nursing home on the basis of either global budgets or fee schedules, or instead on the basis of another prospective payment method (including capitation) which has been approved and reviewed as appropriate. Restricts payments to Federal health care services providers. Requires health care providers to accept payments under the program for items and services as payment in full. Changes the functions of the Prospective Payment Assessment Commission and the Physician Payment Review Commission (renamed the Professional Payment Review Commission) to require such bodies to instead furnish advice to the Secretary, concerning the global budgets of hospitals and nursing homes and fee schedules of physicians and other health care professionals. Creates the Long-Term Care Payment Review Commission and the General Health Care Payment Review Commission to furnish advice to the Secretary concerning the payment mechanism for health care (including hospice care) furnished outside of hospitals or nursing homes and fee schedules for services which have not been described above. Requires all such bodies to report annually to the Congress and the Secretary on the modification of various payment systems described above to meet its objectives.

Sets forth administrative provisions. Requires administration of the program at the national level by the Secretary. Allows States to administer the program at the State level. Requires the Secretary to establish a national health budget and State health budgets specifying the amount to be spent per calendar year for health care and how revenues from the National Health Trust Fund will be used under the program. Indexes the national budget each year according to corresponding increases in the gross national product. Establishes expenditure targets to control the growth of health care costs. Requires the national budget to set aside separate amounts for capital expenses and direct medical education and to specify the manner of division among the States. Creates advisory boards representing both consumers and health care providers to advise on the implementation of the program at the national and State levels. Authorizes the Secretary or State to enter into contracts with qualified entities to process claims. Allows only one contract per State. Requires the Secretary to establish applicable reporting systems for the program.

Establishes the National Health Trust Fund to finance this Act's initiatives with revenues from: (1) specified tax increases outlined below; (2) hospital insurance taxes imposed on additional State and local government employees and additional changes made to the Internal Revenue Code over time to fund the program; (3) long-term care/health care premiums imposed on elderly individuals who do not have low incomes; (4) State payments determined according to a specified formula tied to corresponding increases in the gross national product; and (5) amounts remaining in the trust funds supporting the Medicare program after the settlement of claims for payment under Medicare has been completed and amounts applicable to Medicare and OASDI trust fund provisions incorporated into the National Health Care program resulting from gifts and bequests, investments, and overpayments.

Amends the Internal Revenue Code to: (1) increase personal and corporate income taxes, employer hospital insurance taxes, and the amount of social security benefits subject to income taxation; (2) repeal the limitation on the amount of wages subject to employee and employer hospital insurance taxes; and (3) expand the category of employees subject to hospital insurance taxes as described above.

Terminates the Medicare and Medicaid (title XIX of the Social Security Act) programs, Federal Employees Health Benefits Program, Civilian Health and Medical Program of the Uniformed Services, and the Department of Veterans Affairs health benefits and medical care program.