Health Care Insurance Act

Health Care Insurance Act - States it to be the purpose of this Act to make it possible for every individual to obtain comprehensive medical and hospitalization insurance of his choice designed to protect against ordinary and catastrophic expenses of illness regardless of prior medical history and on a guaranteed renewable basis. Creates a new title to the Social Security Act: Title XX: Federal Financing of Voluntary Health Insurance.

Establishes for eligible beneficiaries and their dependents a program for the issuance of health insurance certificates of entitlement which shall operate to reduce or eliminate the cost to any individual of protection under a qualified health care insurance policy or plan of his choice.

Provides that eligible beneficiaries under this title include: (1) a husband and his wife, both under age 65, living together; and (2) any person, under age 65, other than a married person living with his or her spouse where both are under age 65, who is not a dependent beneficiary.

Defines a dependent beneficiary as any child or step-child of an eligible beneficiary who, during the base year of such eligible beneficiary, receives more than 50 percent of his support from such eligible beneficiary, and who at the close of such year has not attainted the age of twenty-one, or, if he is a full-time student, has not attained the age of twenty-three.

Provides that every individual who is an eligible beneficiary shall be eligible to receive a health insurance certificate of entitlement, which shall be applicable in full or part payment of allowable premiums on a qualified health care insurance policy or plan.

States that the value to be assigned to the health insurance certificate of entitlement shall be the sum of: (1) the allowable premiums for qualified health care insurance paid for basic coverage for the beneficiary's benefit year, multiplied by the applicable percentage factor ranging from 100 percent for persons with an income tax liability of $0 to 10 percent for persons with an income tax liability of $891 or over; and (2) 100 percent of the allowable premiums paid for the catastrophic expense coverage for the beneficiary's benefit year.

Provides that the allowable premium which shall be taken into account in the assignment of value to a health insurance certificate of entitlement shall be that portion of the aggregate amount of premiums paid or payable by an eligible beneficiary for one or more qualified health care insurance policies or plans providing coverage for such eligible beneficiary and his dependent beneficiaries for a twelve-month period that represents the cost of the protection required in a qualified health care insurance policy or plan.

Provides that a health insurance certificate of entitlement means a certificate issued by the Secretary to an eligible beneficiary to apply toward payment of premium on a qualified health care insurance policy or plan.

Defines a "qualified health care insurance policy or plan" as a contractual agreement specifying benefits under a program offered by a qualified carrier, which carrier and program have been registered by the State insurance department or by such other agency as may be authorized by the State, and which provides: (1) basic coverage providing for all expenses incurred for institutional care, emergency and outpatient services, medical care, dental or oral surgery, and ambulance services; and (2) catastrophic expense coverage.

Provides that hospital and medical benefits under the basic coverage shall be subject to payment by the beneficiary of: (1) $50 for costs incurred during each stay in the hospital or extended care facility as an inpatient; (2) 20 percent coinsurance on the first $500 of expenses incurred during the twelve-month policy period for the eligible beneficiary and his dependent beneficiaries combined for emergency room or outpatient services in the hospital; and (3) 20 percent coinsurance on the first $500 of medical expenses and the expenses of dental or oral surgery and ambulance services incurred during such policy period for the eligible beneficiary and his dependent beneficiaries combined.

Provides that benefits payable under the catastrophic expense coverage in a qualified health care insurance policy or plan shall be subject to reduction for the twelve-month policy period.

Establishes a Health Insurance Advisory Board to: (1) prescribe such regulations as may be necessary to carry out the purposes and provisions of this title; (2) establish minimum Federal standards for the use of State insurance departments in determining whether an insurance company and plan are qualified under this title; and (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 the effective utilization of available financial resources, health manpower, and facilities, through utilization review, peer review, and other means which provide for the participation of the insurance carriers and the providers of services.

Sets forth the qualifications of carriers under this Act.

Establishes in the Treasury of the United States a trust fund to be known as the Federal Health Insurance Redemption Fund.

Authorizes to be appropriated, from time to time out of moneys in the Treasury not otherwise appropriated, to the fund an amount equal to the aggregate amount of premiums paid under this title through the redemption of health insurance certificates issued pursuant to this Act.

Provides that sums authorized to be appropriated pursuant to this section shall be considered premiums payable under this Act and deposited in such fund. Provides that certificates upon presentation to the Secretary of Health, Education, and Welfare shall be redeemed through payments from the fund.