National Health Care Act

National Health Care Act - Title I: Findings and Declaration of Purpose - Declares the purpose of this Act to be to improve the organization, delivery, and financing of health care for all Americans by increasing health personnel, promoting ambulatory care, strengthening health planning, establishing national standards of health care benefits, including coverage for medical catastrophes, encouraging provisions of such benefits through comprehensive health care insurance, and by assisting persons of low income or in poor health to secure that insurance.

Title II: Provisions to Increase the Supply and Improve the Distribution of Health Care Personnel - Allows a medical student to borrow the lesser of the sum of the full cost of tuition, fees, and reasonable amounts for room, board, books, supplies, and other related costs, or $5,000.

Authorizes to be appropriated for the operation of a student loan fund $62,500,000 for the fiscal year 1976, and $50,000,000 for fiscal year 1977. Authorizes to be appropriated for fiscal year 1978 and each of the two succeeding fiscal years such sums as may be necessary to enable students who have received a loan prior to October 1, 1977, to continue their education.

Authorizes to be appropriated to the Secretary of Health, Education and Welfare for Federal capital contributions to student loan funds, $40,000,000 for fiscal year 1975, $50,000,000 for fiscal year 1976, $40,000,000 for fiscal year 1977, and such sums for fiscal year 1978 and the two following fiscal years to enable students receiving loans prior to October 1, 1977, to complete their education.

Authorizes to be appropriated as grants to public or nonprofit private institutions, that train personnel in the allied health professions $12,500,000 for fiscal year 1976, and $12,000,000 for fiscal year 1977.

Allows up to 50 percent of a loan for a student in the allied health professions to be cancelled at the rate of 20 percent a year for service in a public or nonprofit institution or agency, and at a rate of 33 1/3 percent a year for appropriate service in an area designated as having a shortage of allied health professionals.

Authorizes to be appropriated to the Secretary for student loans $18,750,000 for fiscal year 1976, $15,000,000 for fiscal year 1977, and such sums for fiscal year 1978, and each of the next 2 succeeding fiscal years as is necessary to enable students who have received loans prior to October 1, 1977, to complete their education.

Includes in the term "training center for allied health professions" junior colleges, colleges, and universities which offer training in health care center administration or the effective operation of comprehensive ambulatory health care centers or who are affiliated with such a hospital or a comprehensive ambulatory health care center.

Establishes a program of special project grants to help educational institutions meet the cost of developing curriculums and training programs to develop the skills needed to administer and staff comprehensive ambulatory health care centers. Authorizes to be appropriated for such grants $12,500,000 for 1976, $25,000,000 for fiscal year 1977.

Establishes a program of Federal grants to medical personnel in return for service in urban and rural areas of critical need to alleviate the distribution of health care personnel. Authorizes the Secretary of Health, Education, and Welfare to contract with individual health professionals, nurses, or allied health professionals who agree to provide health care services for a period of at least two years in an area designated by the Secretary as having a critical need for those services.

Provides that the amount of the grant is that amount which, when added to the recipient's income from providing health care services for each contract year, provides a total income equal to 110 percent of the national annual median income for persons of comparable education and training, or 110 percent of his earnings from providing health care services in the previous year, whichever is greater.

Provides that in determining the precise amount of the grant the Secretary may consider such factors as he deems relevant, including: (1) the national median annual income for the applicant's profession; (2) the cost of living in the area of need; (3) the background, training, and education of the applicant; (4) the amount of income the applicant can reasonably expect to receive from service in the area; (5) the number of persons of applicant's profession needed in the area; and (6) where appropriate, cost of equipment, supplies, and facilities.

Authorizes to be appropriated for such grants $37,500,000 for fiscal year 1976, and $50,000,000 for fiscal year 1977.

Title III: Provisions to Encourage Comprehensive Ambulatory Health Care Centers - Provides grants to comprehensive ambulatory health care centers. Sets up a special category of grants to comprehensive ambulatory health care centers.

Revises the declaration of purpose of title VI of the Public Health Service Act to recognize specifically the concept of a comprehensive ambulatory health care center. Provides that for fiscal year 1976 and for each of the next succeeding four fiscal years $200,000,000 is authorized to be appropriated for construction and modernization grants. Revises the method of computing the allotment for each State for carrying out construction and modernization under this Act.

Requires the Surgeon General to determine the priority of projects by regulation for the construction of comprehensive ambulatory health care centers.

Adds the requirement that any State desiring to participate must submit a plan setting forth the comprehensive ambulatory health care centers needed to provide adequate amublatory health care services for patients residing in the State.

Permits the United States to recover a specified portion of the funds with respect to which funds have been paid for the construction of a comprehensive amublatory health care center and which has ceased to serve that function.

Defines comprehensive ambulatory health care centers to encompass only facilities which provide a wide range of preventive, diagnostic and treatment services for ambulatory patients.

Title IV: Provisions to Strengthen Health Care Planning - Directs the President to transmit to Congress on July 1st of each year a health report setting forth: (1) the status of the health care system; (2) current trends in the health care needs of the nation; (3) the adequacy of available manpower and physical resources; (4) a review of the health programs of the Federal, State and local governments, and nongovernmental entities; and (5) a program for carrying out the policy of this Act.

Creates in the Executive Office of the President a three member Health Policy Board, appointed by the President, by and with the advice and consent of the Senate. Directs the Board to (1) assist the President in preparation of the health report; (2) to review Federal Government health programs; (3) to develop procedures for interagency coordination of Federal health programs; and (4) to develop measures to assure adequate manpower, services, and facilities for the Nation's health care.

Authorizes to be appropriated $1,000,000 in any fiscal year as may be necessary to enable the Board to carry out its functions under this Act.

Directs that all agencies of the Federal Government shall include in every recommendation or report on proposals for legislation the positive and negative impact of the proposals on human health and the Nation's health care system.

Title V: Provisions to Make Comprehensive Health Care Insurance Available to All - Establishes under the Internal Revenue Code the minimum standard health care benefits for a covered individual. Creates two categories of health expenses. Sets the minimum standard benefits at 80 percent of category I expenses over the deductible and 100 percent of the category II expenses incurred by the individual in that year.

Provides for a deductible of $100 prior to January 1, 1978, and $100 times the ratio of the Consumer Price Index for each year commencing after January 1, 1978.

Enumerates exemptions for specified injuries and treatments.

Prohibits under the Internal Revenue Code any deduction equal to the disallowed percentage for any amount paid or incurred by the taxpayer for medical care of any employee of the taxpayer, employee's spouse, or any dependent of the employee. Exempts amounts paid or incurred by the taxpayer pursuant to a qualified employee health care plan, as a tax imposed by the United States, and as medical care provided directly by the employer.

Permits under the Internal Revenue Code an unlimited deduction for the medical insurance expenses of an individual covered by a qualified health care plan.

Permits the Secretary of the Treasury to accept the determination of the State insurance regulatory authority that a plan of health care benefits filed with such authority is a plan which qualifies as a qualified employee health care plan.

Adds a new title XX to the Social Security Act.

Authorizes to be appropriated for each fiscal year a sum sufficient to provide comprehensive health care insurance to needy individuals and families.

Defines a qualified State health care plan to be a contract between a State and an administering carrier which provides for payment to physicians and medical institutions the minimum health care benefits. Permits an individual or family to opt for coverage under a plan between a carrier and an approved health maintenance organization.

Provides for a variable deductible under the qualified State health care plan.

Specifies the requirements for eligibility to enroll in a State health care plan.

Delcares that the premium rate to be charged under a qualified State health care plan for each policy year shall be actuarially established in each State for a (1) single individual, (2) family of two, and (3) family of three or more.

Sets forth the factors which shall be used to determine the premium rate for a given risk category to be charged for the initial policy year and for each subsequent policy year.

Requires the State to file the premium rates for each policy year with the chief actuary for the Social Security Administration. Directs the chief actuary to recommend to the Secretary a commensurate reduction in the Federal health care percentage if he determines that the rates are unjustifiably high for such State.

Requires the appropriate State agency to enroll each Federal cash recipient required under this Act to be made eligible, and to file his application with the administering carrier.

Permits all other individuals who provide the family's chief support to enroll in a qualified State health care plan.

Requires individuals and families enrolled in such plan to contribute toward the cost of the plan by paying a specified amount determined on the individual's adjusted gross income.

Requires the State to pay any contribution for that month of any policy year that an individual establishes that he is a Federal cash recipient.

Requires each State which has a qualified State health care plan to make available and pay premiums for Medicare benefits under the Social Security Act to any individual who qualifies.

Stipulates a qualified State health care plan shall immediately extend to any child, born to or adopted by, an eligible family member subsequent to the day the application for enrollment was made.

Terminates coverage under such plan as of the first day of any calendar month if any contribution due with respect to that month has not been paid by the applicable due date.

Declares that there shall be a State health care institutions cost commission designated as a State agency by the Governor of such State. Provides that the commission shall operate with the advice of a council appointed by the Governor.

Prohibits reimbursing charges for services rendered or supplies furnished by medical facilities in excess of the rates approved by such commission.

Requires the commission to review budgets and charges for the health care institutions in the State to establish prospectively approved charges which shall be applicalbe to all purchasers of services and supplies from health care institutions.

Directs the Secretary to pay to any State which has a qualified State health care plan 75 percent of the reasonable amounts expended by the State each quarter for the administration of the State's health care institutions cost commission and its advisory council.

Requires each State commission to file with the Secretary a report of the level of rates charged within such State.

Stipulates that if the Secretary determines that the level of rates approved for a given category of health care is unjustifiably high, he shall order a reduction for that State in the Federal medical assistance percentage and a reduction in the Federal health care percentage.

Declares that the qualified State health care benefits pool shall be administered by the administering carrier.

Deposits into the pool the premiums collected pursuant to this Act, specified service charges, and the reimbursements for pool losses. Makes available pool funds to: (1) pay health care plan benefit claims; (2) to repay to pool reinsurers their losses, if any; and (3) to pay other charges for which the pool has liability.

Requires an accounting to be made of pool funds and submitted to the Secretary, the State, and to all reinsurers.

Directs the Secretary to pay to each State which has a qualified State health care plan an amount equal to the product obtained by multiplying the total premiums for the qualified State health care plan paid by a State to the administering carrier by the Federal health care percentage. Sets such percentage at 100 percent less the State percentage, which shall not be more than 30 percent.

Requires an NHI underwriter, in order to protect against insolvency, to have a combined capital and surplus of not less than the greater of: (1) $1,500,000, or (2) 2 percent of the gross premium income of the underwriter for its immediately preceding fiscal year of operation. Permits the underwriter to obtain a performance bond as an alternative. Defines NHI to mean pertaining to one or more qualified health care plans. Specifies the reserve requirements that each NHI underwriter shall maintain.

Places responsibility on the State insurance commissioner for assuring the establishment of a facility to underwrite or reinsure minimum standard health care benefits for individuals, families, and groups of employees to whom such benefits would not otherwise be available.

Directs such facility to design one form of qualified individual health care plan and one form of qualified employee health care plan.