Health Care Improved Access Act of 1986

Health Care Improved Access Act of 1986 - Amends the Internal Revenue Code to impose an excise tax on large employers equal to ten percent of the expenses paid for employee health benefits if the employer does not participate in a State established qualified health insurance pooling association. Defines a "large employer" as an employer who has employed 20 or more individuals on each of 20 days during the taxable year. Defines a "qualified pooling association" as a State chartered nonprofit corporation which offers individuals and their dependents health insurance which: (1) has a limit of annual out-of-pocket expenses for covered services of $1,500 for individual coverage and $3,000 for family coverage; (2) has a lifetime benefit limit for any individual of not less than $500,000; (3) has deductibles which do not exceed $1,000; (4) denies services for preexisting conditions for no more than six months; (5) has a pool premium rate which does not exceed 150 percent of the average premium rates for comparable health insurance coverage; and (6) assesses losses of the pool equitably among all participating members.

Amends title XVIII (Medicare) of the Social Security Act to require States to develop programs of health care assistance for the uninsured and the underinsured. Requires that such program must provide for payment for the unreimbursed costs incurred by each hospital in the State in furnishing medically necessary inpatient and outpatient services. Requires States to implement such a program by January 1, 1988, or on the first January 1st following State legislative sessions which do not occur before January 1, 1988, in order to continue to qualify for Federal matching funds for Medicare administrative expenses.

Denies an income tax deduction for employer contributions made to group health plans unless: (1) the employer allows terminated employees the option of continuing health insurance for a period of up to 22 months after termination (extended from 18 months); (2) the employer continues premium payments for health benefits for a period of four months after an employee has been involuntarily terminated; and (3) the employer provides an open-enrollment period when an employee's spouse has lost employment.

Allows an income tax deduction for certain group health plan contributions for the benefit of self-employed individuals.

Requires the Secretary of Health and Human Services to conduct studies and demonstration projects on ways to reduce the costs for small employers and self-employed individuals in obtaining health insurance. Requires the Secretary to report to the Congress on the results of such studies and demonstration projects not later than January 1, 1988.