Comprehensive Health Insurance Act

Comprehensive Health Insurance Act - Title I: National Health Care Benefits Program. States that the purpose of this title is to provide adequate protection against costs by requiring all employers to offer health care plans to their employees; and to assist the States in making similar plans available to individuals in need of such protection. Requires, under the Social Security Act, that every employer provide to each of his employees under the age of 65 a reasonable opportunity, as determined under regulations prescribed by the Secretary of Health, Education, and Welfare, to obtain coverage for himself and the members of his family under the age 65 at the option of the employee: (1) an employee health care insurance plan approved under this title or an assisted health care insurance plan obtained by the employer, (2) a group practice prepaid health care plan approved under this title, or (3) an individual practice prepaid health care plan approved under this title. States that the employer shall provide an amount equal to at least 75 percent of the cost of that coverage. Prohibits discrimination against an indiviudal with respect to the opportunity for employment, or the compensation, terms, condition, or privileges of employment, because of the individual's health status or the health status of his dependents, except when directly related to the capacity of the individual to perform his duties as an employee. Directs the Secretary to make grants for health care programs to States which have submitted approved plans for the provision of health care benefits to individuals under the age of 65 who are otherwise unable to obtain such benefits. Authorizes appropriations for each fiscal year of sums necessary to carry out this purpose. Directs the Secretary to establish a Federal health care benefits program under which an individual who has attained the age of 65 and is entitled to monthly insurance benefits under Title II of this Act (Old-Age, Survivor's, and Disability Insurance Benefits) shall be entitled to Federal health care benefits under Title XVIII (Medicare). States that the benefits provided under the program shall be at the option of the individual: (1) to obtain coverage under the Federal health care insurance plan, or (2) to have the Secretary pay to any prepaid health care plan approved under this title under which the individual has obtained coverage at a rate which the Secretary determines is reasonable, on behalf of the individual, an amount equal to the cost to the Government of providing coverage under a Federal health care insurance plan, as determined under regulations prescribed by the Secretary. Provides that the Federal health care insurance plan shall impose, with respect to all items and services other than outpatient drugs and biologicals, and other blood and blood product, a per individual deductible equal to a specified percentage of the income base. States that the Federal health care insurance plan shall provide: (1) that an account will be established against which a covered individual may charge the cost of obtaining items and services covered under the plan, without regard to the deductible and coinsurance requirements applicable under the plan; (2) that payment for items and services covered under the plan, other than emergency services, will be made only on the basis of charges against that account; and (3) that payment will be made on the basis of charges against the account for items and services covered under the plan at the applicable reimbursement rates. Authorizes the Secretary to enter into contracts with carriers for the administration of benefits under the Federal health care insurance program. Establishes a Federal Helath Care Benefits Trust Fund. States that the Trust Fund shall consist of such gifts and bequests as may be made together with such amounts as may be deposited in, or appropriated to, such Fund under the provisions of this Act. Sets forth criteria for determining the amount to be aporopriated to the Trust Fund for each fiscal year. Establishes a Board of Trustees to be composed of the Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health, Education, and Welfare. States that the duties of the Board of Trustees shall be to: (1) hold the Trust Fund; (2) report to the Congress not later than the first day of April of each year on the operation and status of the Trust Fund during the preceding fiscal year and on its expected operation and status during the current fiscal year and the next two fiscal years; (3) report immediately to the Congress whenever the Board is of the opinion that the amount of the Trust Fund is unduly small; and (4) review the general policies followed in managing the Trust Fund, and recommend changes in such policies, including necessary changes in the provisions of law which govern the way in which the Trust Fund is to be managed. Requires that employee health care insurance plans provide for the following services for each covered individual: (1) inpatient hospital services; (2) physicians' services; (3) medical and other health services; (4) home health services; (5) post-hospital extended care services; (6) outpatient drugs and biologicals; (7) routine dental services for individuals under the age of 13; (8) developmental vision care services, as defined in regulations prescribed by the Secretary routine eye and vision examinations, and eyeglasses, for individuals under the age of 13; and (9) hearing aids and examinations therefor, for individuals under the age of 13. Sets forth limits for employee health care insurance plans, including the following: (1) post-hospital extended care services shall be limited to 100 days per calendar year; (2) home health services must be limited to 100 visits per calendar year; and (3) inpatient hospital services for the treatment of mental illness shall be limited to 30 days per calendar year, with each day of partial hospitalization, as defined in regulations prescribed by the Secretary, counting as one-half day of inpatient services. Enumerates the requirements for meeting the provisions of this Act. States that a group practice pre-paid health care plan must: (1) provide physicians' services (other than infrequently used services, as determined under regulations prescribed by the Secretary) through physicians who are employees or partners of the organization, or through arrangements with one or more groups of physicians engaged in the coordinated practice of their profession for the organization; and (2) meet such requirements concerning its organizational structure and financial arrangements as the Secretary may, by regulation, prescribe. Provides that the Secretary may, by regulation, make such modifications in the requirements imposed by this section as he determines are appropriate with respect to group practice prepaid health care plans offered to employees whose place of employment is outside the United States. Sets forth requirements for approval of individual practice prepaid health care plans, approval of special employee health care programs, and requirements for certification of providers. States that any State dissatisfied with a determination of the Secretary with respect to whether the State is meeting the provisions of this Act may file a petition for review of such determination with the United States court of appeals to the circuit in which such state is located. Stipulates that the court shall have jurisdiction to affirm the action of the Secretary, or to set it aside, in whole or in part. Sets forth judicial remedies and criminal sanctions for noncompliance. Title II: Reduction in Services Provided Under Medical Assistance Programs - Sets forth technical and conforming amendments to the Medical Program. Title III: Sets forth technical and conforming amendments to the Professional Standards Review Program, and the Capital Expenditures Review Program. Title IV - General Provisions: States that if a provision of this Act is held invalid, all other provisions so enacted shall remain in effect.

Written by analysts at the Congressional Research Service and published on Congress.gov, not by Civibrief. Summarized at the "Introduced in House" stage on March 13, 1974. It describes the bill, it is not the legal text.

Every answer above is assembled from this measure's own record on Congress.gov and from published counts of what Congress has passed before. Civibrief does not predict outcomes and takes no position on any measure.