II 

109TH CONGRESS 

1ST SESSION S. 2007 

To examine the circumstances contributing to the problems facing the health 

care system of the United States and to develop public and private 

policies as appropriate to address rising health care costs and the number 

of uninsured Americans. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 14, 2005 

Mr. SALAZAR (for himself and Mr. MCCAIN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To examine the circumstances contributing to the problems 

facing the health care system of the United States and 

to develop public and private policies as appropriate to 

address rising health care costs and the number of uninsured Americans. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘National Commission 

5 on Health Care Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 
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1 (1) Americans are expected to spend 

2 $1,900,000,000,000 on health care in 2005, up from 

3 $1,400,000,000,000 in 2001. 

4 (2) While 174,000,000 Americans were covered 

5 by employer-sponsored health insurance in 2004, ris6 ing health care costs to both employers and employ7 ees jeopardize the ability of employers and employees 

8 to maintain needed coverage. 

9 (3) One in every 6 people in the United States, 

10 or approximately 46,000,000 people lacked health 

11 insurance in 2004, and the number of uninsured in12 dividuals is expected to grow. 

13 (4) The medicare program under title XVIII of 

14 the Social Security Act (42 U.S.C. 1395 et seq.) 

15 provided health insurance to 41,700,000 elderly and 

16 disabled Americans in 2004, while the medicaid pro17 gram under title XIX of the Social Security Act (42 

18 U.S.C. 1396 et seq.) provided health care for 

19 55,000,000 low-income children and their parents, 

20 pregnant women, and low-income elderly individuals 

21 in 2004. Federal and State government expenditures 

22 for both programs were approximately 

23 $606,000,000,000 in 2004. 
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1 SEC. 3. PURPOSE. 

2 The purpose of this Act is to establish a National 

3 Commission on Health Care to— 

4 (1) examine and report on— 

5 (A) the factors leading to the rising costs 

6 of health care for individuals and businesses 

7 participating in employer-based health insur8 ance and the rising health care expenditures for 

9 public health care programs; 

10 (B) the barriers that prevent individuals 

11 from securing adequate health care coverage; 

12 and 

13 (C) the issues faced by people covered by 

14 public health care programs; 

15 (2) ascertain, evaluate, and report on the evi16 dence developed by all relevant Federal, State, and 

17 local governmental agencies regarding the facts and 

18 circumstances surrounding rising health care costs 

19 and the barriers to adequate insurance coverage; 

20 (3) build upon the investigations of past and 

21 current entities by reviewing the findings, conclu22 sions, and recommendations of— 

23 (A) executive branch, congressional, or 

24 independent commission investigations into the 

25 issues of health care services or health care 

26 costs; and 
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1 (B) State and local entities that have de2 veloped innovative solutions to deal with the 

3 health care needs in their respective commu4 nities; and 

5 (4) investigate and report to the President and 

6 the Congress on its findings, conclusions, and rec7 ommendations for policy solutions to the health care 

8 problems, including current private and public serv9 ices and the lack of health care insurance for nearly 

10 46,000,0000 Americans. 

11 SEC. 4. ESTABLISHMENT. 

12 There is established in the legislative branch the Na13 tional Commission on Health Care (referred to in this Act 

14 as the ‘‘Commission’’). 

15 SEC. 5. COMPOSITION OF COMMISSION. 

16 (a) MEMBERS.—The Commission shall be composed 

17 of 10 members, of whom— 

18 (1) 1 member shall be appointed by the Presi19 dent, who shall serve as chairman of the Commis20 sion; 

21 (2) 1 member shall be appointed by the leader 

22 of the Senate of the Democratic Party, in consulta23 tion with the leader of the House of Representatives 

24 of the Democratic Party, who shall serve as vice 

25 chairman of the Commission; 
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1 (3) 2 members shall be appointed by the senior 

2 member of the Senate leadership of the Republican 

3 Party; 

4 (4) 2 members shall be appointed by the senior 

5 member of the Senate leadership of the Democratic 

6 Party; 

7 (5) 2 members shall be appointed by the senior 

8 member of the leadership of the House of Represent9 atives of the Republican Party; and 

10 (6) 2 members shall be appointed by the senior 

11 member of the leadership of the House of Represent12 atives of the Democratic Party. 

13 (b) QUALIFICATIONS; INITIAL MEETING.— 

14 (1) POLITICAL PARTY AFFILIATION.—Not more 

15 than 5 members of the Commission shall be from 

16 the same political party. 

17 (2) NONGOVERNMENTAL APPOINTEES.—An in18 dividual appointed to the Commission may not be an 

19 officer or employee of the Federal Government or 

20 any State or local government. 

21 (3) OTHER QUALIFICATIONS.—It is the sense of 

22 Congress that individuals appointed to the Commis23 sion should be prominent United States citizens, 

24 with national recognition and significant depth of ex25 perience in such professions or memberships as gov-
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1 ernmental service, health care services, health care 

2 administration, business, public administration, and 

3 research institutions or programs with health care 

4 emphasis. 

5 (4) DEADLINE FOR APPOINTMENT.—All mem6 bers of the Commission shall be appointed not later 

7 than October 15, 2005, or 60 days after the date of 

8 enactment of this Act, whichever is later. 

9 (5) INITIAL MEETING.—The Commission shall 

10 meet and begin the operations of the Commission as 

11 soon as practicable after all members of the Com12 mission are appointed. 

13 (c) QUORUM; VACANCIES.—After its initial meeting, 

14 the Commission shall meet upon the call of the chair15 person or a majority of its members. Six members of the 

16 Commission shall constitute a quorum. Any vacancy in the 

17 Commission shall not affect its powers, and shall be filled 

18 in the same manner in which the original appointment was 

19 made. 

20 SEC. 6. FUNCTIONS OF COMMISSION. 

21 (a) IN GENERAL.—The functions of the Commission 

22 are to— 

23 (1) conduct a study that— 

24 (A) investigates relevant facts and experi25 ences relating to the problems within the sphere 
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1 of health care, including any relevant legisla2 tion, Executive order, regulation, plan, policy, 

3 practice, or procedure; and 

4 (B) investigates relevant facts and cir5 cumstances relating to— 

6 (i) the rising costs of health care; 

7 (ii) the impact of the rising costs of 

8 health care on American businesses; 

9 (iii) the provision of health care by 

10 State and local health care agencies; 

11 (iv) the effects of increases in insur12 ance premiums on health care coverage for 

13 businesses and individuals; 

14 (v) the private health insurance indus15 try; 

16 (vi) the public health programs; 

17 (vii) innovations and reforms nec18 essary to increase the provision of afford19 able, quality health care to all Americans; 

20 (viii) the role of congressional over21 sight and resource allocation; and 

22 (ix) other areas of the public and pri23 vate sectors determined relevant by the 

24 Commission for its inquiry; 
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1 (2) identify, review, and evaluate the lessons 

2 learned from past legislative structuring of health 

3 care, coordination, management policies, and proce4 dures of the Federal Government, and, when appro5 priate, State and local governments and nongovern6 mental entities, relative to administering, rep7 resenting and implementing and receiving health 

8 care; and 

9 (3) submit to the President and Congress such 

10 reports as are required by this Act containing such 

11 findings, conclusions, and recommendations as the 

12 Commission shall determine, including proposing or13 ganization, coordination, planning, management ar14 rangements, procedures, rules, and regulations. 

15 SEC. 7. POWERS OF COMMISSION. 

16 (a) HEARINGS AND EVIDENCE.—The Commission or, 

17 on the authority of the Commission, any subcommittee or 

18 member thereof, may hold such hearings, sit and act at 

19 such times and places, take such testimony, and receive 

20 such evidence as the Commission determines appropriate 

21 for the purposes of carrying out this Act. 

22 (b) CONTRACTING.—The Commission may, to such 

23 extent and in such amounts as are provided for in appro24 priation Acts, enter into contracts to enable the Commis25 sion to discharge its duties under this Act. 
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1 (c) INFORMATION FROM FEDERAL AGENCIES.— 

2 (1) IN GENERAL.—The Commission is author3 ized to secure directly from any executive depart4 ment, bureau, agency, board, commission, office, 

5 independent establishment, or instrumentality of the 

6 Government, information, suggestions, estimates, 

7 and statistics for the purposes of this Act. Each de8 partment, bureau, agency, board, commission, office, 

9 independent establishment, or instrumentality shall, 

10 to the extent authorized by law, furnish such infor11 mation, suggestions, estimates, and statistics di12 rectly to the Commission, upon request made by the 

13 chairperson, the chairperson of any subcommittee 

14 created by a majority of the Commission, or any 

15 member designated by a majority of the Commis16 sion. 

17 (2) RECEIPT, HANDLING STORAGE, AND DIS18 SEMINATION.—Information shall only be received, 

19 handled, stored, and disseminated by members of 

20 the Commission and its staff consistent with all ap21 plicable statutes, regulations, and Executive orders. 

22 (d) ASSISTANCE FROM FEDERAL AGENCIES.— 

23 (1) GENERAL SERVICES ADMINISTRATION.— 

24 The Administrator of General Services shall provide 

25 to the Commission on a reimbursable basis adminis-
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1 trative support and other services for the perform2 ance of the Commission’s functions. 

3 (2) OTHER DEPARTMENTS AND AGENCIES.—In 

4 addition to the assistance prescribed in paragraph 

5 (1), departments and agencies of the United States 

6 may provide to the Commission such services, funds, 

7 facilities, staff, and other support services as they 

8 may determine advisable and as may be authorized 

9 by law. 

10 (e) GIFTS.—The Commission may accept, use, and 

11 dispose of gifts or donations of services or property. 

12 (f) POSTAL SERVICES.—The Commission may use 

13 the United States mails in the same manner and under 

14 the same conditions as departments and agencies of the 

15 United States. 

16 SEC. 8. STAFF OF COMMISSION. 

17 (a) IN GENERAL.— 

18 (1) APPOINTMENT AND COMPENSATION.—The 

19 chairperson of the Commission, in consultation with 

20 vice chairperson, in accordance with rules agreed 

21 upon by the Commission, may appoint and fix the 

22 compensation of a staff director and such other per23 sonnel as may be necessary to enable the Commis24 sion to carry out its functions, without regard to the 

25 provisions of title 5, United States Code, governing 
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1 appointments in the competitive service, and without 

2 regard to the provisions of chapter 51 and sub3 chapter III of chapter 53 of such title relating to 

4 classification and General Schedule pay rates, except 

5 that no rate of pay fixed under this subsection may 

6 exceed the equivalent of that payable for a position 

7 at level V of the Executive Schedule under section 

8 5316 of title 5, United States Code. 

9 (2) PERSONNEL AS FEDERAL EMPLOYEES.— 

10 (A) IN GENERAL.—The staff director and 

11 any personnel of the Commission who are em12 ployees shall be employees under section 2105 

13 of title 5, United States Code, for purposes of 

14 chapters 63, 81, 83, 84, 85, 87, 89, and 90 of 

15 that title. 

16 (B) MEMBERS OF COMMISSION.—Subpara17 graph (A) shall not be construed to apply to 

18 members of the Commission. 

19 (b) DETAILEES.—Any Federal Government employee 

20 may be detailed to the Commission without reimbursement 

21 from the Commission, and such detailee shall retain the 

22 rights, status, and privileges of the detailee’s regular em23 ployment without interruption. 

24 (c) CONSULTANT SERVICES.—The Commission is au25 thorized to procure the services of experts and consultants 
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1 in accordance with section 3109 of title 5, United States 

2 Code, but at rates not to exceed the daily rate paid a per3 son occupying a position at level IV of the Executive 

4 Schedule under section 5315 of title 5, United States 

5 Code. 

6 SEC. 9. COMPENSATION AND TRAVEL EXPENSES. 

7 (a) COMPENSATION.—Each member of the Commis8 sion may be compensated at a rate not to exceed the daily 

9 equivalent of the annual rate of basic pay in effect for 

10 a position at level IV of the Executive Schedule under sec11 tion 5315 of title 5, United States Code, for each day dur12 ing which that member is engaged in the actual perform13 ance of the duties of the Commission. 

14 (b) TRAVEL EXPENSES.—While away from their 

15 homes or regular places of business in the performance 

16 of services for the Commission, members of the Commis17 sion shall be allowed travel expenses, including per diem 

18 in lieu of subsistence, in the same manner as persons em19 ployed intermittently in the Government service are al20 lowed expenses under section 5703(b) of title 5, United 

21 States Code. 

22 SEC. 10. REPORTS OF COMMISSION; TERMINATION. 

23 (a) INTERIM REPORTS.—The Commission may sub24 mit to the President and Congress interim reports con25 taining such findings, conclusions, and recommendations 
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1 for corrective measures as have been agreed to by a major2 ity of Commission members. 

3 (b) FINAL REPORT.—Not later than 12 months after 

4 the date of the enactment of this Act, the Commission 

5 shall submit to the President and Congress a final report 

6 containing such findings, conclusions, and recommenda7 tions for corrective measures as have been agreed to by 

8 a majority of Commission members. 

9 (c) TERMINATION.— 

10 (1) IN GENERAL.—The Commission, and all the 

11 authorities of this Act, shall terminate 60 days after 

12 the date on which the final report is submitted 

13 under subsection (b). 

14 (2) ADMINISTRATIVE ACTIVITIES BEFORE TER15 MINATION.—The Commission may use the 60 day 

16 period referred to in paragraph (1) for the purpose 

17 of concluding its activities, including providing testi18 mony to committees of Congress concerning its re19 ports and disseminating the final report. 

20 SEC. 11. FUNDING. 

21 (a) AUTHORIZATION OF APPROPRIATIONS.—There is 

22 authorized to be appropriated to carry out this Act 

23 $6,000,000. 
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1 (b) DURATION OF AVAILABILITY.—Amounts made 

2 available to the Commission under subsection (a) shall re3 main available until the termination of the Commission. 

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