I
103D CONGRESS
1ST SESSION
H. R. 3719
To establish a wellness program for Americans.
IN THE HOUSE OF REPRESENTATIVES
NOVEMBER 23, 1993
Mr. LEWIS of California introduced the following bill; which was referred to
the Committee on Energy and Commerce
A BILL
To establish a wellness program for Americans.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be referred to as ‘‘The Well America
Act’’.
SEC. 2. WELLNESS TRUST FUND.
(a) ESTABLISHMENT.—There is hereby created on
the books of the Treasury of the United States a trust
fund to be known as the ‘‘Wellness Trust Fund’’. The
Wellness Trust Fund shall consist of such gifts and be-
quests as may be made and such amounts as may be de-
posited in, or appropriated to, such fund.
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(b) There are hereby appropriated to the Trust Fund
for each year 4 percent of all health care premiums, as
well as 4 percent of all Federal expenditures on health
care for populations served outside of health care plans.
SEC. 3. WELLNESS PROGRAM.
(a) WELLNESS VOUCHER.—The Secretary shall issue
to each enrollee satisfying the conditions of paragraph (b)
a wellness voucher card which may be used for identifica-
tion, verifying eligibility for benefits under this section,
and processing of payments under this section to partici-
pating wellness providers selected by the enrollee. The
wellness voucher card shall bear an indication of its total
value as computed under paragraph (g), the portion of its
value used and the portion remaining at any time. The
wellness voucher card function may be incorporated into
the health security card.
(b) ELIGIBILITY.—Those eligible for wellness benefits
are:
(1) Any enrollee thirty years of age or older;
(2) Any enrollee under thirty years of age who
is certified by his or her primary care provider as in
special need of wellness benefits as a result of un-
usual physical characteristics or conditions; or
(3) Any enrollee under thirty years of age who
uses tobacco, for the purpose of a tobacco-use-ces-
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sation program; or whose cholesterol condition is
certified by his primary care provider to place him
or her at high health risk, for the purpose of a
weight-loss, nutrition, or exercise program; or whose
body weight is certified by his primary care physi-
cian to place him or her at high health risk, for the
purpose of a weight-loss, nutrition or exercise pro-
gram.
(c) BENEFITS.—Benefits provided under this section
are intended to promote greater health and reduced injury
and illness through programs which increase general
health status, or promote healthier lifestyles by changing
health related behaviors, such as hygiene or nutritional
education programs. They are not intended to duplicate
or substitute for therapeutic or rehabilitative services more
properly included in treatments for illnesses, injuries or
conditions covered by medical benefits. In addition to the
activities specified in paragraph (b)(3), States shall peri-
odically determine the range of other services eligible for
reimbursement from wellness voucher funds. Enrollees eli-
gible under paragraph (b)(2) are eligible only for such
benefits related to the characteristic or condition certified
by the primary care provider.
(d) ENROLLEE USE.—An eligible enrollee obtains
benefits under this section by presenting the wellness
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voucher card to a participating wellness provider in return
for covered benefits up to the total value remaining on
the card. Covered benefits costing more than the value re-
maining on the card may be purchased, but the enrollee
is personally responsible for the portion of the cost which
exceeds the value remaining on the voucher card.
(e) PARTICIPATING PROVIDERS.—
(1) Wellness providers must be licensed under
any applicable State laws relating to the activities
provided. The States may establish standards for
minimum solvency and insurance (which may include
bonding) for participating providers.
(2) As a condition of participation in the pro-
gram established by this section, providers agree to
provide a defined course of covered benefits in re-
turn for the payment made by the Secretary under
this section, to provide covered benefits in return for
payment in full by the Secretary from a portion of
the value of the wellness voucher, or to provide cov-
ered benefits to be paid in part by payment from the
Secretary under this section.
(3) As a condition of participation in the pro-
gram established by this section, providers must
agree to inform the enrollee’s primary care physician
of the services rendered and consult with the pri-
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mary care physician if requested on any ongoing
course of services.
(4) Each State shall maintain a list of wellness
providers satisfying the requirements of this Act,
which it shall make public and shall transmit to the
Secretary, and shall promptly notify the Secretary of
any additions thereto or deletions therefrom.
(f) PAYMENT.—The Secretary shall establish a mech-
anism for paying to participating providers from the
Wellness Trust Fund the cost of covered benefits under
this section as they are provided, and as claims for same
are made. In no event shall the Secretary be liable for
so much of claims which individually or in the aggregate
exceed the value of the enrollee’s wellness voucher.
(g) 
COMPUTATION
OF
WELLNESS
VOUCHER
VALUE.—Prior to the beginning of each year, the Sec-
retary shall project the total income to the Wellness Trust
Fund for the coming year, and shall divide this figure,
less a contingency reserve not to exceed 2 percent, by the
number of enrollees whom the Secretary projects will be
eligible for benefits under this section in that year. The
quotient is the value of the wellness voucher of each eligi-
ble enrollee for that year, except that the Secretary may
adjust the value of wellness vouchers relative to each other
to take into consideration differences in the cost of serv-
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ices among States or alliance service areas. Such process
of adjustment shall not increase the total aggregate value
of all wellness vouchers.
SEC. 4. DEFINITIONS.—
For purposes of this title:
(a) ‘‘Enrollee’’ means an individual—
(i) who is entitled to participate in an alli-
ance or who is provided health benefits through
a Federal health care program outside of an al-
liance, and
(ii) who is entitled to receive services under
this Act.
(b) ‘‘Primary care providers’’ means a primary
care physician with the training and experience to
assess and treat the full range of basic health care
needs, and properly coordinate and refer to others
for specialized treatment, or, if licensed or certified
as such under State law, a nurse practitioner with
equivalent training and experience.
(c) ‘‘Provider’’ means any person who provides
services to enrollees or to other providers for enroll-
ees within the meaning of this Act.
(d) ‘‘Participating provider’’ means providers
who have agreed to abide by the conditions and re-
quirements of this Act.
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(e) ‘‘Secretary’’ means the Secretary of the
Treasury unless otherwise specified.
(f) ‘‘Services’’ includes goods, such as equip-
ment.
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