I 
110TH CONGRESS 
2D SESSION 
H. R. 6110 
To provide for the reform of health care, the Social Security system, the 
tax code for individuals and business, and the budget process. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 21, 2008 
Mr. RYAN of Wisconsin introduced the following bill; which was referred to 
the Committee on Ways and Means, and in addition to the Committees 
on Energy and Commerce, Education and Labor, Rules, and the Budget, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To provide for the reform of health care, the Social Security 
system, the tax code for individuals and business, and 
the budget process. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Roadmap for America’s Future Act of 2008’’. 
(b) TABLE OF CONTENTS.— 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings and purpose. 
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TITLE I—HEALTH CARE REFORM 
Subtitle A—Tax Changes 
Sec. 101. Refundable credit for health insurance coverage. 
Sec. 102. Changes to existing tax preferences for medical coverage, etc., for in-
dividuals eligible for qualified health insurance credit. 
Subtitle B—Health Plan Choice; Small Business Health Fairness 
Sec. 111. Cooperative governing of individual health insurance coverage. 
Sec. 112. Small business health fairness. 
Subtitle C—Health Care Services Commission 
PART 1—ESTABLISHMENT AND GENERAL DUTIES 
Sec. 121. Establishment. 
Sec. 122. General authorities and duties. 
Sec. 123. Dissemination. 
PART 2—FORUM FOR QUALITY AND EFFECTIVENESS IN HEALTH CARE 
Sec. 131. Establishment of office. 
Sec. 132. Membership. 
Sec. 133. Duties. 
Sec. 134. Adoption and enforcement of guidelines and standards. 
Sec. 135. Additional requirements. 
PART 3—GENERAL PROVISIONS 
Sec. 141. Certain administrative authorities. 
Sec. 142. Funding. 
Sec. 143. Definitions. 
PART 4—TERMINATIONS AND TRANSITION 
Sec. 151. Termination of Agency for Healthcare Research and Quality. 
Sec. 152. Transition. 
PART 5—INDEPENDENT HEALTH RECORD TRUST 
Sec. 161. Short title of part. 
Sec. 162. Purpose. 
Sec. 163. Definitions. 
Sec. 164. Establishment, certification, and membership of independent health 
record trusts. 
Sec. 165. Duties of IHRT to IHRT participants. 
Sec. 166. Availability and use of information from records in IHRT consistent 
with privacy protections and agreements. 
Sec. 167. Voluntary nature of trust participation and information sharing. 
Sec. 168. Financing of activities. 
Sec. 169. Regulatory oversight. 
TITLE II—MEDICAID AND SCHIP REFORM 
Sec. 201. Medicaid reform. 
Sec. 202. SCHIP Reform. 
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TITLE III—MEDICARE REFORM 
Subtitle A—New Medicare Program 
Sec. 301. Benefit changes. 
Sec. 302. Increase in Medicare eligibility age. 
Sec. 303. Unified Medicare Trust Fund. 
Subtitle B—Changes in Current Medicare Program 
Sec. 311. Income-related reduction in part D premium subsidy. 
Sec. 312. Reduction in hospital marketbasket increases. 
Sec. 313. Elimination of indexing of income thresholds for part B income-re-
lated premiums. 
TITLE IV—SOCIAL SECURITY REFORM 
Sec. 401. Short title and table of contents of title. 
Sec. 402. Establishment of Personal Social Security Savings Program. 
Sec. 403. Monthly insurance benefits for participating individuals. 
Sec. 404. Tax treatment of accounts. 
Sec. 405. Self-Liquidating Social Security Transition Fund. 
Sec. 406. Budgetary treatment of social security. 
Sec. 407. Accounting for the Old-Age, Survivors, and Disability Insurance Pro-
gram and the Personal Social Security Savings Program. 
Sec. 408. Progressive indexing of benefits for old-age, wife’s, and husband’s in-
surance benefits. 
Sec. 409. Enhancements to part A benefits. 
Sec. 410. Adjustments to schedule for increases in normal retirement age. 
TITLE V—SIMPLIFIED INCOME TAX 
Sec. 501. Short title. 
Sec. 502. Repeal of alternative minimum tax for noncorporate taxpayers. 
Sec. 503. Simplified income tax system. 
Sec. 504. Exclusion for capital gains, dividends, and interest. 
Sec. 505. Repeal of estate and gift taxes. 
TITLE VI—BUSINESS CONSUMPTION TAX 
Sec. 601. Short title. 
Sec. 602. Repeal of corporate income tax; new tax paid by corporations and 
other businesses. 
Sec. 603. Repeal of chapter 6. 
Sec. 604. Revisions to the Code. 
Sec. 605. Application of subtitle F. 
Sec. 606. Effective dates. 
TITLE VII—BUDGET ENFORCEMENT 
Sec. 701. Short title; table of contents; definitions. 
Sec. 702. Long-term projections. 
Sec. 703. Preview spending reduction order. 
Sec. 704. Final spending reduction order. 
Sec. 705. Eliminating excess spending amounts. 
Sec. 706. Special procedures. 
Sec. 707. Suspension in the event of war or low growth. 
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‘‘(iii) The term ‘number of elapsed years’ has 
the meaning provided in subsection (b)(2)(B)(iii).’’. 
SEC. 410. ADJUSTMENTS TO SCHEDULE FOR INCREASES IN 
NORMAL RETIREMENT AGE. 
(a) COMPLETION OF PHASE-IN OF NORMAL RETIRE-
MENT AGE TO AGE 67 BY 2021.—Section 216(l) of the 
Social Security Act (42 U.S.C. 416(l)) is amended— 
(1) in paragraph (1)(C), by striking ‘‘2017’’ 
and inserting ‘‘2016’’; 
(2) in paragraph (1)(D), by striking ‘‘2016’’ 
and inserting ‘‘2015’’, and by striking ‘‘2022’’ and 
inserting ‘‘2021’’; 
(3) in paragraph (1)(E), by striking ‘‘2021’’ 
and inserting ‘‘2020’’; and 
(4) in paragraph (3)(B), by striking ‘‘2017’’ 
and inserting ‘‘2016’’, by striking ‘‘2021’’ and in-
serting ‘‘2020’’, and by striking ‘‘2017’’ and insert-
ing ‘‘2016’’. 
(b) ADJUSTMENTS TO NORMAL RETIREMENT AGE 
AFTER 2021.—Section 216(l) of such Act (as amended 
by subsection (a)) is amended further— 
(1) in paragraph (1)(E), by inserting ‘‘and be-
fore January 1, 2022,’’ after ‘‘2020,’’ and by strik-
ing ‘‘age.’’ and inserting ‘‘age; and’’ ; 
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