I 
109TH CONGRESS 
1ST SESSION H. R. 2089
To amend the Internal Revenue Code of 1986 to allow individuals a refund-
able credit against income tax for the purchase of private health insur-
ance. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 4, 2005
Ms. GRANGER (for herself, Mr. WYNN, Mr. BURGESS, Mr. FITZPATRICK of 
Pennsylvania, Mrs. JOHNSON of Connecticut, Mr. NORWOOD, Mr. SIMP-
SON, Mr. BOOZMAN, Mr. BONILLA, Mr. MARCHANT, Mr. NEUGEBAUER, 
Mr. CUNNINGHAM, Mr. GOODE, Mr. MCHUGH, and Mr. SANDERS) intro-
duced the following bill; which was referred to the Committee on Ways 
and Means 
A BILL 
To amend the Internal Revenue Code of 1986 to allow indi-
viduals a refundable credit against income tax for the 
purchase of private health insurance.
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 cited as the ‘‘Securing Access, 
Value, and Equality in Health Care Act’’.
SEC. 2. REFUNDABLE CREDIT FOR HEALTH INSURANCE 
COVERAGE. 
(a) IN GENERAL.—Subpart C of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
1986 (relating to refundable credits) is amended by redes-
ignating section 36 as section 37 and by inserting after 
section 35 the following new section: 
‘‘SEC. 36. HEALTH INSURANCE COSTS. 
‘‘(a) IN GENERAL.—In the case of an individual, 
there shall be allowed as a credit against the tax imposed 
by this chapter an amount equal to the amount paid dur-
ing the taxable year for qualified health insurance for the 
taxpayer, his spouse, and dependents. 
‘‘(b) LIMITATIONS.—
‘‘(1) IN GENERAL.—The amount allowed as a 
credit under subsection (a) to the taxpayer for the 
taxable year shall not exceed the sum of the monthly 
limitations for coverage months during such taxable 
year for each individual referred to in subsection (a) 
for whom the taxpayer paid during the taxable year 
any amount for coverage under qualified health in-
surance. 
‘‘(2) PHASEOUT OF AMOUNT.—
‘‘(A) REDUCTION
BASED
ON
ADJUSTED 
GROSS INCOME.—The amount determined under 
paragraph (1) for any taxable year shall be re-
duced (but not below zero) by the amount de-
termined under subparagraph (B). 
‘‘(B) 
AMOUNT
OF
REDUCTION.—The 
amount determined under this subparagraph 
with respect to any amount determined under 
paragraph (1) shall be the amount which bears 
the same ratio to such amount determined 
under paragraph (1) as—
‘‘(i) the excess of—
‘‘(I) 
the 
taxpayer’s 
adjusted 
gross income for such taxable year, 
over 
‘‘(II) 
the 
applicable 
dollar 
amount, bears to 
‘‘(ii) $10,000. 
The rules of subparagraphs (B) and (C) of sec-
tion 219(g)(2) shall apply to any reduction 
under this subparagraph. 
‘‘(C) DEFINITIONS.—For purposes of this 
paragraph—
‘‘(i) adjusted gross income shall be de-
termined in the same manner as under sec-
tion 408A(c)(3)(C)(i), and 
‘‘(ii) the applicable dollar amount is—
‘‘(I) in the case of a taxpayer fil-
ing a joint return, $105,000, 
‘‘(II) in the case of any other 
taxpayer (other than a married indi-
vidual 
filing 
a 
separate 
return), 
$65,000, and 
‘‘(III) in the case of a married 
individual filing a separate return, 
zero. 
‘‘(3) MONTHLY LIMITATION.—
‘‘(A) IN GENERAL.—The monthly limita-
tion for an individual for each coverage month 
of such individual during the taxable year is the 
amount equal to 1⁄12th of—
‘‘(i) the base amount, plus 
‘‘(ii) 50 percent of the amount paid in 
excess of the base amount. 
‘‘(B) BASE AMOUNT.—For purposes of this 
paragraph, the base amount is—
‘‘(i) $1,000 if such individual is the 
taxpayer, 
‘‘(ii) $1,000 if—
‘‘(I) such individual is the spouse 
of the taxpayer,
‘‘(II) the taxpayer and such 
spouse are married as of the first day 
of such month, and 
‘‘(III) the taxpayer files a joint 
return for the taxable year, and 
‘‘(iii) $500 if such individual is an in-
dividual for whom a deduction under sec-
tion 151(c) is allowable to the taxpayer for 
such taxable year. 
‘‘(C) LIMITATION
TO
DEPENDENTS.—
Not more than 2 individuals may be taken into 
account by the taxpayer under subparagraph 
(B)(iii). 
‘‘(D) SPECIAL RULE FOR MARRIED INDI-
VIDUALS.—In the case of an individual—
‘‘(i) who is married (within the mean-
ing of section 7703) as of the close of the 
taxable year but does not file a joint return 
for such year, and 
‘‘(ii) who does not live apart from 
such individual’s spouse at all times during 
the taxable year, 
the limitation imposed by subparagraph (C) 
shall be divided equally between the individual
and the individual’s spouse unless they agree on 
a different division. 
‘‘(4) COVERAGE MONTH.—For purposes of this 
subsection—
‘‘(A) IN
GENERAL.—The term ‘coverage 
month’ means, with respect to an individual, 
any month if—
‘‘(i) as of the first day of such month 
such individual is covered by qualified 
health insurance, and 
‘‘(ii) the premium for coverage under 
such insurance for such month is paid by 
the taxpayer. 
‘‘(B) 
EMPLOYER-SUBSIDIZED
COV-
ERAGE.—
‘‘(i) IN
GENERAL.—Such term shall 
not include any month for which such indi-
vidual participates in any subsidized health 
plan (within the meaning of section 
162(l)(2)) maintained by any employer of 
the taxpayer or of the spouse of the tax-
payer. 
‘‘(ii) PREMIUMS
TO
NONSUBSIDIZED 
PLANS.—If an employer of the taxpayer or 
the spouse of the taxpayer maintains a
health plan which is not a subsidized 
health plan (as so defined) and which con-
stitutes qualified health insurance, em-
ployee contributions to the plan shall be 
treated as amounts paid for qualified 
health insurance. 
‘‘(C) CAFETERIA
PLAN
AND
FLEXIBLE 
SPENDING
ACCOUNT
BENEFICIARIES.—Such 
term shall not include any month during a tax-
able year if any amount is not includible in the 
gross income of the taxpayer for such year 
under section 106 with respect to—
‘‘(i) a benefit chosen under a cafeteria 
plan (as defined in section 125(d)), or 
‘‘(ii) a benefit provided under a flexi-
ble spending or similar arrangement. 
‘‘(D) MEDICARE
AND
MEDICAID.—Such 
term shall not include any month with respect 
to an individual if, as of the first day of such 
month, such individual—
‘‘(i) is entitled to any benefits under 
title XVIII of the Social Security Act, or 
‘‘(ii) is a participant in the program 
under title XIX or XXI of such Act.
‘‘(E) CERTAIN
OTHER
COVERAGE.—Such 
term shall not include any month during a tax-
able year with respect to an individual if, at any 
time during such year, any benefit is provided 
to such individual under—
‘‘(i) chapter 89 of title 5, United 
States Code, 
‘‘(ii) chapter 55 of title 10, United 
States Code, 
‘‘(iii) chapter 17 of title 38, United 
States Code, or 
‘‘(iv) any medical care program under 
the Indian Health Care Improvement Act. 
‘‘(F) PRISONERS.—Such term shall not in-
clude any month with respect to an individual 
if, as of the first day of such month, such indi-
vidual is imprisoned under Federal, State, or 
local authority. 
‘‘(G) INSUFFICIENT PRESENCE IN UNITED 
STATES.—Such term shall not include any 
month during a taxable year with respect to an 
individual if such individual is present in the 
United States on fewer than 183 days during 
such year (determined in accordance with sec-
tion 7701(b)(7)).
‘‘(5) COORDINATION
WITH
DEDUCTION
FOR 
HEALTH INSURANCE COSTS OF SELF-EMPLOYED IN-
DIVIDUALS.—In the case of a taxpayer who is eligi-
ble to deduct any amount under section 162(l) for 
the taxable year, this section shall apply only if the 
taxpayer elects not to claim any amount as a deduc-
tion under such section for such year. 
‘‘(c) REDUCED
CREDIT
FOR
PARTICIPANTS
IN 
HEALTH PLANS OF EMPLOYERS.—In the case of any indi-
vidual who participates in a subsidized health plan (within 
the meaning of section 162(l)(2)) maintained by any em-
ployer of the taxpayer or of the spouse of the taxpayer 
(not including a cafeteria plan (as defined in section 
125(d)), there shall be allowed to the taxpayer one-quarter 
of the credit that would be allowed to the taxpayer under 
subsection (a) (determined without regard to the partici-
pation in the health plan) if the monthly limitation were 
determined without the addition of the amount described 
in subsection (b)(3)(A)(ii). 
‘‘(d) QUALIFIED HEALTH INSURANCE.—For pur-
poses of this section—
‘‘(1) IN GENERAL.—The term ‘qualified health 
insurance’ means insurance which constitutes med-
ical care as defined in section 213(d) without regard 
to—
‘‘(A) paragraph (1)(C) thereof, and 
‘‘(B) so much of paragraph (1)(D) thereof 
as relates to qualified long-term care insurance 
contracts. 
‘‘(2) EXCLUSION
OF
CERTAIN
OTHER
CON-
TRACTS.—Such term shall not include insurance if a 
substantial portion of its benefits are excepted bene-
fits (as defined in section 9832(c)). 
‘‘(e) MEDICAL
AND HEALTH SAVINGS ACCOUNT 
CONTRIBUTIONS.—
‘‘(1) IN GENERAL.—If a deduction would (but 
for paragraph (2)) be allowed under section 220 or 
223 to the taxpayer for a payment for the taxable 
year to the medical or health savings account of an 
individual, subsection (a) shall be applied by treating 
such payment as a payment for qualified health in-
surance for such individual. 
‘‘(2) DENIAL OF DOUBLE BENEFIT.—No deduc-
tion shall be allowed under section 220 or 223 for 
that portion of the payments otherwise allowable as 
a deduction under section 220 or 223 (as the case 
may be) for the taxable year which is equal to the 
amount of credit allowed for such taxable year by 
reason of this subsection. 
‘‘(f) SPECIAL RULES.—