I 
111TH CONGRESS 
1ST SESSION H. R. 4230 
To limit access of Members of Congress to Government-administered health 
care benefits so long as comprehensive health reform legislation has 
not become law. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 8, 2009 
Mr. BLUMENAUER introduced the following bill; which was referred to the 
Committee on House Administration, and in addition to the Committees 
on Oversight and Government Reform, Ways and Means, Energy and 
Commerce, and Veterans’ Affairs, for a period to be subsequently deter-
mined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To limit access of Members of Congress to Government- 
administered health care benefits so long as comprehen-
sive health reform legislation has not become law. 
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 ‘‘Health Care Reality 
Check Act’’. 
VerDate Nov 24 2008 
03:37 Dec 09, 2009
Jkt 089200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H4230.IH
H4230
rfrederick on DSKD9S0YB1PROD with BILLS
SEC. 2. LIMITING ACCESS OF MEMBERS OF CONGRESS TO 
GOVERNMENT-ADMINISTERED HEALTH CARE 
BENEFITS SO LONG AS COMPREHENSIVE 
HEALTH REFORM LEGISLATION HAS NOT BE-
COME LAW. 
(a) IN GENERAL.—Effective for months beginning 
after the date of the enactment of this Act, no Member 
of or delegate to the United States House of Representa-
tives and no Member of the United States Senate shall 
be eligible for any Government-administered health care 
benefit until the first day of the first month following the 
date on which comprehensive health reform legislation is 
signed into law. 
(b) DEFINITIONS.—In this section: 
(1) 
GOVERNMENT-ADMINISTERED
HEALTH 
CARE
BENEFIT.—The term ‘‘Government-adminis-
tered health care benefit’’ includes health care bene-
fits or services under or through any of the fol-
lowing: 
(A) FEHBP.—Chapter 89 of title 5, 
United States Code (relating to the Federal 
Employees 
Health 
Benefits 
Program 
or 
FEHBP). 
(B) MEDICARE.—The Medicare program 
under title XVIII of the Social Security Act. 
VerDate Nov 24 2008 
03:37 Dec 09, 2009
Jkt 089200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H4230.IH
H4230
rfrederick on DSKD9S0YB1PROD with BILLS
(C) VA.—The Department of Veterans Af-
fairs. 
(D) OAP.—The Office of the Attending 
Physician in the United States Capitol. 
(E) FSA.—Payment through a flexible 
spending account program. 
(2) COMPREHENSIVE HEALTH REFORM LEGIS-
LATION.—The term ‘‘comprehensive health reform 
legislation’’ means an Act of Congress that includes 
at least all of the following: 
(A) Establishment of an inclusive and ac-
cessible health insurance marketplace which in-
cludes a public health insurance option. 
(B) A prohibition of discrimination in 
health benefits coverage based on pre-existing 
conditions and a prohibition on the imposition 
of lifetime limits on coverage. 
(C) A limit on the ability of health insur-
ance issuers to charge higher premiums due to 
health status, age, or gender. 
(D) A requirement that health insurance 
issuers expend a minimum medical loss ratio of 
at least 85 percent of premium dollars on med-
ical care, rather than on administration, mar-
keting, and profit, and refund to consumers or 
VerDate Nov 24 2008 
03:37 Dec 09, 2009
Jkt 089200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4230.IH
H4230
rfrederick on DSKD9S0YB1PROD with BILLS
subsequently adjust premiums insofar as it fails 
to meet such loss ratio. 
(E) Establishment of an essential health 
benefits requirement for all health insurance 
coverage that includes coverage of hospitaliza-
tion, physician services, prescription drugs, pre-
ventive services with no cost-sharing, mental 
health services, and oral health and vision for 
children. 
(F) Preserving individual choice of doctors 
and health providers. 
(G) Providing a sliding scale of afford-
ability credit to low- and moderate- income indi-
viduals and families and limiting annual out-of- 
pocket spending for all income levels to prevent 
bankruptcies from medical expenses. 
(H) Creating shared responsibility among 
individuals, employers, and government to en-
sure that all Americans have affordable cov-
erage of essential health benefits. 
Æ 
VerDate Nov 24 2008 
03:37 Dec 09, 2009
Jkt 089200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6301
E:\BILLS\H4230.IH
H4230
rfrederick on DSKD9S0YB1PROD with BILLS