I
106TH CONGRESS
1ST SESSION
H. R. 1687
To amend the Internal Revenue Code of 1986 to allow individuals a refund-
able credit against income tax for health insurance costs, to allow employ-
ees who elect not to participate in employer subsidized health plans
an exclusion from gross income for employer payments in lieu of such
participation, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MAY 5, 1999
Mr. SHADEGG (for himself, Mr. HOSTETTLER, Mr. LARGENT, Mr. WAMP, Mr.
DOOLITTLE, Mr. ARMEY, Mr. SMITH of Michigan, Mr. GRAHAM, Mrs.
EMERSON, Mr. TANCREDO, Mr. NORWOOD, Mr. SALMON, Mr. WELDON
of Florida, and Mr. COBURN) introduced the following bill; which was re-
ferred to the Committee on Commerce, and in addition to the Committees
on Ways and Means, and Education and the Workforce, for a period to
be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee
concerned
A BILL
To amend the Internal Revenue Code of 1986 to allow indi-
viduals a refundable credit against income tax for health
insurance costs, to allow employees who elect not to
participate in employer subsidized health plans an exclu-
sion from gross income for employer payments in lieu
of such participation, and for other purposes.
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
‘‘Patients’ Health Care Choice Act of 1999’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Purposes.
TITLE I—HEALTHMARTS
Sec. 101. Expansion of consumer choice through Healthmarts.
TITLE II—HEALTH CARE ACCESS AND CHOICE THROUGH
INDIVIDUAL MEMBERSHIP ASSOCIATIONS (IMAS)
Sec. 201. Expansion of access and choice through individual membership asso-
ciations (IMAs).
TITLE III—FEDERAL MATCHING FUNDING FOR STATE
INSURANCE EXPENDITURES
Sec. 301. Federal matching funding for State insurance expenditures.
TITLE IV—SMALL BUSINESS ACCESS AND CHOICE FOR
ENTREPRENEURS ACT OF 1999
Sec. 401. Short title of title.
Sec. 402. Rules.
Sec. 403. Clarification of treatment of single employer arrangements.
Sec. 404. Clarification of treatment of certain collectively bargained arrange-
ments.
Sec. 405. Enforcement provisions.
Sec. 406. Cooperation between Federal and State authorities.
Sec. 407. Effective date and transitional and other rules.
TITLE V—IMPROVEMENT TO ACCESS AND CHOICE OF HEALTH
CARE
Sec. 501. Exclusion for employer payments made to compensate employees who
elect not to participate in employer-subsidized health plans.
Sec. 502. Family insurance allowance.
Sec. 503. Medical Savings Account Effectiveness Act of 1999.
Sec. 504. Increase of highest permitted deductibles under high deductible
health plans.
TITLE VI—PATIENT ACCESS TO INFORMATION
Sec. 601. Patient access to information regarding plan coverage, managed care
procedures, health care providers, and quality of medical care.
Sec. 602. Effective date.
(c) CONSTITUTIONAL AUTHORITY TO ENACT THIS
LEGISLATION.—The constitutional authority upon which
this Act rests is the power of Congress to regulate com-
merce with foreign nations and among the several States,
set forth in article I, section 8 of the United States Con-
stitution.
SEC. 2. FINDINGS.
(a) NEED FOR STRUCTURAL REFORMS.—Congress
finds that the majority of Americans are receiving health
care of a quality unmatched elsewhere in the world but
that the method by which health care currently is financed
and delivered is inflationary and does not distribute qual-
ity care to all Americans. Congress further finds that the
major structural reforms must be implemented in order
to institute a competitive system based on individual
choice, under which each American is permitted individual
choice to select the method of health care delivery which
he believes is most appropriate for himself and his family,
with appropriate assistance from the United States gov-
ernment. Such a system would introduce internal incen-
tives for the cost-effective delivery of quality health care
to the American people.
(b) SPECIFIC DEFICIENCIES.—Congress finds that
the major deficiencies of the present method of delivering
and financing health care as follows:
(1) EMPLOYER OWNERSHIP OF HEALTH BENE-
FITS.—The biggest problem with health care today
is that the tax code has encouraged employers, not
individuals, to become the purchaser of health insur-
ance. Employers have a tax incentive to offer health
care benefits to their employees, which means that
employers are truly the owner of the plan, not indi-
viduals. Therefore employees, who are the consumers
of health care services are unconcerned with and not
involved with issues of cost and over utilize health
care services in the belief that such services are
‘‘free’’.
(2) INSUFFICIENT ACCESS.—Numerous persons
are not able to obtain sufficient health care either
because the necessary personnel and facilities are
not located in their communities or because they do
not have adequate financial resources to obtain such
services, or both.
(3) EXCESSIVE
GOVERNMENT
REGULATION.—
Continually increasing and complex Government reg-
ulation of the economic aspects of the health care
delivery system has proven ineffective in restraining
costs and is itself expensive and counterproductive in
fulfilling its purposes and detrimental to the care of
patients.