I 
113TH CONGRESS 
1ST SESSION 
H. R. 676 
To provide for comprehensive health insurance coverage for all United States 
residents, improved health care delivery, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 13, 2013 
Mr. CONYERS (for himself, Mr. NADLER, Ms. SCHAKOWSKY, Ms. PINGREE of 
Maine, Mr. GRIJALVA, Mr. ELLISON, Mr. JOHNSON of Georgia, Ms. 
EDDIE BERNICE JOHNSON of Texas, Mr. TAKANO, Ms. NORTON, Ms. 
LOFGREN, Mr. RANGEL, Ms. MOORE, Ms. CHU, Mr. AL GREEN of Texas, 
Mr. FARR, Mr. MCGOVERN, Mr. WELCH, Ms. CLARKE, Ms. LEE of Cali-
fornia, Mr. NOLAN, Mr. POCAN, Mr. DOYLE, Mr. ENGEL, Mr. GUTIER-
REZ, Ms. WILSON
of Florida, Mr. COHEN, Ms. EDWARDS, Mr. 
MCDERMOTT, Mr. CLAY, Mr. HUFFMAN, Ms. ROYBAL-ALLARD, Mr. 
CUMMINGS, Mr. YARMUTH, Mr. GEORGE MILLER of California, Mr. 
HONDA, Mrs. CHRISTENSEN, and Mr. RUSH) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committees on Ways and Means and Natural Re-
sources, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To provide for comprehensive health insurance coverage for 
all United States residents, improved health care deliv-
ery, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Expanded & Improved Medicare For All Act’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Definitions and terms. 
TITLE I—ELIGIBILITY AND BENEFITS 
Sec. 101. Eligibility and registration. 
Sec. 102. Benefits and portability. 
Sec. 103. Qualification of participating providers. 
Sec. 104. Prohibition against duplicating coverage. 
TITLE II—FINANCES 
Subtitle A—Budgeting and Payments 
Sec. 201. Budgeting process. 
Sec. 202. Payment of providers and health care clinicians. 
Sec. 203. Payment for long-term care. 
Sec. 204. Mental health services. 
Sec. 205. Payment for prescription medications, medical supplies, and medically 
necessary assistive equipment. 
Sec. 206. Consultation in establishing reimbursement levels. 
Subtitle B—Funding 
Sec. 211. Overview: funding the Medicare For All Program. 
Sec. 212. Appropriations for existing programs. 
TITLE III—ADMINISTRATION 
Sec. 301. Public administration; appointment of Director. 
Sec. 302. Office of Quality Control. 
Sec. 303. Regional and State administration; employment of displaced clerical 
workers. 
Sec. 304. Confidential electronic patient record system. 
Sec. 305. National Board of Universal Quality and Access. 
TITLE IV—ADDITIONAL PROVISIONS 
Sec. 401. Treatment of VA and IHS health programs. 
Sec. 402. Public health and prevention. 
Sec. 403. Reduction in health disparities. 
TITLE V—EFFECTIVE DATE 
Sec. 501. Effective date. 
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SEC. 2. DEFINITIONS AND TERMS. 
In this Act: 
(1) MEDICARE FOR ALL PROGRAM; PROGRAM.— 
The terms ‘‘Medicare For All Program’’ and ‘‘Pro-
gram’’ mean the program of benefits provided under 
this Act and, unless the context otherwise requires, 
the Secretary with respect to functions relating to 
carrying out such program. 
(2) NATIONAL BOARD OF UNIVERSAL QUALITY 
AND ACCESS.—The term ‘‘National Board of Uni-
versal Quality and Access’’ means such Board estab-
lished under section 305. 
(3) REGIONAL OFFICE.—The term ‘‘regional of-
fice’’ means a regional office established under sec-
tion 303. 
(4) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(5) DIRECTOR.—The term ‘‘Director’’ means, 
in relation to the Program, the Director appointed 
under section 301. 
TITLE I—ELIGIBILITY AND 
BENEFITS 
SEC. 101. ELIGIBILITY AND REGISTRATION. 
(a) IN GENERAL.—All individuals residing in the 
United States (including any territory of the United 
States) are covered under the Medicare For All Program 
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entitling them to a universal, best quality standard of care. 
Each such individual shall receive a card with a unique 
number in the mail. An individual’s Social Security num-
ber shall not be used for purposes of registration under 
this section. 
(b) REGISTRATION.—Individuals and families shall 
receive a Medicare For All Program Card in the mail, 
after filling out a Medicare For All Program application 
form at a health care provider. Such application form shall 
be no more than 2 pages long. 
(c) PRESUMPTION.—Individuals who present them-
selves for covered services from a participating provider 
shall be presumed to be eligible for benefits under this Act, 
but shall complete an application for benefits in order to 
receive a Medicare For All Program Card and have pay-
ment made for such benefits. 
(d) RESIDENCY CRITERIA.—The Secretary shall pro-
mulgate a rule that provides criteria for determining resi-
dency for eligibility purposes under the Medicare For All 
Program. 
(e) COVERAGE FOR VISITORS.—The Secretary shall 
promulgate a rule regarding visitors from other countries 
who seek premeditated non-emergency surgical proce-
dures. Such a rule should facilitate the establishment of 
country-to-country reimbursement arrangements or self 
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