(22) Permitting health care professionals to ne-
gotiate collectively with health care plans will create 
a more equal balance of negotiating power, will pro-
mote competition, and will enhance the quality of 
patient care. 
(23) The benefits of an electronic healthcare in-
formation system include improved quality of care, 
reduced costs associated with medication errors, 
more accurate and complete medical documentation, 
more accurate capture of codes and charges, and im-
proved communication among providers enabling 
them to respond more quickly to patients’ needs and 
increase health care quality. 
(24) To secure access to quality health care it 
is essential to have well trained and an appropriate 
number of physicians and surgeons to administer 
that care. 
(25) Data shows that median private medical 
school tuition and fees has increased by 50 percent 
(in real dollars) in the 20 years between 1984 and 
2004. Median public medical school tuition and fees 
increased by 133 percent over the same time period. 
(26) The cost of tuition may prevent students 
from low-income or minority populations and those 
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with other financial responsibilities from attending 
medical school. 
(27) Students with high debt are less likely to 
pursue family practice and primary care specialties 
and instead seek specialties with potentially higher 
income or more leisure time, which contributes to 
the physician shortages all over the country. 
(28) Emergency medical care is an essential 
element of the health care safety net. 
(29) The Emergency Medical Treatment and 
Labor Act (‘‘EMTALA’’) requires that all patients 
who come to an emergency department be evaluated 
and their emergency medical conditions be stabilized, 
regardless of the patient’s ability to pay. 
(30) Nationally, more than 35 percent of emer-
gency department patients are uninsured or are 
Medicaid or SCHIP enrollees. 
(31) Strain on emergency departments is due to 
multiple factors, including the shortage of nurses 
and on-call physicians, a decrease in the total num-
ber of community hospitals, and high levels of bad 
debt incurred as a result of providing care to indi-
gent patients. 
(32) With the decline in physicians, surgeons, 
hospitals, emergency rooms, employer-sponsored 
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health insurance, and the rising number of unin-
sured, the imperative for comprehensive health sys-
tem reform is readily apparent. 
(33) Patient access to quality care has been 
harmed by decreasing compensation to physicians 
through a flawed Medicare sustainable growth rate 
(SGR) system that fails to appropriately account for 
severity of illness, intensity of treatment, medical in-
flation, or costs. 
(34) Decisions regarding health care are often 
the most personal and important made in an individ-
ual’s life, however these decisions are increasingly 
being made without appropriate input by either pa-
tients or health care providers. 
(35) Fundamental reform throughout a wide 
array of our health care system is required in order 
to achieve a 21st century system that is innovative, 
responsive, affordable, accessible, accountable, of the 
highest quality, and, above all, patient-centered. 
(c) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; findings; table of contents. 
TITLE I—TAX INCENTIVES FOR MAINTAINING HEALTH 
INSURANCE COVERAGE 
Sec. 101. Refundable tax credit for health insurance costs of low-income indi-
viduals. 
Sec. 102. Advance payment of credit as premium payment for qualified health 
insurance. 
Sec. 103. Deduction for qualified health insurance costs of individuals. 
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Sec. 104. Limitation on employer deduction for group health plan expenses. 
Sec. 105. Equal employer contribution rule to promote choice. 
TITLE II—QUALITY HEALTH-CARE PROFESSIONALS COALITION 
ACT 
Sec. 201. Short title. 
Sec. 202. Application of the antitrust laws to health care professionals negoti-
ating with health plans. 
TITLE III—INTERSTATE MARKET FOR HEALTH INSURANCE 
Sec. 301. Cooperative governing of individual health insurance coverage. 
TITLE IV—HELP EFFICIENT, ACCESSIBLE, LOW-COST, TIMELY 
HEALTHCARE (HEALTH) ACT OF 2007 
Sec. 401. Short title. 
Sec. 402. Findings and purpose. 
Sec. 403. Encouraging speedy resolution of claims. 
Sec. 404. Compensating patient injury. 
Sec. 405. Maximizing patient recovery. 
Sec. 406. Additional HEALTH benefits. 
Sec. 407. Punitive damages. 
Sec. 408. Authorization of payment of future damages to claimants in 
HEALTH care lawsuits. 
Sec. 409. Definitions. 
Sec. 410. Effect on other laws. 
Sec. 411. State flexibility and protection of States’ rights. 
Sec. 412. Applicability; effective date. 
Sec. 413. Sense of Congress. 
Sec. 414. State grants to create administrative health care tribunals. 
TITLE V—TAX CREDIT FOR HEALTH INFORMATION 
TECHNOLOGY 
Sec. 501. Purchase of qualified health care information technology. 
Sec. 502. Telecommunications credit for qualified medical care providers. 
Sec. 503. Development of health care information technology standards. 
TITLE VI—MEDICAL LIABILITY REFORMS 
Sec. 601. Constitutional authority. 
Sec. 602. Protection against legal liability for emergency and related services 
furnished to any individual. 
TITLE VII—TAX DEDUCTION FOR UNCOMPENSATED CARE IN 
EMERGENCY ROOMS 
Sec. 701. Bad debt deduction for doctors to partially offset the cost of pro-
viding uncompensated care required to be provided under 
amendments made by the Emergency Medical Treatment and 
Labor Act. 
TITLE VIII—ADDITIONAL CHANGES 
Sec. 801. Application of section 1115 waivers by other States. 
Sec. 802. HIPAA Technical Advisory Group. 
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Sec. 803. Medicare physician payment update reform. 
Sec. 804. Removing limitations on balance billing with beneficiary notice for 
highest income beneficiaries. 
Sec. 805. Election of tax credit instead of alternative government benefits. 
Sec. 806. Use of private contracts by medicare beneficiaries for professional 
services. 
Sec. 807. EMTALA Technical Advisory Group. 
Sec. 808. Federally-Supported Student Loan Funds for Medical Students. 
Sec. 809. Establishment of performance-based quality measures. 
TITLE I—TAX INCENTIVES FOR 
MAINTAINING 
HEALTH 
IN-
SURANCE COVERAGE 
SEC. 101. REFUNDABLE TAX CREDIT FOR HEALTH INSUR-
ANCE COSTS OF LOW-INCOME INDIVIDUALS. 
(a) IN GENERAL.—Subpart C of subchapter A of 
chapter 1 of the Internal Revenue Code of 1986 (relating 
to refundable credits) is amended by redesignating section 
36 as section 37 and by inserting after section 35 the fol-
lowing new section: 
‘‘SEC. 36. HEALTH INSURANCE COSTS OF LOW-INCOME IN-
DIVIDUALS. 
‘‘(a) IN GENERAL.—In the case of an individual, 
there shall be allowed as a credit against the tax imposed 
by subtitle A the aggregate amount paid by the taxpayer 
for coverage of the taxpayer and the taxpayer’s qualifying 
family members under qualified health insurance for eligi-
ble coverage months beginning in the taxable year. 
‘‘(b) LIMITATIONS.— 
‘‘(1) IN GENERAL.—The amount allowable as a 
credit under subsection (a) for the taxable year shall 
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not exceed the sum of the monthly limitations for 
months during such taxable year that the taxpayer 
or the taxpayer’s qualifying family members is an el-
igible individual. 
‘‘(2) MONTHLY LIMITATION.—The monthly lim-
itation for any month is the credit percentage of 1⁄12 
of the sum of— 
‘‘(A) $4,000 for coverage of the taxpayer, 
‘‘(B) in the case of a joint return, $4,000 
for coverage of the taxpayer’s spouse, and 
‘‘(C) $2,000 for coverage of each depend-
ent of the taxpayer. 
‘‘(3) CREDIT PERCENTAGE.— 
‘‘(A) IN GENERAL.—For purposes of this 
section, the term ‘credit percentage’ means 90 
percent reduced by 1 percentage point for each 
$1,000 (or fraction thereof) by which the tax-
payer’s adjusted gross income for the taxable 
year exceeds the threshold amount. 
‘‘(B) THRESHOLD AMOUNT.—For purposes 
of this paragraph, the term ‘threshold amount’ 
means, with respect to any taxpayer for any 
taxable year, the sum of— 
‘‘(i) $20,000, 
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‘‘(ii) in the case of a joint return, 
$6,000, and 
‘‘(iii) $5,000 for each dependent of 
the taxpayer. 
‘‘(4) ONLY
DEPENDENTS
TAKEN
INTO
AC-
COUNT.—Not more than 2 dependents of the tax-
payer may be taken into account under paragraphs 
(2)(C) and (3)(B)(iii). 
‘‘(5) INFLATION ADJUSTMENT.—In the case of 
any taxable year beginning in a calendar year after 
2009, each dollar amount contained in paragraph 
(2) or (3) shall be increased by an amount equal 
to— 
‘‘(A) such dollar amount, multiplied by 
‘‘(B) the cost-of-living adjustment deter-
mined under section 1(f)(3) for the calendar 
year in which the taxable year begins, deter-
mined by substituting ‘calendar year 2008’ for 
‘calendar year 1992’ in subparagraph (B) 
thereof. 
Any increase determined under the preceding sen-
tence shall be rounded to the nearest multiple of 
$50. 
‘‘(c) ELIGIBLE COVERAGE MONTH.—For purposes of 
this section, the term ‘eligible coverage month’ means, 
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with respect to any individual, any month if, as of the first 
day of such month, the individual— 
‘‘(1) is covered by qualified health insurance, 
‘‘(2) does not have other specified coverage, and 
‘‘(3) is not imprisoned under Federal, State, or 
local authority. 
‘‘(d) QUALIFYING FAMILY MEMBER.—For purposes 
of this section, the term ‘qualifying family member’ 
means— 
‘‘(1) in the case of a joint return, the taxpayer’s 
spouse, and 
‘‘(2) any dependent of the taxpayer. 
‘‘(e) QUALIFIED HEALTH INSURANCE.— 
‘‘(1) IN GENERAL.—For purposes of this sec-
tion, the term ‘qualified health insurance’ means any 
insurance which constitutes medical care. 
‘‘(2) EXCEPTIONS.—Such term does not include 
insurance— 
‘‘(A) substantially all of the coverage of 
which is of excepted benefits described in sec-
tion 9832(c); or 
‘‘(B) offered in the individual market (as 
defined in paragraph (1) of section 2791(e) of 
the Public Health Service Act) or small group 
market (as defined in paragraph (5) of such 
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section) unless the insurance meets the require-
ments of paragraph (3). 
‘‘(3) INSURANCE
REQUIREMENTS.—For pur-
poses of paragraph (2)(B), the requirements of this 
paragraph with respect to insurance are the fol-
lowing: 
‘‘(A) The issuer of the insurance may not 
decline to offer the insurance, or deny enroll-
ment, of any individual based on any factor de-
scribed in section 9802(a)(1). 
‘‘(B) The insurance conforms to standards 
(established by the National Association of In-
surance Commissioners in consultation with in-
surance companies and recognized by the Sec-
retary) relating to each of the following: 
‘‘(i) Limitation on application of pre-
existing condition exclusions (as defined in 
section 9801(b)(1)). 
‘‘(ii) Guaranteed renewability. 
‘‘(iii) Premium ratings. 
‘‘(iv) Risk-spreading. 
‘‘(v) Consumer disclosures. 
‘‘(vi) Information provided to States 
and the Federal Government. 
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‘‘(f) OTHER SPECIFIED COVERAGE.—For purposes of 
this section, an individual has other specified coverage for 
any month if, as of the first day of such month— 
‘‘(1) COVERAGE UNDER MEDICARE, MEDICAID, 
OR SCHIP.—Such individual— 
‘‘(A) is entitled to benefits under part A of 
title XVIII of the Social Security Act or is en-
rolled under part B of such title, or 
‘‘(B) is enrolled in the program under title 
XIX or XXI of such Act (other than under sec-
tion 1928 of such Act). 
‘‘(2) CERTAIN OTHER COVERAGE.—Such indi-
vidual— 
‘‘(A) is enrolled in a health benefits plan 
under chapter 89 of title 5, United States Code, 
or 
‘‘(B) is entitled to receive benefits under 
chapter 55 of title 10, United States Code. 
‘‘(g) SPECIAL RULES.— 
‘‘(1) COORDINATION WITH ADVANCE PAYMENTS 
OF CREDIT; RECAPTURE OF EXCESS ADVANCE PAY-
MENTS.—With respect to any taxable year— 
‘‘(A) the amount which would (but for this 
subsection) be allowed as a credit to the tax-
payer under subsection (a) shall be reduced 
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(but not below zero) by the aggregate amount 
paid on behalf of such taxpayer under section 
7529 for months beginning in such taxable 
year, and 
‘‘(B) the tax imposed by section 1 for such 
taxable year shall be increased by the excess (if 
any) of— 
‘‘(i) the aggregate amount paid on be-
half of such taxpayer under section 7529 
for months beginning in such taxable year, 
over 
‘‘(ii) the amount which would (but for 
this subsection) be allowed as a credit to 
the taxpayer under subsection (a). 
‘‘(2) COORDINATION
WITH
OTHER
DEDUC-
TIONS.—Amounts taken into account under sub-
section (a) shall not be taken into account in deter-
mining— 
‘‘(A) any deduction allowed under section 
162(l), 213, or 224, or 
‘‘(B) any credit allowed under section 35. 
‘‘(3) MEDICAL
AND
HEALTH
SAVINGS
AC-
COUNTS.—Amounts distributed from an Archer 
MSA (as defined in section 220(d)) or from a health 
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