Health Care Assurance Act of 1995

Summary

TABLE OF CONTENTS: Title I: Health Care Insurance Coverage Subtitle A: Definitions Subtitle B: Increased Availability and Continuity of Health Coverage Subtitle C: Required Coverage Options for Eligible Employees and Dependents of Small Employers Subtitle D: Required Coverage Options for Individuals Insured Through Association Plans Subtitle E: 1-Year Extension of Medicare Select Subtitle F: Tax Provisions Title II: Primary and Preventive Care Services Title III: Patient's Right to Decline Medical Treatment Title IV: Primary and Preventive Care Providers Title V: Cost Containment Title VI: Long-Term Care Subtitle A: Tax Treatment of Qualified Long-Term Care Insurance Policies and Services Subtitle B: Tax Incentives for Purchase of Qualified Long-Term Care Insurance Health Care Assurance Act of 1995 - Title I: Health Care Insurance Coverage - Subtitle A: Definitions - Sets forth definitions. Subtitle B: Increased Availability and Continuity of Health Coverage - Part 1: Reform of Health Insurance Marketplace for Small Employers - Subpart A: Insurance Market Reform - Requires each insurer that makes available a health insurance plan to a small employer in a State to make a qualified health insurance plan available to each such small employer. (Sec. 112) Requests the National Association of Insurance Commissioners (NAIC)to submit for certification to the Secretary of Health and Human Services a set of rules for determining the actuarial value of the coverage offered by a health insurance plan. Sets forth requirements for determining standard coverage under health insurance plans. (Sec. 113) Requests the NAIC to submit to the Secretary model regulations that specify standards with respect to the requirement that insurers provide qualified health insurance plans. Authorizes States to implement standards for health insurance plans to small employers that are more stringent than the requirements under this Act; except that such standards shall not prevent the offering by an insurer of at least one health insurance plan that provides standard coverage. Requires each State to submit to the Secretary by a specified time a report on the steps it is taking to implement and enforce the standards with respect to insurers and their qualified health insurance plans. Subpart B: Additional Standards for Health Insurance Plans Offered to Small Employers - Requires any insurer offering a health insurance plan to a small employer to meet specified issuance requirements. (Sec. 122) Requires each health insurance plan offered to a small employer to establish within each community rating area in which such plan is offered a standard premium for enrollment of eligible employees and individuals for the standard coverage. (Sec. 123) Requires an insurer to fully disclose rating practices for their health insurance plan to the appropriate certifying authority. Authorizes such plans to require advanced payment from a new enrollee equal to the monthly premium. Subpart C: Small Employer Purchasing Groups - Sets forth qualified small employer purchasing group requirements. (Sec. 136) Authorizes appropriations for grants to States and small employer purchasing groups to assist them in planning, developing, and operating such groups. Part 2: Standards Applicable to All Health Insurance Plans - Requires an insurer offering a health insurance plan to meet specified coverage requirements, including: (1) guaranteed eligibility for individuals (including any dependents); (2) certain limitations on coverage of preexisting conditions of an individual; and (3) guaranteed renewability of plans. Part 3: Enforcement of Standards for Health Insurance Plans - Amends the Internal Revenue Code to impose a tax on insurers who fail to comply with certain standards for health insurance plans. Part 4: Effective Dates - Declares that this subtitle is effective upon enactment. Subtitle C: Required Coverage Options for Eligible Employees and Dependents of Small Employers - Requires small employers to offer eligible employees a group health plan. Declares that such employer is not required to make a contribution to the cost of coverage under such plan. (Sec. 172) Sets forth certain employer requirements with respect to multiemployer health plans. (Sec. 173) Amends the Internal Revenue Code to impose a tax on small employers who fail to comply with certain requirements for health insurance plans. Subtitle D: Required Coverage Options for Individuals Insured Through Association Plans - Part 1: Qualified Association Plans - Sets forth qualified association plan requirements. (Sec. 182) Defines such plan as a multiple employer welfare arrangement which: (1) is maintained by a qualified association; (2) has at least 500 participants in the United States; (3) provides benefits consisting solely of medical care; and (4) meets other specified criteria. Part 2: Special Rule for Church, Multiemployer, and Cooperative Plans - Sets forth requirements for church, multiemployer, and cooperative health plans. Part 3: Enforcement - Amends the Internal Revenue Code to impose a tax on qualified associations, church plans, multiemployer plans, or rural electric cooperative or rural telephone cooperative association plans for failure to comply with certain standards for associations and health insurance plans. Subtitle E: 1-Year Extension of Medicare Select - Amends the Omnibus Budget Reconciliation Act of 1990 to extend for one year the period for issuance of Medicare select policies. Subtitle F: Tax Provisions - Amends the Internal Revenue Code to make permanent the deduction for health insurance costs of self-employed individuals for medical care for themselves, their spouses, and dependents. Increases the deduction from the current 25 percent of premiums paid during taxable years beginning in 1994 or 1995 by 25 percent increments up to 100 percent for years beginning in 2000 or after. (Sec. 1022) Revises continuation coverage requirements of group health plans (under the Consolidated Omnibus Budget Reconciliation Act of 1985, or COBRA '85) to: (1) allow such coverage to offer annual deductibles of $1,000 and $3,000; (2) increase from 18 months to 24 months the maximum required period of continuation coverage; and (3) provide for termination of continuation coverage only after 90 days of eligibility for employer-based coverage under a new plan. Title II: Primary and Preventive Care Services - Authorizes the Secretary to make grants to States in order to: (1) reduce infant mortality and low birth weight births; and (2) to improve the health of pregnant women, mothers, infants, and their families for a five-year period. Authorizes appropriations. (Sec. 202) Amends the Public Health Service Act to reauthorize appropriations for specified: (1) immunization programs; (2) tuberculosis and sexually transmitted disease prevention programs; (3) migrant and community health centers; (4) health services for the homeless; (5) family planning services; (6) breast and cervical cancer prevention; (7) preventive health and health services block grants; and (8) early intervention services regarding immunodeficiency virus (HIV) disease. Amends title V (Maternal and Child Health Services Block Grant) of the Social Security Act (SSA) to authorize appropriations to improve the health of all mothers and children. (Sec. 203) Requires the Secretary of Education to award grants to States for local programs of comprehensive health education and prevention, early health intervention, and health education in elementary and secondary schools. Establishes the Office of Comprehensive School Health Education. Authorizes appropriations. (Sec. 204) Mandates grants to Head Start training agencies for training and technical assistance regarding health education to Head Start teachers and other child care providers. Reserves funds for the development of innovative model health education programs or curricula. Authorizes appropriations. Title III: Patient's Right to Decline Medical Treatment - Prohibits State restrictions, except to protect a third party, on the right: (1) of a competent person to consent to or decline medical treatment; or (2) of an incapacitated person to consent to or decline medical treatment through a power of attorney. Requires all health care providers to honor such forms. Shields providers who act in good faith from criminal or civil liability or professional discipline. Denies Medicare and Medicaid payment for services contrary to advance directives and powers of attorney. (Sec. 301) Requires the Secretary to develop a national advance directive form and a national durable power of attorney form. Declares that nothing in this title shall be construed to permit, condone, authorize, or approve suicide or mercy killing, or any affirmative act to end a human life. Title IV: Primary and Preventive Care Providers - Amends SSA title XVIII (Medicare) to modify or establish payment requirements regarding certified nurse midwives, nurse practitioners, clinical nurse specialists, and physician assistants. Makes payment to the employer of a physician assistant or nurse practitioner for the services provided discretionary, instead of, as currently, mandatory. (Sec. 402) Amends SSA title XIX (Medicaid) to include physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists in the Medicaid definition of "medical assistance" for which payment will be made. (Sec. 403) Amends the Public Health Service Act to establish grant programs to: (1) provide medical (including osteopathic medical) students for programs to interest high school or college students in careers in general medical practice (medical student tutorial program grants); and (2) develop strategies for recruiting and placing medical students interested in practicing general medicine (general medical practice grants). Authorizes appropriations. Title V: Cost Containment - Amends the Public Health Service Act to authorize a program of clinical trials regarding promising new drugs and disease treatments. Authorizes appropriations. (Sec. 502) Authorizes appropriations for the Agency for Health Care Policy Research. Amends the Internal Revenue Code to impose a tax on health insurance premiums, payable by any person who makes, signs, issues, or sells any of the documents and instruments subject to the tax or for whose use or benefit the same are made, signed, issued, or sold. Establishes, and deposits the resulting tax receipts in, the Trust Fund for Medical Treatment Outcomes Research. Mandates annual distributions from the Trust Fund for outcomes research. (Sec. 503) Requires the Secretary to establish a national health insurance data and claims system. Authorizes appropriations. (Sec. 504) Requires the Secretary to make grants to States that establish health care cost containment and quality information systems. Authorizes appropriations. Title VI: Long-Term Care - Subtitle A: Tax Treatment of Qualified Long-Term Care Insurance Policies and Services - Amends the Internal Revenue Code to allow a deduction for expenses paid during the year for qualified long-term care services. (Sec. 603) Prohibits a deduction for charges against a life insurance contract's cash surrender value, unless such charges are includible as income and the coverage provided by the rider is a qualified long-term care insurance policy. (Sec. 604) Requires treatment of qualified long-term care insurance as accident and health insurance for purposes of taxation of insurance companies. (Sec. 605) Excludes from gross income amounts (accelerated death benefits) paid under a life insurance contract to an individual who is terminally ill, has a dread disease, or is permanently confined to a nursing home. Subtitle B: Tax Incentives for Purchase of Qualified Long-Term Care Insurance - Allows a tax credit for a portion of long-term care insurance premiums. (Sec. 612) Excludes from gross income benefits received under long-term care insurance. (Sec. 613) Allows employers to deduct from gross income any contributions made for an employee's long-term care insurance. (Sec. 614) Allows employees to select long-term care insurance as part of a cafeteria plan. (Sec. 615) Excludes from gross income amounts received: (1) on the surrender, cancellation, or exchange of a life insurance contract if the individual is at least a specified age and the amount is used to pay for long-term care insurance; and (2) on a home equity conversion sale-leaseback, if the gain is used to purchase long-term care insurance.

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3 official files

• Introduced in Senate (text)

  Introduced in Senate · EN · 4 January 1995

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• Introduced in Senate (PDF)

  Introduced in Senate · EN · 4 January 1995

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• Introduced in Senate

  summary · EN · 4 January 1995

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