Tuesday, May 25, 2010

Summary of H.R. 676, “The United States National Health Care Act,” Or “Expanded & Improved Medicare For All”

Introduced by Rep. John Conyers, Jr.

Brief Summary of Legislation
The United States National Health Care Act (USNHC) establishes a unique American universal health
insurance program with single payer financing. The bill would create a publicly financed, privately
delivered health care system that improves and expands the already existing Medicare program to all
U.S. residents, and all residents living in U.S. territories. The goal of the legislation is to ensure that all
Americans will have access, guaranteed by law, to the highest quality and most cost effective health care
services regardless of their employment, income or health care status. In short, health care becomes a
human right. With 47 million uninsured Americans, and another 50 million who are underinsured, the
time has come to change our inefficient and costly fragmented non-system of health care.

Who is Eligible
Every person living or visiting in the United States and the U.S. Territories would receive a United
States National Health Insurance Card and ID number once they enroll at the appropriate location. Social
Security numbers may not be used when assigning ID cards.

Health Care Services Covered
This program will cover all medically necessary services, including primary care, inpatient care,
outpatient care, emergency care, prescription drugs, durable medical equipment, hearing services, long
term care, palliative care, podiatric care, mental health services, dentistry, eye care, chiropractic, and
substance abuse treatment. Patients have their choice of physicians, providers, hospitals, clinics, and
practices. There no co-pays or deductibles under this act.

Conversion To A Non-Profit Health Care System
Doctors, hospitals, and clinics will continue to operate as privately entities. However, they will be
unable to issue stock. Private health insurers shall be prohibited under this act from selling coverage that
duplicates the benefits of the USNHC program. Exceptions to this rule include coverage for cosmetic
surgery, and other medically unnecessary treatments. Those workers who are displaced as the result of
the transition to a non-profit health care system will be the first to be hired and retrained under this act.
Furthermore, workers would receive their same salary for up to two years, and would then be eligible for
unemployment benefits. The conversion to a not-for- profit health care system will take place as soon as
possible, but not to exceed a 15 year period, through the sale of U.S. treasury bonds.

Cost Containment Provisions/ Reimbursement
The USNHC program will negotiate reimbursement rates annually with physicians, allow for global
budgets (monthly lump sums for operating expenses) for hospitals, and negotiate prices for prescription
drugs, medical supplies and equipment. A “Medicare For All Trust Fund” will be established to ensure a
dedicated stream of funding. An annual Congressional appropriation is also authorized to ensure
optimal levels of funding for the program, in particular, to ensure the requisite number of physicians and
nurses need in the health care delivery system. (over)
H.R. 676 Would Reduce Overall Health Care Costs

Families Will Pay Less
Currently, the average family of four covered under an employee health plan spends a total of $4,225 on
health care annually – $2,713 on premiums and another $1,522 on medical services, drugs and supplies
(Employer Health Benefits 2006 Annual Survey, Kaiser Family Foundation and Health Research and
Educational Trust; U.S. Department of Labor, Bureau of Labor Statistics, Consumer Expenditure
Survey.) This figure does not include the additional 1.45% Medicare payroll tax levied on employees.
A study by Dean Baker of the Center for Economic Research and Policy concluded that under H.R. 676,
a family of four making the median family income of $56,200 per year would pay about $2,700 for all
health care costs.

Business Will Pay In 2006, health insurers charged employers an average of $11,500 for a health plan for a family of four.
On average, the employer paid 74% of this premium, or $8,510 per year. This figure does not include
the additional 1.45% payroll tax levied on employers for Medicare. Under H.R. 676, employers would
pay a 4.75% payroll tax for all health care costs. For an employee making the median family income of
$56,200 per year, the employer would pay about $2,700.
The Nation Will Pay About the Same, While Covering All Americans
Savings from reduced administration, bulk purchasing, and coordination among providers will allow
coverage for all Americans while reducing health care inflation in the long term. Annual savings from
enacting H.R. 676 are estimated at $387 billion (Baker).

Proposed Funding For USNHI Program
• Maintain current federal and state funding for existing health care programs
• Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)
• Establish a 5% health tax on the top 5% of income earners, 10% tax on top 1% of wage earners
• ¼ of 1% stock transaction tax
• Close corporate tax loopholes
• Repeal the Bush tax cuts for the highest income earners

*For more information, contact Joel Segal ( or Michael Darner
( with Rep. John Conyers at 202 225-5126, or contact Olivia Boykins at
313 961-5670.

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