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H.R. 1200, American Health Security Act of 1993 1 (December 1993)

handle is hein.congrec/cbo9165 and id is 1 raw text is: S. 491, AMERICAN HEALTH SECURITY ACT OF 1993 S. 491 would create a single-payer program of national health insurance modeled after the Canadian system. The bill was introduced by Senator Paul Wellstone in March 1993. This memorandum provides a preliminary estimate of the effects of S. 491 on government outlays and national health expenditures. It does not include an estimate of revenues, because many of the revenue-raising provisions of S. 491 were included in the Omnibus Budget Reconciliation Act of 1993. The estimate assumes that S. 491 would be enacted in 1994 and that the program would begin in 1997. A recent CBO paper., Estimates ofHealth Care Proposals from the 102nd Congress (July 1993), summarizes BO's methodology for estimating the effects of health reform proposals and emphasizes th e uncertainty of such estimates. SUMMARY OF THE BILL S. 491 would make all legal residents eligit le for comprehensive health benefits with no out- of-pocket payments. People would pick their own health care providers, and providers acceptingpayments from stateprogramsw<u1d be prohibited from billing patients for covered services. Coinsurance or copayments would be prohibited for all items. (A similar bill, H.R. 1200, would prohibit coinsurance or copay ments only for acute care or preventive services.) The national health insurance progriim (called the American Health Security Program) would be financed largely by the federal government and would be administered by the states under the direction of a federal Health Security Standards Board. The board would develop most of the policies and regulations required to carry out the program. It would also establish a national health budget, which would grow no more rapidly than the economy plus the rate of growth of the population.! States that established a health security program would receive federal grants that would average 86 percent of their per capita share of the budget but could vary from 81 percent to 91 percent depending on their income and other factors. This estimate assumes that all states would decide to participate. Benefits The benefits provided by the program would include payment for hospital care, physician and other professional services, nursing home care, home health services, hospice care, prescription drugs, preventive health services, home and community-based long-term care services for people unable to perform two or more activities of daily living, durable medical items such as eyeglasses and hearing aids, routine dental care, and other services. The bill 1. As noted below, S. 491 defines the limit on the growth of health expenditures in two different ways. The alternative definition would limit the growth of health spending to the rate of increase of GDP.

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