[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 441 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                 S. 441

    To improve health care quality and reduce health care costs by 
      establishing a National Fund for Health Research that would 
   significantly expand the nation's investment in medical research.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 13, 1997

Mr. Harkin (for himself and Mr. Specter) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
    To improve health care quality and reduce health care costs by 
      establishing a National Fund for Health Research that would 
   significantly expand the nation's investment in medical research.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``National Fund for Health Research 
Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Nearly 4 of 5 peer reviewed research projects deemed 
        worthy of funding by the National Institutes of Health are not 
        funded.
            (2) Less than 3 percent of the nearly one trillion dollars 
        our Nation spends on health care is devoted to health research, 
        while the defense industry spends 15 percent of its budget on 
        research and development.
            (3) Public opinion surveys have shown that Americans want 
        more Federal resources put into health research and are willing 
        to pay for it.
            (4) Ample evidence exists to demonstrate that health 
        research has improved the quality of health care in the United 
        States. Advances such as the development of vaccines, the cure 
        of many childhood cancers, drugs that effectively treat a host 
        of diseases and disorders, a process to protect our Nation's 
        blood supply from the HIV virus, progress against 
        cardiovascular disease including heart attack and stroke, and 
        new strategies for the early detection and treatment of 
        diseases such as colon, breast, and prostate cancer clearly 
        demonstrates the benefits of health research.
            (5) Health research which holds the promise of prevention 
        of intentional and unintentional injury and cure and prevention 
        of disease and disability, is critical to holding down health 
        care costs in the long term.
            (6) Expanded medical research is also critical to holding 
        down the long-term costs of the medicare program under title 
        XVIII of the Social Security Act. For example, recent research 
        has demonstrated that delaying the onset of debilitating and 
        costly conditions like Alzheimer's disease could reduce general 
        health care and medicare costs by billions of dollars annually.
            (7) The state of our Nation's research facilities at the 
        National Institutes of Health and at universities is 
        deteriorating significantly. Renovation and repair of these 
        facilities are badly needed to maintain and improve the quality 
        of research.
            (8) Because discretionary spending is likely to decline in 
        real terms over the next 5 years, the Nation's investment in 
        health research through the National Institutes of Health is 
        likely to decline in real terms unless corrective legislative 
        action is taken.
            (9) A health research fund is needed to maintain our 
        Nation's commitment to health research and to increase the 
        percentage of approved projects which receive funding at the 
National Institutes of Health.
            (10) Americans purchase health insurance and participate in 
        the medicare program to protect themselves and their families 
        against the high cost of illness and disability. Because of 
        this, it makes sense to devote 1 cent of every health insurance 
        dollar to finding preventions, cures, and improved treatments 
        for illnesses and disabilities through medical research.

SEC. 3. ESTABLISHMENT OF FUND.

    (a) Establishment.--There is established in the Treasury of the 
United States a fund, to be known as the ``National Fund for Health 
Research'' (hereafter in this section referred to as the ``Fund''), 
consisting of such amounts as are transferred to the Fund under 
subsection (b) and any interest earned on investment of amounts in the 
Fund.
    (b) Transfers to Fund.--
            (1) In general.--The Secretary of the Treasury shall 
        transfer to the Fund amounts equivalent to amounts designated 
        under paragraph (2) and received in the Treasury.
            (2) Amounts.--
                    Health plan set aside.--With respect to each 
                calendar year beginning with the first full calendar 
                year after the date of enactment of this Act, each 
                health plan shall set aside and transfer to the 
                Treasury of the United States an amount equal to--
                            (i) for the first full calendar year, .25 
                        percent of all health premiums received with 
                        respect to the plan for such year;
                            (ii) for the second full calendar year, .5 
                        percent of all health premiums received with 
                        respect to the plan for such year;
                            (iii) for the third full calendar year, .75 
                        percent of all health premiums received with 
                        respect to the plan for such year; and
                            (iv) for the fourth and each succeeding 
                        full calendar year, 1 percent of all health 
                        premiums received with respect to the plan for 
                        such year.
            (3) Transfers based on estimates.--The amounts transferred 
        by paragraph (1) shall annually be transferred to the Fund 
        within 30 days after the President signs an appropriations Act 
        for the Departments of Labor, Health and Human Services, and 
        Education, and related agencies, or by the end of the first 
        quarter of the fiscal year. Proper adjustment shall be made in 
        amounts subsequently transferred to the extent prior estimates 
        were in excess of or less than the amounts required to be 
        transferred.
            (4) Definition.--As used in this subsection, the term 
        ``health plan'' means a group health plan (as defined in 
        section 2791(a) of the Public Health Service Act (as added by 
the Health Insurance Portability and Accountability Act of 1996)) and 
any individual health insurance (as defined in section 2791(b)(5)) 
operated by a health insurance issuer.
    (c) Obligations From Fund.--
            (1) In general.--Subject to the provisions of paragraph 
        (4), with respect to the amounts made available in the Fund in 
        a fiscal year, the Secretary of Health and Human Services shall 
        distribute--
                    (A) 2 percent of such amounts during any fiscal 
                year to the Office of the Director of the National 
                Institutes of Health to be allocated at the Director's 
                discretion for the following activities:
                            (i) for carrying out the responsibilities 
                        of the Office of the Director, including the 
                        Office of Research on Women's Health and the 
                        Office of Research on Minority Health, the 
                        Office of Alternative Medicine, the Office of 
                        Rare Disease Research, the Office of Behavioral 
                        and Social Sciences Research (for use for 
                        efforts to reduce tobacco use), the Office of 
                        Dietary Supplements, and the Office for Disease 
                        Prevention; and
                            (ii) for construction and acquisition of 
                        equipment for or facilities of or used by the 
                        National Institutes of Health;
                    (B) 2 percent of such amounts for transfer to the 
                National Center for Research Resources to carry out 
                section 1502 of the National Institutes of Health 
                Revitalization Act of 1993 concerning Biomedical and 
                Behavioral Research Facilities;
                    (C) 1 percent of such amounts during any fiscal 
                year for carrying out section 301 and part D of title 
                IV of the Public Health Service Act with respect to 
                health information communications; and
                    (D) the remainder of such amounts during any fiscal 
                year to member institutes and centers, including the 
                Office of AIDS Research, of the National Institutes of 
                Health in the same proportion to the total amount 
                received under this section, as the amount of annual 
                appropriations under appropriations Acts for each 
                member institute and Centers for the fiscal year bears 
                to the total amount of appropriations under 
                appropriations Acts for all member institutes and 
                Centers of the National Institutes of Health for the 
                fiscal year.
            (2) Plans of allocation.--The amounts transferred under 
        paragraph (1)(D) shall be allocated by the Director of the 
        National Institutes of Health or the various directors of the 
        institutes and centers, as the case may be, pursuant to 
        allocation plans developed by the various advisory councils to 
        such directors, after consultation with such directors.
            (3) Grants and contracts fully funded in first year.--With 
        respect to any grant or contract funded by amounts distributed 
        under paragraph (1), the full amount of the total obligation of 
        such grant or contract shall be funded in the first year of 
        such grant or contract, and shall remain available until 
        expended.
            (4) Trigger and release of monies and phase-in.--
                    (A) Trigger and release.--No expenditure shall be 
                made under paragraph (1) during any fiscal year in 
                which the annual amount appropriated for the National 
                Institutes of Health is less than the amount so 
                appropriated for the prior fiscal year.
                    (B) Phase-in.--The Secretary of Health and Human 
                Services shall phase-in the distributions required 
                under paragraph (1) so that--
                            (i) 25 percent of the amount in the Fund is 
                        distributed in the first fiscal year for which 
                        funds are available;
                            (ii) 50 percent of the amount in the Fund 
                        is distributed in the second fiscal year for 
                        which funds are available;
                            (iii) 75 percent of the amount in the Fund 
                        is distributed in the third fiscal year for 
                        which funds are available; and
                            (iv) 100 percent of the amount in the Fund 
                        is distributed in the fourth and each 
                        succeeding fiscal year for which funds are 
                        available.
    (d) Budget Treatment of Amounts in Fund.--The amounts in the Fund 
shall be excluded from, and shall not be taken into account, for 
purposes of any budget enforcement procedure under the Congressional 
Budget Act of 1974 or the Balanced Budget and Emergency Deficit Control 
Act of 1985.
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