I 111th CONGRESS 1st Session H. R. 4230 IN THE HOUSE OF REPRESENTATIVES December 8, 2009 Mr. Blumenauer introduced the following bill; which was referred to the Committee on House Administration, and in addition to the Committees on Oversight and Government Reform, Ways and Means, Energy and Commerce, and Veterans’ Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To limit access of Members of Congress to Government-administered health care benefits so long as comprehensive health reform legislation has not become law.

1.

Short title

This Act may be cited as the Health Care Reality Check Act.

2.

Limiting access of Members of Congress to Government-administered health care benefits so long as comprehensive health reform legislation has not become law

(a)

In general

Effective for months beginning after the date of the enactment of this Act, no Member of or delegate to the United States House of Representatives and no Member of the United States Senate shall be eligible for any Government-administered health care benefit until the first day of the first month following the date on which comprehensive health reform legislation is signed into law. (b)

Definitions

In this section: (1)

Government-administered health care benefit

The term Government-administered health care benefit includes health care benefits or services under or through any of the following: (A)

FEHBP

Chapter 89 of title 5, United States Code (relating to the Federal Employees Health Benefits Program or FEHBP). (B)

Medicare

The Medicare program under title XVIII of the Social Security Act. (C)

VA

The Department of Veterans Affairs. (D)

OAP

The Office of the Attending Physician in the United States Capitol. (E)

FSA

Payment through a flexible spending account program. (2)

Comprehensive health reform legislation

The term comprehensive health reform legislation means an Act of Congress that includes at least all of the following: (A)Establishment of an inclusive and accessible health insurance marketplace which includes a public health insurance option. (B)A prohibition of discrimination in health benefits coverage based on pre-existing conditions and a prohibition on the imposition of lifetime limits on coverage. (C)A limit on the ability of health insurance issuers to charge higher premiums due to health status, age, or gender. (D)A requirement that health insurance issuers expend a minimum medical loss ratio of at least 85 percent of premium dollars on medical care, rather than on administration, marketing, and profit, and refund to consumers or subsequently adjust premiums insofar as it fails to meet such loss ratio. (E)Establishment of an essential health benefits requirement for all health insurance coverage that includes coverage of hospitalization, physician services, prescription drugs, preventive services with no cost-sharing, mental health services, and oral health and vision for children. (F)Preserving individual choice of doctors and health providers. (G)Providing a sliding scale of affordability credit to low- and moderate- income individuals and families and limiting annual out-of-pocket spending for all income levels to prevent bankruptcies from medical expenses. (H)Creating shared responsibility among individuals, employers, and government to ensure that all Americans have affordable coverage of essential health benefits.