[Congressional Record Volume 140, Number 21 (Wednesday, March 2, 1994)]
[Senate]
[Page S]
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[Congressional Record: March 2, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                          AMENDMENTS SUBMITTED

                                 ______


        SOCIAL SECURITY ADMINISTRATION INDEPENDENCE ACT OF 1993

                                 ______


                 COHEN (AND OTHERS) AMENDMENT NO. 1474

  Mr. COHEN (for himself, Mr. Dole, Mrs. Kassebaum, Mr. Domenici, Mr. 
Thurmond, Mr. Grassley, Mr. Nickles, Mr. Lieberman, Mrs. Feinstein, and 
Mr. Danforth) proposed an amendment to the bill (S. 1560) to establish 
the Social Security Administration as an independent agency, and for 
other purposes; as follows:

       At the appropriate place insert:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Social Security Disability 
     and Rehabilitation Act of 1994''.

     SEC. 2. REFORM OF MONTHLY INSURANCE BENEFITS BASED ON 
                   DISABILITY INVOLVING SUBSTANCE ABUSE.

       (a) Social Security Disability Insurance.--
       (1) In general.--Section 223 of the Social Security Act (42 
     U.S.C. 423) is amended by adding at the end the following new 
     subsection:

    ``Limitation on Payment of Benefits by Reason of Substance Abuse

       ``(j)(1)(A) Notwithstanding any other provision of this 
     title, no individual whose disability is based in whole or in 
     part on a medical determination that the individual is a drug 
     addict or alcoholic shall be entitled to benefits under this 
     title based on such disability with respect to any month, 
     unless such individual--
       ``(i) is undergoing, or on a waiting list for, any medical 
     or psychological treatment that may be appropriate for such 
     individual's condition as a drug addict or alcoholic (as the 
     case may be) and for the stage of such individual's 
     rehabilitation at an institution or facility approved for 
     purposes of this paragraph by the Secretary (so long as 
     access to such treatment is reasonably available, as 
     determined by the Secretary), and
       ``(ii) demonstrates in such manner as the Secretary 
     requires, including at a continuing disability review not 
     later than one year after such determination, that such 
     individual is complying with the terms, conditions, and 
     requirements of such treatment and with the requirements 
     imposed by the Secretary under subparagraph (B).
       ``(B) The Secretary shall provide for the monitoring and 
     testing of all individuals who are receiving benefits under 
     this title and who as a condition of such benefits are 
     required to be undergoing treatment and complying with the 
     terms, conditions, and requirements thereof as described in 
     subparagraph (A), in order to assure such compliance and to 
     determine the extent to which the imposition of such 
     requirements is contributing to the achievement of the 
     purposes of this title. The Secretary may retain jurisdiction 
     in the case of a hearing before the Secretary under this 
     title to the extent the Secretary determines necessary to 
     carry out the preceding sentence. The Secretary shall 
     annually submit to the Congress a full and complete report on 
     the Secretary's activities under this paragraph.
       ``(C) The representative payee and the referral and 
     monitoring agency for any individual described in 
     subparagraph (A) shall report to the Secretary any 
     noncompliance with the terms, conditions, and requirements of 
     the treatment described in subparagraph (A) and with the 
     requirements imposed by the Secretary under subparagraph (B).
       ``(D)(i) If the Secretary finds that an individual is not 
     complying with the terms, conditions, and requirements of the 
     treatment described in subparagraph (A), or with the 
     requirements imposed by the Secretary under subparagraph (B), 
     or both, the Secretary, in lieu of termination, may suspend 
     such individual's benefits under this title until compliance 
     has been reestablished, including compliance with any 
     additional requirements determined to be necessary by the 
     Secretary.
       ``(ii) Any period of suspension under clause (i) shall be 
     taken into account in determining any 24-month period 
     described in subparagraph (E) and shall not be taken into 
     account in determining the 36-month period described in such 
     subparagraph.
       ``(E)(i) Except as provided in clause (ii), no individual 
     described in subparagraph (A) shall be entitled to benefits 
     under this title for any month following the 24-month period 
     beginning with the determination of the disability described 
     in such subparagraph.
       ``(ii) If at the end of the 24-month period described in 
     clause (i), the individual furnishes evidence in accordance 
     with subsection (d)(5) that the individual continues to be 
     under a disability based in whole or in part on a medical 
     determination that the individual is a drug addict or 
     alcoholic, such individual shall continue to be entitled to 
     benefits under this title based on such disability.
       ``(iii) Subject to clause (iv), if such an individual 
     continues to be entitled to such benefits for an additional 
     24-month period following a determination under clause (ii), 
     clauses (i) and (ii) shall apply with regard to any further 
     entitlement to such benefits following the end of such 
     additional period.
       ``(iv) In no event shall such an individual be entitled to 
     benefits under this title for more than a total of 36 months, 
     unless upon the termination of the 36th month such individual 
     furnishes evidence in accordance with subsection (d)(5) that 
     the individual is under a disability which is not related in 
     part to a medical determination that the individual is a drug 
     addict or alcoholic.
       ``(2)(A) Any benefits under this title payable to any 
     individual referred to in paragraph (1), including any 
     benefits payable in a lump sum amount, shall be payable only 
     pursuant to a certification of such payment to a qualified 
     organization acting as a representative payee of such 
     individual pursuant to section 205(j).
       ``(B) For purposes of subparagraph (A) and section 
     205(j)(4), the term `qualified organization'--
       ``(i) shall have the meaning given such term by section 
     205(j)(4)(B), and
       ``(ii) shall mean an agency or instrumentality of a State 
     or a political subdivision of a State.
       ``(3) Monthly insurance benefits under this title which 
     would be payable to any individual (other than the disabled 
     individual to whom benefits are not payable by reason of this 
     subsection) on the basis of the wages and self-employment 
     income of such a disabled individual but for the provisions 
     of paragraph (1), shall be payable as though such disabled 
     individual were receiving such benefits which are not payable 
     under this subsection.''
       (2) Conforming amendments.--
       (A) Section 205(j)(1) of such Act (42 U.S.C. 405(j)(1)) is 
     amended by inserting '', or in the case of any individual 
     referred to in section 223(j)(1)(A)'' after ``thereby''.
       (B) Section 205(j)(2)(D)(ii)(II) of such Act (42 U.S.C. 
     405(j)(2)(D)(ii)(II)) is amended by striking ``legally 
     incompetent or under the age of 15'' and inserting ``legally 
     incompetent, under the age of 15, or a drug addict or 
     alcoholic referred to in section 223(j)(1)(A)''.
       (b) Supplemental Security Income.--Paragraph (3) of section 
     1611(e) of the Social Security Act (42 U.S.C. 1382(e)) is 
     amended to read as follows:
       ``(3)(A)(i) No person who is an aged, blind, or disabled 
     individual solely by reason of disability (as determined 
     under section 1614(a)(3)) shall be an eligible individual or 
     eligible spouse for purposes of this title with respect to 
     any month if such individual's disability is based in whole 
     or in part on a medical determination that the individual is 
     a drug addict or alcoholic, unless such individual--
       ``(I) is undergoing, or on a waiting list for, any medical 
     or psychological treatment that may be appropriate for such 
     individual's condition as a drug addict or alcoholic (as the 
     case may be) and for the stage of such individual's 
     rehabilitation at an institution or facility approved for 
     purposes of this paragraph by the Secretary (so long as 
     access to such treatment is reasonably available, as 
     determined by the Secretary), and
       ``(II) demonstrates in such manner as the Secretary 
     requires, including at a continuing disability review not 
     later than one year after such determination, that such 
     individual is complying with the terms, conditions, and 
     requirements of such treatment and with the requirements 
     imposed by the Secretary under clause (ii).
       ``(ii) The Secretary shall provide for the monitoring and 
     testing of all individuals who are receiving benefits under 
     this title and who as a condition of such benefits are 
     required to be undergoing treatment and complying with the 
     terms, conditions, and requirements thereof as described in 
     clause (i), in order to assure such compliance and to 
     determine the extent to which the imposition of such 
     requirements is contributing to the achievement of the 
     purposes of this title. The Secretary may retain jurisdiction 
     in the case of a hearing before the Secretary under this 
     title to the extent the Secretary determines necessary to 
     carry out the preceding sentence. The Secretary shall 
     annually submit to the Congress a full and complete report on 
     the Secretary's activities under this subparagraph.
       ``(iii) The representative payee and the referral and 
     monitoring agency for any individual described in clause (i) 
     shall report to the Secretary any noncompliance with the 
     terms, conditions, and requirements of the treatment 
     described in clause (i) and with the requirements imposed by 
     the Secretary under clause (ii).
       ``(iv)(I) If the Secretary finds that an individual is not 
     complying with the terms, conditions, and requirements of the 
     treatment described in clause (i), or with the requirements 
     imposed by the Secretary under clause (ii), or both, the 
     Secretary, in lieu of termination, may suspend such 
     individual's benefits under this title until compliance has 
     been reestablished, including compliance with any additional 
     requirements determined to be necessary by the Secretary.
       ``(II) Any period of suspension under subclause (I) shall 
     be taken into account in determining any 24-month period 
     described in clause (v) and shall not be taken into account 
     in determining the 36-month period described in such clause.
       ``(v)(I) Except as provided in subclause (II), no 
     individual described in clause (i) shall be entitled to 
     benefits under this title for any month following the 24-
     month period beginning with the determination of the 
     disability described in such clause.
       ``(II) If at the end of the 24-month period described in 
     subclause (I), the individual furnishes evidence in 
     accordance with section 223(d)(5) that the individual 
     continues to be under a disability based in whole on a 
     medical determination that the individual is a drug addict or 
     alcoholic, such individual shall be entitled to benefits 
     under this title based on such disability for no more than an 
     additional 36 months.
       ``(III) Subject to subclause (IV), if such an individual 
     continues to be entitled to such benefits for an additional 
     24-month period following a determination under subclause 
     (II), subclauses (I) and (II) shall apply with regard to any 
     further entitlement to such benefits following the end of 
     such additional period.
       ``(IV) In no event shall such an individual be entitled to 
     benefits under this title for more than a total of 36 months, 
     unless upon the termination of the 36th month such individual 
     furnishes evidence in accordance with section 223(d)(5) that 
     the individual is under a disability which is not related in 
     part to a medical determination that the individual is a drug 
     addict or alcoholic.
       ``(B)(i) Any benefits under this title payable to any 
     individual referred to in subparagraph (A), including any 
     benefits payable in a lump sum amount, shall be payable only 
     pursuant to a certification of such payment to a qualified 
     organization acting as a representative payee of such 
     individual pursuant to section 1631(a)(2)(A)(ii).
       ``(ii) For purposes of clause (i) and section 
     1631(a)(2)(D), the term `qualified organization'--
       ``(I) shall have the meaning given such term by section 
     1631(a)(2)(D)(ii), and
       ``(II) shall mean an agency or instrumentality of a State 
     or a political subdivision of a State.''
       (c) Effective Dates; Authorizations.--
       (1) In general.--Except as provided in paragraph (2), the 
     amendments made by this section shall apply to benefits 
     payable for determinations of disability made 90 or more days 
     after the date of the enactment of this Act.
       (2) Current determinations.--
       (A) In general.--With respect to any individual described 
     in subparagraph (B), the Secretary of Health and Human 
     Services shall provide during the 3-year period beginning 
     after the date of the enactment of this Act for the 
     application of the amendments made by this section to such 
     individual with the time periods described in such amendments 
     to begin upon such application.
       (B) Individual described.--An individual is described in 
     this subparagraph if such individual is entitled to benefits 
     under title II or XVI of the Social Security Act based on a 
     disability determined before the date described in paragraph 
     (1) to be based in whole or in part on a medical 
     determination that the individual is a drug addict or 
     alcoholic.
       (3) Authorization of appropriations.--There are authorized 
     to be appropriated such sums as may be necessary to carry out 
     the purposes of the provisions of, and the amendments made 
     by, this section.

     SEC. 3. PRIORITY OF TREATMENT.

       The Secretary of Health and Human Services, through the 
     Administrator of the Substance Abuse and Mental Health 
     Services Administration, shall assure that every individual 
     receiving disability benefits under title II or XVI of the 
     Social Security Act based in whole or in part on a medical 
     determination that the individual is a drug addict or 
     alcoholic be given high priority for treatment through 
     entities supported by the various States through any 
     substance abuse block grant authorized under law.

     SEC. 4. ESTABLISHMENT OF REFERRAL MONITORING AGENCIES 
                   REQUIRED IN ALL STATES.

       The Secretary of Health and Human Services shall, within 1 
     year of the date of the enactment of this Act, provide for 
     the establishment of referral and monitoring agencies for 
     each State for the purpose of carrying out the treatment 
     requirements under sections 223(j)(1) and 1611(e)(3)(A) of 
     the Social Security Act (42 U.S.C. 423(j)(1) and 
     1382(e)(3)(A)).

     SEC. 5. PROCEEDS FROM CERTAIN CRIMINAL ACTIVITIES CONSTITUTE 
                   SUBSTANTIAL GAINFUL EMPLOYMENT.

       (a) Social Security Disability Insurance.--Section 
     223(d)(4) of the Social Security Act (42 U.S.C. 423(d)(4)) is 
     amended by inserting the following after the first sentence: 
     ``If an individual engages in a criminal activity to support 
     substance abuse, any proceeds derived from such activity 
     shall demonstrate such individual's ability to engage in 
     substantial gainful activity.''.
       (b) Supplemental Security Income.--Section 1614(a)(3)(D) of 
     the Social Security Act (42 U.S.C. 1382(a)(3)(D)) is amended 
     by inserting the following after the first sentence: ``If an 
     individual engages in a criminal activity to support 
     substance abuse, any proceeds derived from such activity 
     shall demonstrate such individual's ability to engage in 
     substantial gainful activity.''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to disability determinations conducted on or 
     after the date of the enactment of this Act.

     SEC. 6. CONSISTENT PENALTY PROVISIONS FOR SSDI AND SSI 
                   PROGRAMS.

       (a) Felony Penalties for Fraud.--
       (1) In general.--Subsection (a) of section 1631 of the 
     Social Security Act (42 U.S.C. 1383a) is amended by striking 
     ``shall be guilty of a misdemeanor and upon conviction 
     thereof shall be fined not more than $1,000 or imprisoned for 
     not more than one year, or both'' and inserting ``shall be 
     guilty of a felony and upon conviction thereof shall be fined 
     under title 18, United States Code, or imprisoned for not 
     more than five years, or both''.
       (2) Representative payees.--
       (A) Ssdi.--Subsections (b) and (c) of section 208 of such 
     Act (42 U.S.C. 408) are amended to read as follows:
       ``(b)(1) Any person or other entity who is convicted of a 
     violation of any of the provisions of this section, if such 
     violation is committed by such person or entity in his role 
     as, or in applying to become, a certified payee under section 
     205(j) on behalf of another individual (other than such 
     person's spouse or an entity described in section 
     223(j)(2)(B)(ii)), shall be guilty of a felony and upon 
     conviction thereof shall be fined under title 18, United 
     States Code, or imprisoned for not more than five years, or 
     both.
       ``(2) In any case in which the court determines that a 
     violation described in paragraph (1) includes a willful 
     misuse of funds by such person or entity, the court may also 
     require that full or partial restitution of such funds be 
     made to the individual for whom such person or entity was the 
     certified payee.
       ``(3) Any person or entity convicted of a felony under this 
     section or under section 1632(b) may not be certified as a 
     payee under section 205(j).
       ``(c) For the purpose of subsection (a)(7), the terms 
     `social security number' and `social security account number' 
     mean such numbers as are assigned by the Secretary under 
     section 205(c)(2) whether or not, in actual use, such numbers 
     are called social security numbers.''
       (B) Ssi.--Subsection (b)(1) of section 1632 of such Act (42 
     U.S.C. 1383a) is amended by striking ``(other than such 
     person's spouse)'' and all that follows through the period 
     and inserting ``(other than such person's spouse or an entity 
     described in section 1611(e)(3)(B)(ii)(II)), shall be guilty 
     of a felony and upon conviction thereof shall be fined under 
     title 18, United States Code, or imprisoned for not more than 
     five years, or both.''
       (b) Civil Administrative Penalties.--
       (1) Ssdi.--Section 208 of the Social Security Act (42 
     U.S.C. 408) is amended by adding at the end the following new 
     subsections:
       ``(e) For administrative penalties for false claims and 
     statements with respect to which an individual or other 
     entity knows or has reason to know such falsity, see chapter 
     38 of title 31, United States Code.
       ``(f) In the case of the second or subsequent imposition of 
     an administrative or criminal penalty on any person or other 
     entity under this section, the Secretary may exclude such 
     person or entity from participation in any program under this 
     title and titles V, XVI, XVIII, and XX, and may direct that 
     such person or entity be excluded from any State health care 
     program (as defined in section 1128(h)) and any other Federal 
     program as provided by law.''
       (2) Ssi.--
       (A) In general.--Section 1632 of such Act (42 U.S.C. 1383a) 
     is amended by adding at the end the following new 
     subsections:
       ``(c) For administrative penalties for false claims and 
     statements with respect to which an individual or other 
     entity knows or has reason to know such falsity, see chapter 
     38 of title 31, United States Code.
       ``(d) In the case of the second or subsequent imposition of 
     an administrative or criminal penalty on any person or other 
     entity under this section, the Secretary may exclude such 
     person or entity from participation in any program under this 
     title and titles II, V, XVIII, and XX, and may direct that 
     such person or entity be excluded from any State health care 
     program (as defined in section 1128(h)) and any other Federal 
     program as provided by law.''
       (B) Conforming amendment.--The heading for section 1632 of 
     such Act (42 U.S.C. 1383a) is amended by striking ``for 
     fraud''.
       (c) Effective Date.--The amendments made by this section 
     shall be effective on or after the date of the enactment of 
     this Act.
                                 ______


                       McCAIN AMENDMENT NO. 1475

  Mr. McCAIN proposed an amendment to the bill S. 1560, supra; as 
follows:

       At the appropriate place in the bill, add the following:

                Title   --Social Security Earnings Test.

     SECTION   . SHORT TITLE.

       This title may be cited as the ``Older Americans' Freedom 
     to Work Act of 1994.''

     SEC.   . ELIMINATION OF EARNINGS TEST FOR INDIVIDUALS WHO 
                   HAVE ATTAINED RETIREMENT AGE.

       Section 203 of the Social Security Act is amended--
       (1) in paragraph (1) of subsection (c) and paragraphs 
     (1)(A) and (2) of subsection (d), by striking ``the age of 
     seventy'' and inserting ``retirement age (as defined in 
     section 216(l))'';
       (2) in subsection (f)(1)(B), by striking ``was age seventy 
     or over'' and inserting ``was at or above retirement age (as 
     defined in section 216(l))'';
       (3) in subsection (f)(3), by striking ``33\1/3\ percent'' 
     and all that follows through ``any other individual,'' and 
     inserting ``50 percent of such individual's earnings for such 
     year in excess of the product of the exempt amount as 
     determined under paragraph (8),'' and by striking ``age 70'' 
     and inserting ``retirement age (as defined in section 
     216(l)'';
       (4) in subsection (h)(1)(A), by striking ``age 70'' each 
     place it appears and inserting ``retirement age (as defined 
     in section 216(l))''; and
       (5) in subsection (j), by striking ``Age Seventy'' in the 
     heading and inserting ``Retirement Age'', and by striking 
     ``seventy years of age'' and inserting ``having attained 
     retirement age (as defined in section 216(l))''.

     SEC.   . CONFORMING AMENDMENTS ELIMINATING THE SPECIAL EXEMPT 
                   AMOUNT FOR INDIVIDUALS WHO HAVE ATTAINED 
                   RETIREMENT AGE.

       (a) Uniform Exempt Amount.--Section 203(f)(8)(A) of the 
     Social Security Act is amended by striking ``the new exempt 
     amounts (separately stated for individuals described in 
     subparagraph (D) and for other individuals) which are to be 
     applicable'' and inserting ``a new exempt amount which shall 
     be applicable''.
       (b) Conforming Amendments.--Section 203(f)(8)(B) of such 
     Act is amended--
       (1) in the matter preceding clause (i), by striking 
     ``Except'' and all that follows through ``whichever'' and 
     inserting ``The exempt amount which is applicable for each 
     month of a particular taxable year shall be whichever'';
       (2) in clause (i), by striking ``corresponding''; and
       (3) in the last sentence, by striking ``an exempt amount'' 
     and inserting ``the exempt amount''.
       (c) Repeal of Basis for Computation of Special Exempt 
     Amount.--Section 203(f)(8)(D) of such Act is repealed.

     SEC.   . ADDITIONAL CONFORMING AMENDMENTS.

       (a) Elimination of Redundant References to Retirement 
     Age.--Section 203 of the Social Security Act is amended--
       (1) in the last sentence of subsection (c), by striking 
     ``nor shall any deduction'' and all that follows and 
     inserting ``nor shall any deduction be made under this 
     subsection from any widow's or widower's insurance benefit if 
     the widow, surviving divorced wife, widower, or surviving 
     divorced husband involved became entitled to such benefit 
     prior to attaining age 60.''; and
       (2) in subsection (f)(1), by striking clause (D) and 
     inserting the following: ``(D) for which such individual is 
     entitled to widow's or widower's insurance benefits if such 
     individuals became so entitled prior to attaining age 60, 
     or''.
       (b) Conforming Amendment to Provisions for Determining 
     Amount of Increase on Account of Delayed Retirement.--Section 
     202(w)(2)(B)(ii) of such Act is amended--
       (1) by striking ``either''; and
       (2) by striking ``or suffered deductions under section 
     203(b) or 203(c) in amounts equal to the amount of such 
     benefit''.
       (c) Continued Application of Rule Governing Entitlement of 
     Blind Beneficiaries.--The second sentence of section 
     223(d)(4) of such Act is amended by inserting after 
     ``subparagraph (D) thereof'' where it first appears the 
     following: ``(or would be applicable to such individuals but 
     for the amendments made by the Older Americans' Freedom to 
     Work Act of 1994''.

     SEC.   . EFFECTIVE DATE.

       The amendments made by this Act shall apply only with 
     respect to taxable years beginning after December 31, 1994.
                                 ______


                          HEALTH SECURITY ACT

                                 ______


               HATFIELD (AND HARKIN) AMENDMENT NO. 1476,

  (Ordered to lie on the table.)
  Mr. HATFIELD (for himself and Mr. Harkin) submitted and amendment 
intended to be proposed by him to the bill (S. 1775) to ensure 
individual and family security through health care coverage for all 
Americans in a manner that contains the rate of growth in health care 
costs and promotes responsible health insurance practices, to promote 
choice in health care, and to ensure and protect the health care for 
all Americans; as follows:

       At the appropriate place in title III, insert the following 
     new subtitle:
                     Subtitle ____--Health Research

     SEC. ______1. SHORT TITLE.

       This subtitle may be cited as the ``Health Research Act of 
     1994''.

     SEC. ______2. FINDINGS.

       The 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 2 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.
       (3) Public opinion surveys have shown that Americans want 
     more Federal resources put into health research and support 
     by having a portion of their health insurance premiums set 
     aside for this purpose.
       (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 cardiovasculor 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) Among the most effective methods to control health care 
     costs are prevention and cure of disease and disability, 
     thus, health research which holds the promise of cure and 
     prevention of disease and disability is a critical component 
     of any comprehensive health care reform plan.
       (6) 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.
       (7) Because the Omnibus Budget Reconciliation Act of 1993 
     freezes discretionary spending for 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.
       (8) 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 to at least 33 percent.

     SEC. ______3. NATIONAL FUND FOR HEALTH RESEARCH.

       (a) Establishment.--There is established in the Treasury of 
     the United States an account, to be known as the ``National 
     Fund for Health Research'' (hereafter referred to in this 
     section 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 an amount equal to the amounts 
     designated under paragraph (2) and received in the Treasury.
       (2) Amounts.--
       (A) In general.--With respect to each calendar year 
     beginning with the first full calendar year during which a 
     comprehensive health care reform program utilizing a regional 
     and corporate health alliance structure has been implemented, 
     each such alliance shall set aside and transfer to the 
     Treasury of the United States the applicable amount under 
     subparagraph (B) and under section 6097 of the Internal 
     Revenue Code of 1986.
       (B) Applicable amount.--The applicable amount under this 
     subparagraph with respect to a regional or corporate alliance 
     shall be equal to--
       (i) with respect to the first full calendar year described 
     in subparagraph (A), .25 percent of all health premiums 
     received by the alliance for such year;
       (ii) with respect to the second calendar year described in 
     subparagraph (A), .50 percent of all health premiums received 
     by the alliance for such year;
       (iii) with respect to the third calendar year described in 
     subparagraph (A), .75 percent of all health premiums received 
     by the alliance for such year; and
       (iv) with respect to the fourth and succeeding calendar 
     years described in subparagraph (A), 1 percent of all health 
     premiums received by the alliance for such year.
       (3) Designation of Overpayments and Contributions.--
       (A)  In general.--Subchapter A of chapter 61 of the 
     Internal Revenue Code of 1986 (relating to returns and 
     records) is amended by adding at the end the following new 
     part:

   ``PART IX--DESIGNATION OF OVERPAYMENTS AND CONTRIBUTIONS FOR THE 
                   NATIONAL FUND FOR HEALTH RESEARCH

``Sec. 6097. Amounts for the National Fund for Health Research.

     ``SEC. 6097. AMOUNTS FOR THE NATIONAL FUND FOR HEALTH 
                   RESEARCH.

       ``(a) In General.--Every individual (other than a 
     nonresident alien) may designate that--
       ``(1) a portion (not less than $1) of any overpayment of 
     the tax imposed by chapter 1 for the taxable year, and
       ``(2) a cash contribution (not less than $1),

     be paid over to the National Fund for Health Research 
     established under section ______3 of the Health Research Act 
     of 1994. In the case of a joint return of a husband and wife, 
     each spouse may designate one-half of any such overpayment of 
     tax (not less than $2).
       ``(b) Manner and Time of Designation.--Any designation 
     under subsection (a) may be made with respect to any taxable 
     year only at the time of filing the original return of the 
     tax imposed by chapter 1 for such taxable year. Such 
     designation shall be made either on the 1st page of the 
     return or on the page bearing the taxpayer's signature.
       ``(c) Overpayments Treated as Refunded.--For purposes of 
     this section, any overpayment of tax designated under 
     subsection (a) shall be treated as being refunded to the 
     taxpayer as of the last day prescribed for filing the return 
     of tax imposed by chapter 1 (determined with regard to 
     extensions) or, if later, the date the return is filed.
       ``(d) Designated Amounts Not Deductible.--No amount 
     designated pursuant to subsection (a) shall be allowed as a 
     deduction under section 170 or any other section for any 
     taxable year.
       ``(e) Termination.--This section shall not apply to taxable 
     years beginning in a calendar year after a determination by 
     the Secretary that the sum of all designations under 
     subsection (a) for taxable years beginning in the second and 
     third calendar years preceding the calendar year is less than 
     $5,000,000.''.
       (B) Clerical amendment.--The table of parts for subchapter 
     A of chapter 61 of such Code is amended by adding at the end 
     the following new item:

``Part IX. Designation of overpayments and contributions for the 
              National Fund for Health Research.''.
       (C) Effective date.--The amendments made by this paragraph 
     shall apply to taxable years beginning after December 31, 
     1993.
       (c) Expenditures From Fund.--
       (1) In general.--The Secretary of the Treasury shall pay 
     annually, 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, to the Secretary 
     of Health and Human Services on behalf of the National 
     Institutes of Health, an amount equal to the amount in the 
     National Fund for Health Research at the time of such 
     payment, to enable the Secretary to carry out the purpose of 
     section 404F of the Public Health Service Act, less any 
     administrative expenses which may be paid under paragraph 
     (3).
       (2) Purposes for expenditures from fund.--Part A of title 
     IV of the Public Health Service Act (42 U.S.C. 281 et seq.) 
     is amended by adding at the end the following new section:

     ``SEC. 404F. EXPENDITURES FROM THE NATIONAL FUND FOR HEALTH 
                   RESEARCH.

       ``(a) In General.--From amounts received for any fiscal 
     year from the National Fund for Health Research, the 
     Secretary of Health and Human Services shall distribute--
       ``(1) 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:
       ``(A) for carrying out the responsibilities of the Office 
     of the Director, National Institutes of Health, including the 
     Office of Research on Women's Health and the Office of 
     Research on Minority Health, the Office of the Alternative 
     Medicine and the Office of Rare Diseases Research; and
       ``(B) for construction and acquisition of equipment for or 
     facilities of or used by the National Institutes of Health;
       ``(2) 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;
       ``(3) 1 percent of such amounts during any fiscal year for 
     carrying out section 301 and part D of title IV with respect 
     to health information communications; and
       ``(4) the remainder of such amounts during any fiscal year 
     to member institutes of the National Institutes of Health and 
     Centers 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.
       ``(b) Plans of Allocation.--The amounts transferred under 
     subsection (a) shall be allocated by the Director of NIH 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) Administrative expenses.--Amounts in the National Fund 
     for Health Research shall be available to pay the 
     administrative expenses of the Department of the Treasury 
     directly allocable to--
       (A) modifying the individual income tax return forms to 
     carry out section 6097 of the Internal Revenue Code of 1986;
       (B) carrying out this section with respect to such Fund; 
     and
       (C) processing amounts received under this section and 
     transferring such amounts to such Fund.
       (4) Trigger and release of fund monies.--No expenditures 
     shall be made pursuant to section ____3(c) 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.
       (d) Budget Enforcement.--Amounts contained in the National 
     Fund for Health Research shall be excluded from, and shall 
     not be taken into account for purposes of, any budget 
     enforcement procedures under the Congressional Budget Act of 
     1974 or the Balanced Budget Emergency Deficit Control Act of 
     1985.

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