Congressional Summary Sheet, Health Care Act of 2025 (H.R. XXXX) 

Sponsor: 

[To be inserted by Member of Congress] Committees: Energy and Commerce; Ways and Means; Education and the Workforce; Rules; Oversight and Accountability; Armed Services; Science, Space, and Technology; Judiciary

Purpose: 

To establish a universal, hybrid national health insurance program (“HumanCare”) that ensures comprehensive healthcare for all citizens of the United States. The Act eliminates cost-sharing, integrates Responsible Artificial Intelligence (AI) to improve efficiency and transparency, and preserves free-market participation for providers who choose to offer premium services.

Congressional Findings Congress finds that:

1. The United States spends nearly 19 percent of GDP on healthcare, yet tens of millions remain uninsured or underinsured.
2. Administrative waste, fraud, and inefficiency cost taxpayers more than $140 billion annually.
3. Rising medical and prescription costs contribute to family debt and economic instability.
4. Unequal access to care in rural, low-income, and underserved communities persists.
5. Responsible AI technologies enable ethical, efficient, and fraud-resistant healthcare systems.
6. HumanCare promotes innovation, patient choice, and transparency while ensuring every American citizen has access to quality care.
7. HumanCare saves working families about $1,667 per month in health insurance costs.
8. The integration of Responsible AI is projected to save up to $140 billion annually in fraud, waste, and abuse, per CMS estimates.

Declaration of Policy It is the policy of the United States to:

• Guarantee comprehensive, equitable healthcare coverage for all citizens.
• Eliminate financial barriers to care through $0 out-of-pocket costs.
• Integrate Responsible AI systems to enhance efficiency, prevent fraud, and protect privacy.
• Support free-market participation through transparent pricing for “Signature” providers.
• Strengthen economic security by reducing national healthcare costs and improving outcomes.

Major Provisions:

• Universal Enrollment: All U.S. citizens automatically enrolled through HHS.
• Comprehensive Coverage: Primary care, hospital services, prescription drugs, mental health, substance use, long-term care, dental, and vision.
• No Cost-Sharing: No premiums, copays, or deductibles for covered services.
• HumanCare AI Platform: A secure, AI-powered system for scheduling, telehealth, billing, and fraud detection, with KPIs for equity and bias mitigation aligned with NIST and      ISO/IEC standards.
• Free-Market Flexibility: Providers may offer premium services at disclosed rates.
• Fraud Prevention: AI systems integrated with CMS oversight to reduce waste and abuse.
• Funding Mechanism: Derived from existing health budgets, targeted excise taxes on unhealthy products (phased in over 3 years, including 100% on junk food, tripled alcohol      taxes, $5/pack tobacco increase, 100%-420% on cannabis based on THC, and 100% on e-cigarettes, generating ~$667B), and savings from administrative efficiency.
• Transition: Existing federal programs (Medicare, Medicaid, CHIP) merge into HumanCare over two years, with state-based AI pilots for flexibility.

Expected Outcomes:

• Universal healthcare access for every U.S. citizen, achieving a 0% uninsured rate.
• Estimated $1.24 trillion surplus from reduced fraud, administrative waste, and efficiency gains.
• Reductions in preventable hospitalizations (30%), overdose deaths (20-30%), flu hospitalizations      (15%), and medical bankruptcies (200,000 fewer annually); plus 2-5 years added life expectancy for low-income groups.
• Saving working families about $1,667 per month to relieve financial anxiety.
• Stronger provider-patient relationships via direct HHS billing and weekly payments.
• Increased national productivity, consumer financial stability, and job opportunities through retraining for displaced workers.
• Sustainable, equitable healthcare reform grounded in Responsible AI.

Implementation Timeline:

• Year 1: HHS infrastructure and enrollment systems established.
• Year 2: Full national implementation and coverage activation.

Contact:

Prepared for introduction in the United States House of Representatives. For additional information, contact the Office of the Bill Sponsor or the House Committee on Energy and Commerce.

Legislative Intent Statement: 

The purpose of the Health Care Act of 2025 is to ensure that every American citizen, regardless of income, employment, or geography, can access comprehensive healthcare without financial hardship. This Act replaces inefficiency and fragmentation with a unified, transparent system - one that uses Responsible Artificial Intelligence to improve outcomes, protect privacy, and reduce waste. By combining universal coverage with free-market choice, the bill reflects a pragmatic, bipartisan path toward healthcare that is both compassionate and economically sustainable - capitalism with a boost. Its guiding principle is simple: quality care for every citizen, fiscal responsibility for every taxpayer, and renewed confidence in America’s promise of opportunity and health for all.

 The Health Care Act of 2025 (H.R. XXXX)

(Final Submission-Ready Text, or Ready for Congress Member Review and Improvement)

1 119th CONGRESS

2 1st Session

3 H. R. XXXX

4

5 To establish an improved hybrid national health insurance program (“HumanCare”)

6 that covers all citizens of the United States, eliminates cost-sharing, integrates

7 responsible artificial intelligence, preserves free-market participation for

8 providers, and for other purposes.

9

10 IN THE HOUSE OF REPRESENTATIVES

11

12 October 28, 2025

13

14 Mr./Ms. [Member Name] of [State] introduced the following bill; which was referred

15 to the Committee on Energy and Commerce, and in addition to the Committees on Ways

16 and Means, Education and the Workforce, Rules, Oversight and Accountability, Armed

17 Services, Science, Space, and Technology, and the Judiciary, for a period to be

18 subsequently determined by the Speaker, in each case for consideration of such

19 provisions as fall within the jurisdiction of the committee concerned.

20

21 A BILL

22

23 To establish an improved hybrid national health insurance program that covers all

24 Americans, while allowing free-market participation by Signature Doctors and

25 providers under transparent pricing.

26

27 Be it enacted by the Senate and House of Representatives of the United States of

28 America in Congress assembled,

29

30 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

31 (a) Short title. - This Act may be cited as the “Health Care Act of 2025”.

32 (b) Table of contents. - The table of contents for this Act is as follows:

33

34 Sec. 1. Short title; table of contents.

35 Sec. 2. Findings and declaration of policy.

36 Title I - Eligibility, Enrollment, and Benefits Coverage.

37 Title II - Comprehensive Benefits.

38 Title III - Provider Participation.

39 Title IV - Administration and AI Integration.

40 Title V - Quality and Oversight.

41 Title VI - Health Budget and Payments.

42 Title VII - Universal Medicare Trust Fund.

43 Title VIII - Conforming Amendments.

44 Title IX - Transition and Implementation.

45 Title X - Definitions, Severability and Rules of Construction.

46 Title XI - Fiscal Notes and Pilot Programs.

47

48 SEC. 2. FINDINGS AND DECLARATION OF POLICY.

49 (a) Findings. - Congress finds that:

50 1. The United States spends approximately 19 percent of its gross domestic product

51 on healthcare, yet millions of citizens remain uninsured or underinsured.

52 2. Administrative inefficiencies, waste, and fraud in the delivery of healthcare

53 impose substantial costs on taxpayers and families.

54 3. Escalating healthcare and prescription drug costs undermine family financial

55 security and contribute to medical indebtedness and bankruptcy.

56 4. Access to affordable, high-quality healthcare remains uneven across rural,

57 low-income, and underserved communities.

58 5. Technological advances, including artificial intelligence systems designed and

59 governed responsibly, enable more efficient, equitable, and fraud-resistant

60 healthcare delivery.

61 6. The HumanCare framework supports free-market choice, transparency, and

62 accountability while guaranteeing access to comprehensive care for all citizens.

63 7. The integration of Responsible AI is projected to save up to $140 billion

64 annually in fraud, waste, and abuse, per CMS estimates.

65 (b) Declaration of policy. - It is the policy of the United States that:

66 1. Comprehensive healthcare coverage shall be available to all citizens through a

67 unified national system administered by the Department of Health and Human Services

68 (HHS).

69 2. No individual shall be denied healthcare coverage due to income, employment

70 status, pre-existing conditions, or geography.

71 3. Responsible artificial intelligence systems shall be integrated into the national

72 healthcare program to improve efficiency, prevent fraud, safeguard privacy, and

73 enhance the patient experience.

74 4. Free-market participation by qualified providers shall be preserved, allowing

75 transparent premium offerings while maintaining baseline universal access.

76 5. National healthcare costs shall be reduced, outcomes improved, and economic

77 security for individuals and families strengthened through this reform.

78

79 TITLE I - ELIGIBILITY, ENROLLMENT, AND BENEFITS COVERAGE

80 Sec. 101. Establishment of program. - There is hereby established a national health

81 insurance program, hereafter called “HumanCare”, to provide comprehensive

82 protection against the costs of health care and health-related services, in

83 accordance with the standards specified in, or established under, this Act.

84 Sec. 102. Universal coverage. - (a) In general. - Every individual who is a citizen of

85 the United States is entitled to benefits for health care services under this Act.

86 The Secretary shall promulgate a rule that provides criteria for determining

87 citizenship for eligibility purposes under this Act. Qualified citizenship shall

88 include U.S. citizens, and other individuals meeting criteria established by the

89 Secretary, consistent with existing federal law.

90 (b) Treatment of other individuals. - The Secretary may make eligible for benefits

91 for health care services under this Act other individuals not described in

92 subsection (a), and regulate the eligibility of such individuals, to ensure that

93 every person in the United States has access to health care. In regulating such

94 eligibility, the Secretary shall ensure that individuals are not allowed to travel

95 to the United States for the sole purpose of obtaining health care items and

96 services provided under the program established under this Act.

97 Sec. 103. Freedom of choice. - Any individual entitled to benefits under this Act

98 may obtain health services from any institution, agency, or individual qualified

99 to participate under this Act.

100 Sec. 104. Non-discrimination. - (a) In general. - No person shall, on the basis of

101 race, color, national origin, age, disability, marital status, citizenship status,

102 primary language use, genetic conditions, previous or existing medical conditions,

103 religion, or sex, including sex stereotyping, gender identity, sexual orientation,

104 and pregnancy and related medical conditions (including termination of pregnancy),

105 be excluded from participation in or be denied the benefits of the program

106 established under this Act (except as expressly authorized by this Act for

107 purposes of enforcing eligibility standards described in section 102), or be

108 subject to any reduction of benefits or other discrimination by any participating

109 provider (as defined in section 301), or any entity conducting, administering, or

110 funding a health program or activity, including contracts of insurance, pursuant

111 to this Act.

112 (b) Claims of discrimination. - (1) In general. - The Secretary shall establish a

113 procedure for adjudication of administrative complaints alleging a violation of

114 subsection (a).

115 (2) Jurisdiction. - Any person aggrieved by a violation of subsection (a) by a

116 covered entity may file suit in any district court of the United States having

117 jurisdiction of the parties. A person may bring an action under this paragraph

118 concurrently as such administrative remedies as established in paragraph (1).

119 (3) Damages. - Any person aggrieved by a violation of subsection (a) by a covered

120 entity may, in any action under paragraph (2), or in a separate action or as part

121 of the administrative procedure under paragraph (1), be awarded compensatory

122 damages or punitive damages or both.

123 (c) Continued application of laws. - Nothing in this section shall be construed as

124 invalidating or limiting the rights, remedies, procedures, or legal standards

125 available under title VI of the Civil Rights Act of 1964, title IX of the

126 Education Amendments of 1972, the Age Discrimination Act of 1975, section 504 of

127 the Rehabilitation Act of 1973, or section 1557 of the Patient Protection and

128 Affordable Care Act.

129 Sec. 105. Enrollment. - (a) In general. - The Secretary shall provide a mechanism for

130 the enrollment of individuals eligible for benefits under this Act. The mechanism

131 shall - (1) ensure that all eligible individuals are enrolled;

132 (2) include a process for automatic enrollment at the time of birth in the United

133 States, or at the time of immigration into the United States or other acquisition

134 of qualified citizen status in the United States; and

135 (3) provide for the enrollment, as of the dates described in section 106, of all

136 individuals who are eligible for benefits as of such dates.

137 (b) Issuance of universal Medicare cards. - In the course of establishing the

138 mechanism described in subsection (a), the Secretary shall provide for the

139 issuance of a universal Medicare card to individuals entitled to benefits under

140 this Act.

141 Sec. 106. Effective date. - Benefits shall first be available under this Act for

142 items and services furnished on January 1 of the second calendar year that begins

143 after the date of the enactment of this Act.

144

145 TITLE II - COMPREHENSIVE BENEFITS

146 Sec. 201. Benefits provided. - (a) In general. - Subject to the other provisions of

147 this title and titles IV through IX, individuals enrolled for benefits under this

148 Act are entitled to have payment made by the Secretary to an eligible provider

149 for the following items and services if medically necessary or appropriate for the

150 maintenance of health or for the diagnosis, treatment, or rehabilitation of a

151 health condition:

152 (1) Hospital services, including inpatient and outpatient hospital care, including

153 24-hour-a-day emergency services and inpatient prescription drugs.

154 (2) Ambulatory patient services.

155 (3) Primary and preventive services, including chronic disease management.

156 (4) Prescription drugs and medical devices, including outpatient prescription

157 drugs, medical devices, and biological products.

158 (5) Mental health and substance abuse treatment services, including inpatient

159 care.

160 (6) Laboratory and diagnostic services.

161 (7) Comprehensive reproductive, maternity, and newborn care.

162 (8) Pediatrics.

163 (9) Oral health, audiology, and vision services.

164 (10) Rehabilitative and habilitative services and devices.

165 (11) Emergency services and transportation.

166 (12) Early and periodic screening, diagnostic, and treatment services, as

167 described in sections 1902(a)(10)(A), 1902(a)(43), 1905(a)(4)(B), and 1905(r) of

168 the Social Security Act (42 U.S.C. 1396a; 1396a(a)(43); 1396d(a)(4)(B);

169 1396d(r)).

170 (13) Necessary transportation to receive health care services for persons with

171 disabilities or low-income individuals (as determined by the Secretary).

172 (14) Long-term care services and support (as described in section 204).

173 (15) Preventive Care: Routine check-ups, screenings for chronic diseases (cancer,

174 diabetes, heart conditions). Vaccinations, wellness programs (nutrition

175 counseling, smoking cessation, weight management).

176 (16) Primary Care: Access to a primary care physician for first-line health needs,

177 ongoing condition management, and care coordination.

178 (17) Emergency Services: Coverage for ER visits, urgent care, and ambulance

179 services without prohibitive delays.

180 (18) Hospitalization: Inpatient care, including surgery, intensive care, and all

181 necessary services during hospital stays.

182 (19) Services via AI-powered HHS app (section 402) for appointments, rides,

183 telemedicine, prescriptions, and reminders.

184 (20) Mental Health Services: Psychiatric consultations, therapy, treatment for

185 substance use disorders, and crisis intervention.

186 (21) Specialty Care: Access to specialists, including pediatrics, geriatrics,

187 oncology, cardiology, and allergy care (tests, shots, treatments, inhalers,

188 epi-pens).

189 (22) Prescription Drugs: Coverage for both acute and chronic conditions, including

190 brand name and generic options, including services for sickle cell disease

191 management, overdose prevention (e.g., naloxone distribution), and all

192 FDA-approved medications at no cost.

193 (23) Maternal and Child Health: Prenatal, childbirth, postpartum, pediatric

194 visits, and childhood immunizations.

195 (24) Dental & Vision Care: Routine exams, cleanings, corrective lenses, and

196 essential dental procedures.

197 (25) Rehabilitative & Habilitative Services: Physical, occupational, and speech

198 therapy; developmental disability services.

199 (26) Chronic Disease Management: Comprehensive care plans for diabetes, asthma,

200 cancer, heart disease, and other long-term conditions. Sickle Cell Disease Care &

201 Awareness: Dedicated access to specialists, pain management, new treatments

202 (including gene therapies), routine screenings, and patient education programs to

203 reduce stigma, improve outcomes, and address the historic inequities in sickle

204 cell care, particularly within underserved communities.

205 (27) End-of-Life Care: Palliative and hospice services, prioritizing dignity,

206 comfort, and support for patients and families.

207 (28) Substance Use Disorder Treatment & Recovery: Comprehensive Treatment:

208 Medically supervised detox, medication-assisted treatment (MAT: buprenorphine,

209 methadone, naltrexone, acamprosate, disulfiram), plus evidence-based therapies

210 (CBT, motivational interviewing, family counseling). Prevention & Education:

211 School and community programs, harm reduction efforts (needle exchanges, safe-use

212 education). Recovery Support: Aftercare, peer support, vocational training, and

213 reintegration services. Integrated Care: Dual-diagnosis treatment for co-occurring

214 mental health conditions (depression, PTSD, anxiety). Overdose Prevention:

215 Widespread naloxone distribution, every household can request a USPS-delivered

216 dose for emergency use. Emergency services will be fully equipped to handle

217 overdoses rapidly.

218 (b) Revision and adjustment. - The Secretary shall, at least annually, and on a

219 regular basis, evaluate whether the benefits package should be improved or

220 adjusted to promote the health of beneficiaries, account for changes in medical

221 practice or new information from medical research, or respond to other relevant

222 developments in health science, and shall make recommendations to Congress

223 regarding any such improvements or adjustments.

224 (c) Hearings. - (1) In general. - The Committee on Energy and Commerce and the

225 Committee on Ways and Means of the House of Representatives shall, not less

226 frequently than annually, hold a hearing on the recommendations submitted by the

227 Secretary under subsection (b).

228 (2) Exercise of rulemaking authority. - Paragraph (1) is enacted - (A) as an exercise

229 of rulemaking power of the House of Representatives, and, as such, shall be

230 considered as part of the rules of the House, and such rules shall supersede any

231 other rule of the House only to the extent that rule is inconsistent therewith;

232 and (B) with full recognition of the constitutional right of either House to

233 change such rules (so far as relating to the procedure in such House) at any time,

234 in the same manner, and to the same extent as in the case of any other rule of the

235 House.

236 (d) Complementary and integrative medicine. - (1) In general. - In carrying out

237 subsection (b), the Secretary shall consult with the persons described in

238 paragraph (2) with respect to - (A) identifying specific complementary and

239 integrative medicine practices that are appropriate to include in the benefits

240 package; and (B) identifying barriers to the effective provision and integration

241 of such practices into the delivery of health care, and identifying mechanisms for

242 overcoming such barriers.

243 (2) Consultation. - In accordance with paragraph (1), the Secretary shall consult

244 with - (A) the Director of the National Center for Complementary and Integrative

245 Health; (B) the Commissioner of Food and Drugs; (C) institutions of higher

246 education, private research institutes, and individual researchers with extensive

247 experience in complementary and alternative medicine and the integration of such

248 practices into the delivery of health care; (D) nationally recognized providers of

249 complementary and integrative medicine; and (E) such other officials, entities,

250 and individuals with expertise on complementary and integrative medicine as the

251 Secretary determines appropriate.

252 (e) States may provide additional benefits. - Individual States may provide

253 additional benefits for the citizens of such States, as determined by such State,

254 and may provide benefits to individuals not eligible for benefits under this Act,

255 at the expense of the State, subject to the requirements specified in section

256 1102, including "Signature Doctors" premium services above negotiated rates, via

257 the HHS app.

258 Sec. 202. No cost-sharing. - (a) In general. - The Secretary shall ensure that no

259 cost-sharing, including deductibles, coinsurance, copayments, or similar charges,

260 is imposed on an individual for any benefits provided under this Act, except as

261 described in subsection (e) of section 201.

262 (b) No balance billing. - Notwithstanding contracts in accordance with section 302,

263 no provider may impose a charge to an enrolled individual for covered services for

264 which benefits are provided under this Act, except as described in subsection (e)

265 of section 201.

266 Sec. 203. Free-market participation. - Qualified “Signature Doctors” and

267 participating providers may offer premium services above federally negotiated or

268 standard rates, provided the pricing is transparently listed in the AI-powered HHS

269 HumanCare application established in Section 402 and accessible to patients.

270

271 TITLE III - PROVIDER PARTICIPATION

272 Sec. 301. Standards and participation. - Providers participating in the program must

273 be duly licensed in their state of practice and meet all federal and state quality

274 and safety standards. Participating providers shall uphold a Patients’ Bill of

275 Rights ensuring privacy, non-discrimination, accessible care settings, and choice

276 of provider, including rights to informed consent, appeal denials, language

277 access, and culturally competent care.

278 (a) In general. - An individual or other entity engaged in the delivery of health

279 care services or items may only qualify to provide such services or items for

280 purposes of this Act if such individual or entity - (1) is licensed or certified

281 under applicable State or local laws and meets all other quality and safety

282 standards applicable under Federal, State, and local laws; (2) implements policies

283 to ensure compliance with the patients’ bill of rights described in subsection

284 (b); (3) meets such other requirements as the Secretary determines appropriate to

285 ensure the health, safety, and well-being of patients and to promote the delivery

286 of high-quality health care; and (4) in the case of each institutional provider

287 (as defined by the Secretary), agrees not to charge any beneficiary of the program

288 for any capital expenditures or expenses associated with operating costs,

289 including any interest or money due on debt, lease payments, a return on net

290 assets, depreciation, maintenance, utilities, or other such expenditures or

291 expenses as identified by the Secretary.

292 (b) Patients’ bill of rights. - The patients’ bill of rights described in this

293 subsection requires, at a minimum - (1) a patient’s right to receive information

294 about health care and insurance coverage in a manner that is understandable and

295 accessible to the patient; (2) a patient’s right to refuse health care; (3) a

296 patient’s right to confidentiality of records; (4) a patient’s right to an

297 ombudsman or other advocate to assist such patient in seeking care, appealing

298 care denials, and otherwise navigating the health care system; (5) a patient’s

299 right to appeal - (A) a denial of an item or service under this Act; (B) a failure

300 to provide an item or service under this Act; or (C) a failure to provide adequate

301 care under this Act; (6) a patient’s right to health care regardless of

302 discrimination under section 104(a); (7) a patient’s right to timely access to

303 specialty care; (8) a patient’s right to timely prior authorization decisions,

304 including emergency and urgent situations; and (9) a patient’s right to language

305 access and culturally competent care.

306 (c) Whistleblower protections. - (1) Statement of policy. - It is the policy of this

307 Act that no person or other entity engaged in the delivery of health care

308 services or items under this Act retaliates or discriminates against a person

309 because that person has, in good faith - (A) initiated or participated in an

310 investigation under this Act or any other Federal or State law; or (B) refused to

311 participate in or facilitate a violation of such law.

312 (2) Prohibition against intimidation and retaliation. - No person or other entity

313 engaged in the delivery of health care services or items under this Act shall

314 intimidate, threaten, coerce, discriminate against, or take any retaliatory action

315 against any patient or employee for - (A) the exercise by the patient or employee,

316 of the rights or remedies granted to the patient or employee by any provision

317 under Federal law; (B) the initiation of, testimony in, assistance in, or

318 participation in an investigation, compliance review, proceeding, or action at

319 law or otherwise under this Act or any other Federal law; (C) opposition to an act

320 or practice made unlawful by this Act or any other Federal law; or (D) the filing

321 of a complaint, or the refusal to participate in or facilitate a violation under

322 this Act or any other Federal law.

323 (3) Enforcement. - A patient or employee who alleges a violation of a right under

324 this subsection, or against whom an action prohibited by this subsection is

325 alleged to have been taken, may bring an action in a United States district court.

326 The district courts of the United States shall have jurisdiction of actions

327 commenced pursuant to this subsection without regard to the amount in controversy

328 or the citizenship of the parties involved.

329 Sec. 302. Private contracts. - Providers may enter into private contractual

330 arrangements with enrollees for services not covered under this Act, provided such

331 arrangements are voluntary, clearly disclosed, and not executed in emergency or

332 involuntary circumstances. (a) In general. - Subject to the provisions of this

333 subsection, nothing in this Act shall prohibit an institutional or individual

334 provider from entering into a private contract with an enrolled individual for any

335 item or service - (1) for which no claim for benefits is to be submitted under this

336 Act; and (2) for which the provider receives - (A) no reimbursement under this Act

337 directly or on a capitated basis; and (B) no amount for such item or service from

338 an organization which receives reimbursement for such items or service under this

339 Act directly or on a capitated basis.

340 (b) Beneficiary protections. - (1) In general. - Subsection (a) shall not apply to

341 any contract unless - (A) the contract is in writing and is signed by the

342 beneficiary before any item or service is provided pursuant to the contract; (B)

343 the contract contains the items described in paragraph (2); and (C) the contract

344 is not entered into at a time when the beneficiary is facing an emergency health

345 care situation.

346 (2) Items required to be included in contract. - Any contract to provide items and

347 services to which subsection (a) applies shall clearly indicate that by signing

348 such contract, the beneficiary - (A) agrees not to submit a claim (or to request

349 that the provider submit a claim) under this Act for such items or services even

350 if such items or services are otherwise covered under this Act; (B) agrees to be

351 responsible for payment of such items or services and understands that no

352 reimbursement will be provided under this Act for such items or services; (C)

353 acknowledges that no limits under this Act apply to amounts that may be charged

354 for such items or services; and (D) acknowledges that the provider is providing

355 services outside the scope of the program under this Act. In addition, such

356 contract shall also clearly indicate the terms of the contract, including

357 specifying charges for the service and payment terms.

358 (3) Program integrity. - Such contract shall not be enforceable if the provider is

359 found to have engaged in a pattern or practice of denying, downcoding, or bundling

360 benefits under this Act for the purpose of limiting medical care or to have

361 repeatedly failed to adhere to the patient bill of rights under section 301(b).

362

363 TITLE IV - ADMINISTRATION AND AI INTEGRATION

364 Sec. 401. Administration. - The Secretary shall oversee implementation of HumanCare,

365 promulgate necessary regulations, monitor program performance, and ensure

366 equitable, accessible, and efficient operation nationwide. The Secretary shall

367 report annually on outcomes, including 0% uninsured, 30% fewer preventable

368 hospitalizations, 20-30% fewer overdose deaths, +2-5 years life expectancy for

369 low-income, 15% less flu hospitalizations, and 200,000 fewer bankruptcies.

370 (a) General duties of the Secretary. - (1) In general. - The Secretary shall develop

371 policies, procedures, guidelines, and requirements to carry out this Act,

372 including related to - (A) eligibility for benefits; (B) enrollment; (C) benefits

373 provided; (D) provider participation standards and qualifications, as described in

374 title III; (E) levels of funding; (F) methods for determining amounts of payments

375 to providers of covered items and services, consistent with subtitle B; (G) a

376 process for appealing or petitioning for a determination of coverage or

377 noncoverage of items and services under this Act; (H) planning for capital

378 expenditures and service delivery; (I) planning for health professional education

379 funding; (J) encouraging States to develop regional planning mechanisms; and (K)

380 any other regulations necessary to carry out the purposes of this Act.

381 (2) Regulations. - Regulations authorized by this Act shall be issued by the

382 Secretary in accordance with section 553 of title 5, United States Code.

383 (3) Accessibility. - The Secretary shall have the obligation to ensure the timely

384 and accessible provision of items and services that all eligible individuals are

385 entitled to under this Act.

386 (b) Uniform reporting standards; annual report; studies. - (1) Uniform reporting

387 standards. - (A) In general. - The Secretary shall establish uniform State reporting

388 requirements and national standards to ensure an adequate national database

389 containing information pertaining to health services practitioners, approved

390 providers, the costs of facilities and practitioners providing items and services,

391 the quality of such items and services, the outcomes of such items and services,

392 and the equity of health among population groups. Such database shall include, to

393 the maximum extent feasible without compromising patient privacy, health outcome

394 measures used under this Act, and to the maximum extent feasible without

395 excessively burdening providers, a description of the standards and

396 qualifications, levels of finding, and methods described in subparagraphs (D)

397 through (F) of subsection (a)(1).

398 (B) Required data disclosures. - In establishing reporting requirements and

399 standards under subparagraph (A), the Secretary shall require a provider with an

400 agreement in effect under section 301 to disclose to the Secretary, in a time and

401 manner specified by the Secretary, the following (as applicable to the type of

402 provider): (i) Any data the provider is required to report or does report to any

403 State or local agency, or, as of January 1, 2019, to the Secretary or any entity

404 that is part of the Department of Health and Human Services, except data that are

405 required under the programs terminated in section 803. (ii) Annual financial data

406 that includes information on employees (including the number of employees, hours

407 worked, and wage information) by job title and by each patient care unit or

408 department within each facility (including outpatient units or departments); the

409 number of registered nurses per staffed bed by each such unit or department;

410 information on the dollar value and annual spending (including purchases,

411 upgrades, and maintenance) for health information technology; and risk-adjusted

412 and raw patient outcome data (including data on medical, surgical, obstetric, and

413 other procedures).

414 (C) Reports. - The Secretary shall regularly analyze information reported to the

415 Secretary and shall define rules and procedures to allow researchers, scholars,

416 health care providers, and others to access and analyze data for purposes

417 consistent with quality and outcomes research, without compromising patient

418 privacy.

419 (2) Annual report. - Beginning 2 years after the date of the enactment of this Act,

420 the Secretary shall annually report to Congress on the following: (A) The status

421 of implementation of the Act. (B) Enrollment under this Act. (C) Benefits under

422 this Act. (D) Expenditures and financing under this Act. (E) Cost-containment

423 measures and achievements under this Act. (F) Quality assurance. (G) Health care

424 utilization patterns, including any changes attributable to the program. (H)

425 Changes in the per-capita costs of health care. (I) Differences in the health

426 status of the populations of the different States, including income and racial

427 characteristics, and other population health inequities. (J) Progress on quality

428 and outcome measures, and long-range plans and goals for achievements in such

429 areas. (K) Plans for improving service to medically underserved populations. (L)

430 Transition problems as a result of implementation of this Act. (M) Opportunities

431 for improvements under this Act.

432 (3) Statistical analyses and other studies. - The Secretary may, either directly or

433 by contract - (A) make statistical and other studies, on a nationwide, regional,

434 State, or local basis, of any aspect of the operation of this Act; (B) develop and

435 test methods of delivery of items and services as the Secretary may consider

436 necessary or promising for the evaluation, or for the improvement, of the

437 operation of this Act; and (C) develop methodological standards for policymaking.

438 (c) Audits. - (1) In general. - The Comptroller General of the United States shall

439 conduct an audit of the Department of Health and Human Services every fifth

440 fiscal year following the effective date of this Act to determine the

441 effectiveness of the program in carrying out the duties under subsection (a).

442 (2) Reports. - The Comptroller General of the United States shall submit a report to

443 Congress concerning the results of each audit conducted under this subsection.

444 Sec. 402. Responsible AI integration. - The Secretary shall establish an AI-powered

445 HumanCare application for scheduling, telemedicine, claims adjudication, provider

446 payment interface, and fraud detection. The application shall comply with privacy

447 protections, transparency standards, auditability, and Responsible AI governance

448 frameworks. The app shall process provider payments weekly, show rates

449 transparently, and allow choice of “Signature Doctors”. The Secretary shall

450 develop the app for bookings, rides, telemedicine, prescriptions, fraud detection

451 ($140B saved), and resource optimization. The app shall incorporate KPIs for

452 equity, efficiency, and bias mitigation, aligned with NIST AI Risk Management

453 Framework and ISO/IEC standards.

454 (a) Establishment. - Secretary to develop an AI-powered HHS app for bookings, rides,

455 telemedicine, prescriptions, fraud detection ($140B saved), and resource

456 optimization.

457 (b) Integration. - App to process provider payments (sections 602).

458 (c) Transparency. - Show rates, allow "Signature Doctors" choice.

459 Sec. 403. Fraud control. - All existing federal laws relating to fraud, waste, and

460 abuse in federal healthcare programs shall apply under this Act. The Secretary

461 shall deploy real-time analytics, monitoring, and reporting systems within the

462 HumanCare platform to identify, prevent, and sanction improper conduct. The

463 following sections of the Social Security Act shall apply to this Act in the same

464 manner as they apply to State medical assistance plans under title XIX of such

465 Act (except that in applying such provisions any reference to the Secretary is

466 deemed a reference to the Secretary defined in section 1001 of this Act and any

467 reference to a State plan or State Medicaid program is deemed a reference to the

468 HumanCare Program): (1) Section 1128 (relating to exclusion of individuals and

469 entities). (2) Section 1128A (relating to civil monetary penalties). (3) Section

470 1128B (relating to criminal penalties). (4) Section 1124 (relating to disclosure

471 of ownership and related information). (5) Section 1126 (relating to disclosure of

472 certain owners).

473

474 TITLE V - QUALITY AND OVERSIGHT

475 Sec. 501. Quality standards. - The Secretary shall establish national minimum

476 standards for healthcare quality, patient outcomes, and patient experience. The

477 Secretary shall publish annual performance reports of the HumanCare program, make

478 them publicly available, and update benchmarks periodically. Standards shall

479 include incentives for providers achieving superior outcomes in underserved areas.

480 (a) In general. - The Secretary shall establish quality standards for the delivery

481 of health care services and items under this Act.

482 (b) Quality review system. - The Secretary shall establish a quality review system

483 that includes periodic quality reviews of the care provided to beneficiaries of

484 the HumanCare Program by each provider.

485 (c) Role of health care organizations. - The Secretary may incorporate peer review

486 requirements, standards, and processes utilized by private accrediting

487 organizations (such as the Joint Commission and the National Committee for

488 Quality Assurance) and other health care organizations and may coordinate with

489 such organizations to avoid duplication of efforts.

490 (d) Monitoring and enforcement. - The Secretary shall provide for a process to

491 ensure quality monitoring and enforcement that includes the following: (1)

492 ESTABLISHMENT OF COMPLAINT PROCESS. - There shall be established a process for the

493 receipt and investigation of patient complaints against providers, including the

494 imposition of corrective actions or changes that are to be implemented pursuant

495 to such complaint. (2) EXCEPTION AUTHORITY. - Notwithstanding any other provision

496 of this Act, the Secretary may grant exceptions to a State to the national quality

497 standards established under this section if - (A) the State establishes an

498 enforceable plan for quality review that is equal to or greater than the quality

499 requirements under this Act; or (B) the State has received, prior to the date of

500 the enactment of this Act, a waiver from the Centers for Medicare & Medicaid

501 Services of certain Medicare requirements in order to carry out a Medicare

502 demonstration or pilot project and the Secretary determines that such project

503 requires the granting of an exception under this subparagraph.

504 (e) Quality incentives. - The Secretary shall establish a system of incentives,

505 through payment differentials or bonuses, to promote the delivery of high-quality

506 health care.

507 Sec. 502. Equity and accessibility. - The Secretary shall ensure equitable

508 distribution of care across regions, demographics, income levels, and underserved

509 communities, including rural areas, tribal lands, and territories.

510 (a) Evaluating data collection approaches. - The Secretary shall evaluate approaches

511 for the collection of data under this Act, to be performed in conjunction with

512 existing quality reporting requirements and programs under this Act, that allow

513 for the ongoing, accurate, and timely collection of data on disparities in health

514 care services and performance on the basis of race, ethnicity, gender, geography,

515 socioeconomic status, or other similar factors.

516 (b) Data collection and reporting. - (1) In general. - In carrying out this

517 subsection, the Secretary shall - (A) collect and report data for services

518 furnished under this Act on the basis of race, ethnicity, gender, geography,

519 socioeconomic status, or other similar factors; and (B) implement data collection

520 and reporting activities in accordance with the approaches evaluated under

521 subsection (a) and the standards established under section 3101(a) of the Public

522 Health Service Act (42 U.S.C. 300kk(a)).

523 (2) Data on underserved populations. - In carrying out this subsection, with

524 respect to services furnished under this Act for underserved populations, the

525 Secretary shall - (A) collect and report data for services furnished under this Act

526 on the basis of race, ethnicity, gender, geography, socioeconomic status, or other

527 similar factors; and (B) implement data collection and reporting activities in

528 accordance with the approaches evaluated under subsection (a) and the standards

529 established under section 3101(a) of the Public Health Service Act (42 U.S.C.

530 300kk(a)).

531 (c) Consultation. - In carrying out this section, the Secretary shall consult with

532 governmental agencies, self-accreditation organizations, and private entities in

533 the implementation of the identified approaches under subsection (a).

534

535 TITLE VI - HEALTH BUDGET AND PAYMENTS

536 Sec. 601. National health budget. - A unified national budget shall be developed

537 annually to finance benefits, operations, provider payments, and system

538 infrastructure under HumanCare. The budget shall include a $1.24 trillion surplus

539 for debt reduction, infrastructure, research, and jobs.

540 (a) National health budget. - (1) In general. - By not later than September 1 of each

541 year, beginning with the year prior to the date on which benefits first become

542 available as described in section 106, the Secretary shall establish a national

543 health budget, which specifies a budget for the total expenditures to be made for

544 covered health care items and services under this Act.

545 (2) Division of budget into components. - The national health budget shall consist

546 of the following components: (A) An operating budget. (B) A capital expenditures

547 budget. (C) A special projects budget for purposes of allocating funds for capital

548 expenditures and staffing needs of providers located in rural or medically

549 underserved areas (as defined in section 330(b)(3) of the Public Health Service

550 Act (42 U.S.C. 254b(b)(3))), including areas designated as health professional

551 shortage areas (as defined in section 332(a) of the Public Health Service Act (42

552 U.S.C. 254e(a))). (D) Quality assessment activities under title V. (E) Health

553 professional education expenditures. (F) Administrative costs, including costs

554 related to the operation of regional offices. (G) A reserve fund to respond to the

555 costs of treating an epidemic, pandemic, natural disaster, or other such health

556 emergency, or market-shift adjustments related to patient volume. (H) Prevention

557 and public health activities. (I) Surplus. $1.24 trillion for debt,

558 infrastructure, research, jobs.

559 (3) Allocation among components. - The Secretary shall allocate the funds received

560 for purposes of carrying out this Act among the components described in paragraph

561 (2) in a manner that ensures - (A) that the operating budget allows for every

562 participating provider in the HumanCare Program to meet the needs of their

563 respective patient populations; (B) that the special projects budget is

564 sufficient to meet the health care needs within areas described in paragraph

565 (2)(C) through the construction, renovation, and staffing of health care

566 facilities in a reasonable timeframe; (C) a fair allocation for quality

567 assessment activities; and (D) that the health professional education expenditure

568 component is sufficient to provide for the amount of health professional education

569 expenditures sufficient to meet the need for covered health care services,

570 ensuring $1.24 trillion surplus.

571 (4) Regional allocation. - The Secretary shall annually provide each regional

572 office with an allotment the Secretary determines appropriate for purposes of

573 carrying out this Act in such region, including payments to providers in such

574 region, capital expenditures in such region, special projects in such region,

575 health professional education in such region, administrative expenses in such

576 region, and prevention and public health activities in such region.

577 (5) Operating budget. - The operating budget described in paragraph (2)(A) shall be

578 used for - (A) payments to institutional providers pursuant to section 602; and (B)

579 payments to individual providers pursuant to section 602.

580 (6) Capital expenditures budget. - The capital expenditures budget described in

581 paragraph (2)(B) shall be used for - (A) the construction or renovation of health

582 care facilities, excluding congregate or segregated facilities for individuals

583 with disabilities who receive long-term care services and support; and (B) major

584 equipment purchases.

585 (7) Special projects budget. - The special projects budget shall be used for the

586 construction of new facilities, major equipment purchases, and staffing in rural

587 or medically underserved areas (as defined in section 330(b)(3) of the Public

588 Health Service Act (42 U.S.C. 254b(b)(3))), including areas designated as health

589 professional shortage areas (as defined in section 332(a) of the Public Health

590 Service Act (42 U.S.C. 254e(a))).

591 (8) Temporary worker assistance. - (A) In general. - For up to 5 years following the

592 date on which benefits first become available as described in section 106(a), at

593 least 1 percent of the budget shall be allocated to programs providing assistance

594 to workers who perform functions in the administration of the health insurance

595 system, or related functions within health care institutions or organizations who

596 may be affected by the implementation of this Act and who may experience economic

597 dislocation as a result of the implementation of this Act. (B) Clarification. - 

598 Assistance described in subparagraph (A) shall include wage replacement,

599 retirement benefits, job training, and education benefits.

600 (b) Definitions. - In this section: (1) Capital expenditures. - The term “capital

601 expenditures” means expenses for the purchase, lease, construction, or renovation

602 of capital facilities and for major equipment. (2) Health professional education

603 expenditures. - The term “health professional education expenditures” means

604 expenditures in hospitals and other health care facilities to cover costs

605 associated with teaching and related research activities, including the impact of

606 workforce diversity on patient outcomes.

607 Sec. 602. Provider payments. - The Secretary shall pay participating providers

608 directly using negotiated rates, global budgets, or value-based payment models,

609 ensuring fair compensation and efficient Federal resource use. Payments shall be

610 made weekly via the HHS app.

611 (a) In general. - Not later than the beginning of each fiscal quarter during which

612 an institutional provider of care (including hospitals, skilled nursing

613 facilities, Federally qualified health centers, home health agencies, and

614 independent dialysis facilities) is to furnish items and services under this Act,

615 the Secretary shall pay to such institutional provider a lump sum in accordance

616 with the succeeding provisions of this subsection and consistent with the

617 following: (1) Payment in full. - Such payment shall be considered as payment in

618 full for all operating expenses for items and services furnished under this Act,

619 whether inpatient or outpatient, by such provider for such quarter, including

620 outpatient or any other care provided by the institutional provider or provided by

621 any health care provider who provided items and services pursuant to an agreement

622 paid through the global budget as described in paragraph (3), weekly via HHS app.

623 (2) Quarterly review. - The regional director, on a quarterly basis, shall review

624 whether requirements of the institutional provider’s participation agreement and

625 negotiated global budget have been performed and shall determine whether

626 adjustments to such institutional provider’s payment are warranted. This review

627 shall include consideration for additional funding necessary for unanticipated

628 items and services for individuals with complex medical needs or market-shift

629 adjustments related to patient value. The review shall also include an assessment

630 of any adjustments made to ensure that accuracy and need for adjustment was

631 appropriate.

632 (3) Agreements for salaried payments for certain providers. - Certain group

633 practices and other health care providers, as determined by the Secretary, with

634 agreements to provide items and services at a specified institutional provider

635 paid a global budget under this subsection may elect to be paid through such

636 institutional provider’s global budget in lieu of payment under this title. Any - 

637 (A) individual health care professional of such group practice or other provider

638 receiving payment through an institutional provider’s global budget shall be paid

639 on a salaried basis that is equivalent to salaries or other compensation rates

640 negotiated for individual health care professionals of such institutional

641 provider; and (B) any group practice or other health care provider that receives

642 payment through an institutional provider global budget under this paragraph

643 shall be subject to the same reporting and disclosure requirements of the

644 institutional provider.

645 (b) Payment amount. - (1) In general. - The amount of each payment to a provider

646 described in subsection (a) shall be determined before the start of each fiscal

647 year through negotiations between the provider and the regional director with

648 jurisdiction over such provider. Such amount shall be based on factors specified

649 in paragraph (2).

650 (2) Payment factors. - Payments negotiated pursuant to paragraph (1) shall take

651 into account, with respect to a provider - (A) the historical volume of services

652 provided for each item and services in the previous 3-year period; (B) the actual

653 expenditures of such provider in such provider’s most recent cost report under

654 title XVIII of the Social Security Act for each item and service compared to - (i)

655 such expenditures for other institutional providers in the director’s

656 jurisdiction; and (ii) normative payment rates established under comparative

657 payment rate systems, including any adjustments, for such items and services; (C)

658 projected changes in the volume and type of items and services to be furnished;

659 (D) wages for employees, including any necessary increases mandatory minimum safe

660 registered nurse-to-patient ratios and optimal staffing levels for physicians and

661 other health care workers; (E) the provider’s maximum capacity to provide items

662 and services; (F) education and prevention programs; (G) permissible adjustment

663 to the provider’s operating budget due to factors such as - (i) an increase in

664 primary or specialty care access; (ii) efforts to decrease health care

665 disparities in rural or medically underserved areas; (iii) a response to emergent

666 epidemic conditions; and (iv) proposed new and innovative patient care programs

667 at the institutional level; and (H) any other factor determined appropriate by the

668 Secretary.

669 (3) Limitation. - Payment amounts negotiated pursuant to paragraph (1) may not - (A)

670 take into account capital expenditures of the provider or any other expenditure

671 not directly associated with the provision of items and services by the provider

672 to an individual; (B) be used by a provider for capital expenditures or such other

673 expenditures; (C) exceed the provider’s capacity to provide care under this Act;

674 or (D) be used to pay or otherwise compensate any board member, executive, or

675 administrator of the institutional provider who has any interest or relationship

676 prohibited under section 301(b)(2) of this Act or disclosed under section 301 of

677 this Act.

678 (4) Operating expenses. - For purposes of this subsection, “operating expenses” of

679 a provider include the following: (A) The cost of all items and services

680 associated with the provision of inpatient care and outpatient care, including the

681 following: (i) Wages and salary costs for physicians, nurses, and other health

682 care practitioners employed by an institutional provider, including mandatory

683 minimum safe registered nurse-to-patient staffing ratios and optimal staffing

684 levels for physicians and other healthcare workers. (ii) Wages and salary costs

685 for all ancillary staff and services. (iii) Costs of all pharmaceutical products

686 administered by health care clinicians at the institutional provider’s facilities

687 or through services provided in accordance with State licensing laws or

688 regulations under which the institutional provider operates. (iv) Purchasing costs

689 for nutrition sustenance requirements provided to inpatients as part of their care

690 regimen. (v) Costs for all hospital-based outpatient clinics and all other

691 facilities or entities offering such outpatient services that are operated by the

692 institutional provider. (B) Costs associated with satellite clinics owned or

693 operated by the institutional provider that are not physically attached to the

694 main hospital campus and maintain separate financial accounting systems. (C)

695 Costs associated with operating ambulance services owned by the institutional

696 provider, if such services are required by State law before the individual can be

697 treated at the provider’s facilities. (D) Costs associated with all medical

698 education and training provided by the institutional provider, including - (i)

699 salaries for interns and residents; (ii) costs associated with Graduate Medical

700 Education funding provided by the Centers for Medicare & Medicaid Services; (iii)

701 salaries and fringe benefits for physicians employed by the institutional

702 provider; and (iv) continuing medical education for practitioners. (E) All costs

703 related to the operation of an institution-wide information technology

704 infrastructure related to medical records, billing, and financial accounting,

705 including the purchasing and maintenance costs for information technology,

706 depreciation costs, and other costs associated with changes in policy or capital

707 purchases and leases.

708 (5) Prohibition against co-mingling operating funds with capital expenditures

709 funds. - An institutional provider receiving payment under this section for a fiscal

710 year shall not co-mingle funds for operating expenses with funds for capital

711 expenditures or (if such provider is part of a larger institutional system that

712 provides such capital expenditure funding for member institutions) expend funds

713 from their operating budget to subsidize capital expenditures by the institutional

714 system. An institutional provider that violates the requirement under this

715 paragraph shall be subject to sanctions pursuant to sections 301(b) and 403 of

716 this Act. An institutional provider that has co-mingled funds during the 5-year

717 period prior to the date of the enactment of this Act shall be subject to

718 sanctions at the discretion of the Secretary pursuant to sections 301(b) and 403

719 of this Act.

720 (c) Incorporation of existing regulations. - The Secretary shall incorporate into

721 the payment system under this section all anti-discrimination, workers’ rights,

722 consumer protections, and provider and facility licensing and certification

723 standards applicable to providers under the Medicare program under title XVIII of

724 the Social Security Act (42 U.S.C. 1395 et seq.), as well as any additional

725 anti-discrimination standards the Secretary determines appropriate.

726 (d) In the case of an individual provider, the Secretary shall establish a

727 national fee schedule that is fair and sufficient to ensure access to the full

728 range of items and services provided under this Act and to ensure a sufficient

729 supply of providers. Payments weekly via HHS app.

730 Sec. 603. Funding sources. - The program shall be funded through: (a) existing

731 allocations within HHS and the Medicare program; (b) new excise taxes on products

732 designated by Congress as “unhealthy” (to be defined by statute), including a

733 graduated tax up to 100% on junk food, unhealthy products, and cannabis (100%-420%

734 based on THC levels), phased in over 3 years; alcohol taxes tripled; tobacco taxes

735 increased by $5 per pack; e-cigarettes taxed at 100%; and (c) efficiency gains

736 achieved through AI-driven fraud control, administrative streamlining, and

737 consolidation of redundant programs; plus a FICA Medicare contribution adjustment

738 from 1.45% to 4.35% for employees and employers, totaling $667B in new revenues.

739 Taxes shall generate approximately $667 billion annually, phased in over three

740 years to allow industry adaptation.

741

742 TITLE VII - UNIVERSAL MEDICARE TRUST FUND

743 There is established in the Treasury of the United States a “Universal Medicare

744 Trust Fund” to receive, hold, and disburse funds appropriated and allocated under

745 this Act, ensuring program solvency, transparency, and accountability. The Fund

746 shall be managed by the Secretary, with annual audits by the Comptroller General

747 to ensure transparency and solvency.

748 (a) In general. - There is hereby created on the books of the Treasury of the United

749 States a trust fund to be known as the Universal Medicare Trust Fund (in this

750 section referred to as the “Trust Fund”). The Trust Fund shall consist of such

751 gifts and bequests as may be made and such amounts as may be deposited in, or

752 appropriated to, such Trust Fund as provided in this Act.

753 (b) Appropriations into trust fund. - (1) Taxes. - There are appropriated to the

754 Trust Fund for each fiscal year beginning with the fiscal year which includes the

755 date on which benefits first become available as described in section 106, out of

756 any moneys in the Treasury not otherwise appropriated, amounts equivalent to 100

757 percent of the net increase in revenues to the Treasury which is attributable to

758 the amendments made by sections 801 and 902. The amounts appropriated by the

759 preceding sentence shall be transferred from time to time (but not less frequently

760 than monthly) from the general fund in the Treasury to the Trust Fund, such

761 amounts to be determined on the basis of estimates by the Secretary of the

762 Treasury of the taxes paid to or deposited into the Treasury, and proper

763 adjustments shall be made in amounts subsequently transferred to the extent prior

764 estimates were in excess of or were less than the amounts that should have been so

765 transferred. Funds from... FICA increase (1.45% to 4.35%), junk food (100%),

766 alcohol (x3), tobacco (+$5/pack), cannabis (100%-420%), e-cigarettes (100%),

767 totaling $667B, plus $3.3T HHS/CMS budgets.

768 (2) Current program receipts. - (A) Initial year. - Notwithstanding any other

769 provision of law, there is appropriated to the Trust Fund for the fiscal year

770 containing January 1 of the first year following the date of the enactment of this

771 Act, an amount equal to the aggregate amount appropriated for the preceding fiscal

772 year for the following (increased by the consumer price index for all urban

773 consumers for the fiscal year involved): (i) The Medicare program under title

774 XVIII of the Social Security Act (other than amounts attributable to any premiums

775 under such title). (ii) The Medicaid program under State plans approved under

776 title XIX of such Act. (iii) The Federal Employees Health Benefits program, under

777 chapter 89 of title 5, United States Code. (iv) The TRICARE program, under chapter

778 55 of title 10, United States Code. (v) The maternal and child health program

779 (under title V of the Social Security Act), vocational rehabilitation programs,

780 programs for drug abuse and mental health services under the Public Health Service

781 Act, programs providing general hospital or medical assistance, and any other

782 Federal program identified by the Secretary, in consultation with the Secretary of

783 the Treasury, to the extent the programs provide for payment for health services

784 the payment of which may be made under this Act.

785 (B) Subsequent years. - Notwithstanding any other provision of law, there is

786 appropriated to the trust fund for the fiscal year containing January 1 of the

787 second year following the date of the enactment of this Act, and for each fiscal

788 year thereafter, an amount equal to the amount appropriated to the Trust Fund for

789 the previous year, adjusted for reductions in costs resulting from the

790 implementation of this Act, changes in the consumer price index for all urban

791 consumers for the fiscal year involved, and other factors determined appropriate

792 by the Secretary.

793 (3) Restrictions shall not apply. - Any other provision of law in effect on the date

794 of enactment of this Act restricting the use of Federal funds for any reproductive

795 health service shall not apply to monies in the Trust Fund.

796 (c) Incorporation of provisions. - The provisions of subsections (b) through (i) of

797 section 1817 of the Social Security Act (42 U.S.C. 1395i) shall apply to the Trust

798 Fund under this section in the same manner as such provisions applied to the

799 Federal Hospital Insurance Trust Fund under such section 1817, except that, for

800 purposes of applying such subsections to this section, the “Board of Trustees of

801 the Trust Fund” shall mean the “Secretary”.

802 (d) Transfer of funds. - Any amounts remaining in the Federal Hospital Insurance

803 Trust Fund under section 1817 of the Social Security Act (42 U.S.C. 1395i) or the

804 Federal Supplementary Medical Insurance Trust Fund under section 1841 of such Act

805 (42 U.S.C. 1395t) after the payment of claims for items and services furnished

806 under title XVIII of such Act have been completed, shall be transferred into the

807 Universal Medicare Trust Fund under this section.

808

809 TITLE VIII - CONFORMING AMENDMENTS

810 Existing federal health programs, including the Medicare program under title XVIII

811 of the Social Security Act, the Medicaid program under title XIX of the Social

812 Security Act, and the Children’s Health Insurance Program under title XXI of the

813 Social Security Act, shall be transitioned into the HumanCare program over the

814 two-year period specified in Section 901. The Secretary shall issue guidance for

815 seamless integration, including protections for current beneficiaries.

816 (a) Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP). - 

817 (1) In general. - Notwithstanding any other provision of law and with respect to an

818 individual eligible to enroll under this Act, subject to paragraphs (2) and (3) - 

819 (A) no benefits shall be available under title XVIII of the Social Security Act

820 for any item or service furnished beginning on the date that is 2 years after the

821 date of the enactment of this Act; (B) no individual is entitled to medical

822 assistance under a State plan approved under title XIX of such Act for any item

823 or service furnished on or after such date; (C) no individual is entitled to

824 medical assistance under a State child health plan under title XXI of such Act for

825 any item or service furnished on or after such date; and (D) no payment shall be

826 made to a State under section 1903(a) or 2105(a) of such Act with respect to

827 medical assistance or child health assistance for any item or service furnished on

828 or after such date.

829 (2) Transition. - In the case of inpatient hospital services and extended care

830 services during a continuous period of stay which began before the effective date

831 of benefits under section 106, and which had not ended as of such date, for which

832 benefits are provided under title XVIII of the Social Security Act, under a State

833 plan under title XIX of such Act, or under a State child health plan under title

834 XXI of such Act, the Secretary shall provide for continuation of benefits under

835 such title or plan until the end of the period of stay.

836 (3) School programs. - All school related health programs, centers, initiatives,

837 services, or other activities or work provided under title XIX or title XXI of the

838 Social Security Act as of January 1, 2019, shall be continued and covered by the

839 HumanCare Program.

840 (b) Federal employees health benefits program. - No benefits shall be made

841 available under chapter 89 of title 5, United States Code, for any part of a

842 policy, contract, or plan year that occurs on or after the date on which benefits

843 are first available under section 106(a).

844 (c) TRICARE. - No benefits shall be made available under sections 1071 through

845 1110b of title 10, United States Code for items or services furnished on or after

846 the date on which benefits are first available under section 106(a).

847 (d) Treatment of benefits for veterans and Native Americans. - Nothing in this Act

848 shall affect the eligibility of veterans for the medical benefits and services

849 provided under title 38, United States Code, or of Indians for the medical

850 benefits and services provided by or through the Indian Health Service.

851

852 TITLE IX - TRANSITION AND IMPLEMENTATION

853 Sec. 901. Two-year transition. - The Secretary shall coordinate a phased two-year

854 transition period for enrollees, providers, state agencies, and administrative

855 systems to integrate into HumanCare, ensuring continuity of care and minimal

856 disruption.

857 Notwithstanding any other provision of law, the following transition rules shall

858 apply: (1) First year of HumanCare transition. - For the first year in which

859 benefits are available under section 106(a): (A) Individuals who have attained age

860 55, or who are a pregnant woman or a child (as such terms are defined in section

861 902(c)) shall be deemed to meet the requirement of section 102(a). (B) The

862 premiums, cost-sharing, and benefits under title XVIII of the Social Security Act

863 shall continue to apply to the extent not inconsistent with this Act. (C) The

864 Secretary shall establish a process for individuals described in subparagraph (A)

865 to enroll for benefits under this Act. Such process shall begin not later than 3

866 months before the beginning of such first year.

867 (2) Second year of HumanCare transition. - For the second year in which benefits

868 are available under section 106(a), individuals who have attained age 45 shall be

869 deemed to meet the requirement of section 102(a).

870 Sec. 902. Oversight reporting. - The Secretary shall submit annual reports to

871 Congress detailing program implementation progress, program surpluses, cost

872 savings, fraud reduction metrics, coverage expansion statistics, provider

873 participation data, and other performance indicators. Reports shall include

874 progress toward $1.24 trillion surplus and job retraining for displaced

875 administrative workers.

876

877 TITLE X - DEFINITIONS, SEVERABILITY AND RULES OF CONSTRUCTION

878 Sec. 1001. Definitions. - In this Act:

879 (1) “Secretary” means the Secretary of Health and Human Services.

880 (2) “HumanCare” means the national health insurance program established under

881 this Act.

882 (3) “Participating provider” means a healthcare provider meeting the requirements

883 under this Act and participating in HumanCare.

884 (4) “Signature Doctor” means a participating provider who offers premium services

885 above standard rates consistent with Section 203.

886 (5) “State” means each of the 50 States, the District of Columbia, and any U.S.

887 territory designated by the Secretary.

888 (6) “HumanCare App” means the AI-powered HHS application established under

889 Section 402.

890 (7) 'Responsible AI' means AI systems governed by principles of fairness,

891 accountability, transparency, and safety, as defined by the Secretary in

892 regulations.

893 Sec. 1002. Severability. - If any provision of this Act, or the application thereof

894 to any person or circumstance, is held invalid, the remainder of this Act and its

895 application to other persons or circumstances shall not be affected thereby.

896 Sec. 1003. Rules of construction. - For purposes of this Act:

897 (a) Nothing in this Act shall be construed to diminish or pre-empt any state law

898 that provides greater healthcare protections or benefits than those provided under

899 this Act.

900 (b) The singular includes the plural, and the plural the singular; the masculine,

901 feminine, and neuter include each other.

902 (c) The terms “means” and “includes” are to be interpreted according to their

903 customary legislative usage and consistent with the guidelines provided by the

904 Office of the Legislative Counsel.

905

906 TITLE XI - FISCAL NOTES AND PILOT PROGRAMS

907 Sec. 1101. CBO Scoring. - The Director of the Congressional Budget Office shall

908 provide a cost estimate within 90 days of enactment.

909 Sec. 1102. Pilot Programs. - The Secretary may implement state-based pilots for AI

910 integration.