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H.R.676 / 111th Congress

United States National Health Care Act

Referred to the Subcommittee on Health.

Official summary

Version 00 · Introduced in House · Jan 26, 2009

United States National Health Care Act or the Expanded and Improved Medicare for All Act - Establishes the United States National Health Care (USNHC) Program to provide all individuals residing in the United States and U.S. territories with free health care that includes all medically necessary care, such as primary care and prevention, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care.

Prohibits an institution from participating unless it is a public or nonprofit institution. Allows nonprofit health maintenance organizations (HMOs) that deliver care in their own facilities to participate. Gives patients the freedom to choose from participating physicians and institutions. Prohibits a private health insurer from selling health insurance coverage that duplicates the benefits provided under this Act. Allows such insurers to sell benefits that are not medically necessary, such as cosmetic surgery benefits. Sets forth methods to pay institutional providers of care and health professionals for services. Prohibits financial incentives between HMOs and physicians based on utilization. Establishes the USNHC Trust Fund to finance the Program with amounts deposited: (1) from existing sources of government revenues for health care; (2) by increasing personal income taxes on the top 5% income earners; (3) by instituting a progressive excise tax on payroll and self-employment income; and (4) by instituting a small tax on stock and bond transactions. Transfers and appropriates to carry out this Act amounts that would have been appropriated for federal public health care programs, including Medicare, Medicaid, and the State Children's Health Insurance Program. Requires the USNHC Program to give first priority in retraining and job placement and USNHC employment transition benefits to individuals whose jobs are eliminated due to reduced administration. Requires creation of a confidential electronic patient record system. Establishes a National Board of Universal Quality and Access to provide advice on quality, access, and affordability. Provides for: (1) the eventual integration of the Indian Health Service into the Program; and (2) evaluation of the continued independence of Department of Veterans Affairs (VA) health programs.

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Who introduced it

Rep. Conyers, John, Jr. [D-MI-14] · D–MI

Committees

  • Energy and Commerce Committee
  • Natural Resources Committee
  • Ways and Means Committee
88 cosponsorship records, including any withdrawals

Actions

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  1. Referred to the Subcommittee on Health.

  2. Referred to House Natural Resources

  3. Referred to House Ways and Means

  4. Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Natural Resources, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

  5. Referred to House Energy and Commerce

  6. Introduced in House

  7. Introduced in House

Bill text & related measures

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Related bills identified by Congress.gov

No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.

Source last updated: Aug 14, 2025. Consult Congress.gov for the current record.

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Neutral evidence review

Objective

Analyze H.R.676 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.

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Fairness and public impact

Progressive lens

Examine H.R.676 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.

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Institutions and government scope

Conservative lens

Examine H.R.676 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.

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Individual rights and government power

Liberty lens

Examine H.R.676 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.

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