Sec. 601. National health budget
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By not later than September 1 of each year, beginning with the year prior to the date on which benefits first become available as described in section 106(a), the Secretary shall establish a national health budget, which specifies a budget for the total expenditures to be made for covered health care items and services under this Act. The national health budget shall consist of the following components: An operating budget. A capital expenditures budget. A special projects budget.
Quality assessment activities under title V. Health professional education expenditures. Administrative costs, including costs related to the operation of regional offices. A reserve fund. Prevention and public health activities. The Secretary shall allocate the funds received for purposes of carrying out this Act among the components described in paragraph
(2)in a manner that ensures— that the operating budget allows for every participating provider in the Medicare for All Program to meet the needs of their respective patient populations; that the special projects budget is sufficient to meet the health care needs within areas described in paragraph (2)(C) through the construction, renovation, and staffing of health care facilities in a reasonable timeframe; a fair allocation for quality assessment activities; and that the health professional education expenditure component is sufficient to provide for the amount of health professional education expenditures sufficient to meet the need for covered health care services. The Secretary shall annually provide each regional office with an allotment the Secretary determines appropriate for purposes of carrying out this Act in such region, including payments to providers in such region, capital expenditures in such region, special projects in such region, health professional education in such region, administrative expenses in such region, and prevention and public health activities in such region. The operating budget described in paragraph (2)(A) shall be used for— payments to institutional providers pursuant to section 611; and payments to individual providers pursuant to section 612. The capital expenditures budget described in paragraph (2)(B) shall be used for— the construction or renovation of health care facilities, excluding congregate or segregated facilities for individuals with disabilities who receive long-term care services and support; and major equipment purchases. The special projects budget described in paragraph (2)(C) shall be used for the purposes of allocating funds for the construction of new facilities, major equipment purchases, and staffing in rural or medically underserved areas (as defined in section 330(b)(3) of the Public Health Service Act ( 42 U.S.C. 254b(b)(3) )), including areas designated as health professional shortage areas (as defined in section 332(a) of the Public Health Service Act ( 42 U.S.C. 254e(a) )), and to address health disparities, including racial, ethnic, national origin, primary language use, age, disability, sex (including gender identity and sexual orientation), geography, or socioeconomic health disparities. For up to 5 years following the date on which benefits first become available as described in section 106(a), at least 1 percent of the budget shall be allocated to programs providing assistance to workers who perform functions in the administration of the health insurance system, or related functions within health care institutions or organizations who may be affected by the implementation of this Act and who may experience economic dislocation as a result of the implementation of this Act. Assistance described in subparagraph
(A)shall include wage replacement, retirement benefits, job training and placement, preferential hiring, and education benefits. The reserve fund described in paragraph (2)(G) shall be used to respond to the costs of an epidemic, pandemic, natural disaster, or other such health emergency, or market-shift adjustments related to patient volume. The Secretary shall annually determine the need to provide an allotment of supplemental funds to Indian Health Services, including payments to providers, capital expenditures, special projects, health professional education, administrative expenses, and prevention and public health activities. In this section: The term capital expenditures means expenses for the purchase, lease, construction, or renovation of capital facilities and for major equipment. The term health professional education expenditures means expenditures in hospitals and other health care facilities to cover costs associated with teaching and related research activities, including the impact of workforce diversity on patient outcomes.
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