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Health Maintenance Organization Amendments of 1978

Public Law 95-559 · S. 2534 · 95th Congress · began in the Senate

Signed by Jimmy Carter (D) on Nov 1, 1978 · Health

Sponsor: Sen. Richard Schweiker (R-PA)

Cosponsors (12): Sen. Ted Kennedy,

Passage votesYeaNay

  • HouseRecorded vote: 309 yea, 33 nay309–33
  • SenateMethod not stated
Data notes

The final version of the law, as each chamber passed it. A chamber that passed it by voice vote or unanimous consent has no count. “Method not stated” means the record does not say how the chamber voted. Where the record has a member-by-member vote, the “Who voted for it” section shows who voted yea.

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Summary

The Congressional Research Service’s plain-language summary of what the law does.

Health Maintenance Organization Amendments - Extends the authorization of appropriations under the Public Health Service Act through fiscal year 1981 for: (1) grants and contracts for surveys of the feasibility of establishing, operating or expanding health maintenance organizations (HMO's); and (2) grants, contracts, loans and loan guarantees for planning and initial development costs related to the establishment of HMO's.

Increases the maximum dollar limit for initial development project grants, contracts, and loan guarantees for HMO's from $1,000,000 to $2,000,000, effective September 30, 1979. Increases from one to three years the time within which grants are available for the planning and initial operation of HMO's after a contract for an HMO has been made.

Increases the aggregate amount of principal of loans which may be made or guaranteed, or both, for the initial costs of operation of an HMO to $4,000,000 in total or $2,000,000 annually provided the Secretary of Health, Education, and Welfare makes a written determination of need.

Authorizes the Secretary to make loans to HMO's for projects for the acquisition or construction of ambulatory health care facilities and for the acquisition of equipment for facilities acquired or constructed with such loans and to guarantee to lenders: (1) their loans to nonprofit private HMO's for such projects; and (2) their loans to private HMO's for such projects which will serve medically underserved populations.

Authorizes a qualified HMO to receive a grant or loan guarantee for the expansion of its services or the significant expansion of its membership or the area served by it.

Requires the Secretary to establish a National Health Maintenance Organization Intern Program to provide training to individuals to become administrators of HMO's or to assume other managerial positions with HMO's.

Authorizes the Secretary to provide technical assistance through grants: (1) to entities for feasibility surveys to determine the feasibility of developing or expanding HMO's; (2) to entities for the initial development costs of HMO's; (3) to entities intending to become a qualified HMO; and (4) to HMO's.

Directs employers who are required to offer membership in a HMO to their employees to arrange, at the option of the employee, for payroll deductions from such employees' salary for membership in a qualified HMO.

Requires each HMO to annually file with the Secretary specified financial information. Requires the Secretary to annually file a report with Congress based on the information gathered from such financial disclosures.

Provides that any false statement or representation made knowingly and willingly in connection with any such financial statement shall be a felony punishable by a fine of $25,000 and/or five years imprisonment.

Requires public HMO's to have an advisory Board to the policymaking body operating the organization to which policymaking authority for the organization may be delegated.

Authorizes a HMO to seek reimbursement for the cost of services provided to a member entitled to benefits under a workmen's compensation law or an insurance policy.

Provides that a HMO need only make a good faith effort to provide health services in the event of a major disaster, war, riot, civil disturbance, or other similar event.

Provides that a HMO need not provide a basic health service which the Secretary determines is unusual or infrequently provided and not necessary for the protection of individual health.

Requires the Comptroller General to evaluate: (1) the adequacy and effectiveness of the policy and procedures of the Secretary for the management of the grant and loan programs established under Title XIII (HMO's) of the Public Health Service Act; and (2) the adequacy of the amounts of assistance available under such Title, and to report to Congress the results of the evaluations.

Amends Title XIX (Medicaid) of the Social Security Act to make it a crime for present or former State or local employees responsible for the expenditure of substantial amounts of Medicaid funds from committing any act in relation to the State Medicaid plan.

Amends Title XI (General Provisions and Professional Standards Review) of the Social Security Act to remove HMO's from the capital expenditures limitations of the Medicare, Medicaid, and Maternal and Child Health programs of such Act.

Who voted for it

Every House member of the 95th Congress on the ideology compass. Highlighted: the 311 who voted yea on final passage. Faded: everyone else, including those who voted nay, did not vote, or had not yet taken office.

311 yea33 nay86 present or did not vote

Dimension 2
Economic left–right
More liberalMore conservative

Democrats who voted yea(222)

  • Rep. Louis StokesD-OH-21
  • Rep. Edward RoybalD-CA-25
  • Rep. Anthony BeilensonD-CA-23
  • Rep. Charlie RangelD-NY-19
  • Rep. Don EdwardsD-CA-10
  • Rep. James CormanD-CA-21
  • Rep. Frederick RichmondD-NY-14
  • Rep. Gus HawkinsD-CA-29
  • Rep. Robert GarciaD-NY-21
  • Rep. Pete StarkD-CA-9
  • Rep. Shirley ChisholmD-NY-12
  • Rep. Benjamin RosenthalD-NY-8
  • Rep. Ronald DellumsD-CA-8
  • Rep. Robert NixD-PA-2
  • Rep. Jonathan BinghamD-NY-22
  • Rep. Frank ThompsonD-NJ-4
  • Rep. George BrownD-CA-36
  • Rep. Theodore WeissD-NY-20
  • Rep. Cardiss CollinsD-IL-7
  • Rep. George DanielsonD-CA-30
  • Rep. James OberstarD-MN-8
  • Rep. Henry GonzálezD-TX-20
  • Rep. Daniel RostenkowskiD-IL-8
  • Rep. Charles DiggsD-MI-13
  • Rep. William BurlisonD-MO-10
  • Rep. John SeiberlingD-OH-14
  • Rep. Paul SimonD-IL-24
  • Rep. William FordD-MI-15
  • Rep. Richard NolanD-MN-6
  • Rep. Robert KastenmeierD-WI-2
  • Rep. David BoniorD-MI-12
  • Rep. Robert EckhardtD-TX-8
  • Rep. Peter RodinoD-NJ-10
  • Rep. John BrademasD-IN-3
  • Rep. Stephen SolarzD-NY-13
  • Rep. James HowardD-NJ-3
  • Rep. Harold JohnsonD-CA-1
  • Rep. Daniel AkakaD-HI-2
  • Rep. James WrightD-TX-12
  • Rep. Dante FascellD-FL-15
  • Rep. John DingellD-MI-16
  • Rep. William BrodheadD-MI-17
  • Rep. Henry ReussD-WI-5
  • Rep. Norman MinetaD-CA-13
  • Rep. Dave ObeyD-WI-7
  • Rep. Elizabeth HoltzmanD-NY-16
  • Rep. James ScheuerD-NY-11
  • Rep. Donald FraserD-MN-5
  • Rep. Ozzie MyersD-PA-1
  • Rep. William MoorheadD-PA-14
  • Rep. Bruce VentoD-MN-4
  • Rep. Daniel FloodD-PA-11
  • Rep. Joseph AddabboD-NY-7
  • Rep. Clement ZablockiD-WI-4
  • Rep. John MurphyD-NY-17
  • Rep. Sidney YatesD-IL-9
  • Rep. Abner MikvaD-IL-10
  • Rep. Teno RoncalioD-WY
  • Rep. Barbara MikulskiD-MD-3
  • Rep. Raymond LedererD-PA-3
  • Rep. Alvin BaldusD-WI-3
  • Rep. Harold FordD-TN-8
  • Rep. Robert DuncanD-OR-3
  • Rep. Harley StaggersD-WV-2
  • Rep. James BurkeD-MA-11
  • Rep. Lionel Van DeerlinD-CA-42
  • Rep. Morris UdallD-AZ-2
  • Rep. Carl PerkinsD-KY-7
  • Rep. Ed MarkeyD-MA-7
  • Rep. Frederick RooneyD-PA-15
  • Rep. Richard OttingerD-NY-24
  • Rep. Helen MeynerD-NJ-13
  • Rep. Gerry StuddsD-MA-12
  • Rep. James WeaverD-OR-4
  • Rep. Gene MaguireD-NJ-7
  • Rep. John MoakleyD-MA-9
  • Rep. Bill AlexanderD-AR-1
  • Rep. Fernand St. GermainD-RI-1
  • Rep. Morgan MurphyD-IL-2
  • Rep. Lucien NedziD-MI-14
  • Rep. Robert DrinanD-MA-4
  • Rep. John JenretteD-SC-6
  • Rep. John MurthaD-PA-12
  • Rep. Nick RahallD-WV-4
  • Rep. Don BonkerD-WA-3
  • Rep. William LehmanD-FL-13
  • Rep. Edward BeardD-RI-2
  • Rep. Thomas SteedD-OK-4
  • Rep. John DentD-PA-21
  • Rep. Jack BrooksD-TX-9
  • Rep. Thomas DowneyD-NY-2
  • Rep. Toby MoffettD-CT-6
  • Rep. Charles VanikD-OH-22
  • Rep. Charles RoseD-NC-7
  • Rep. Bernice SiskD-CA-15
  • Rep. Christopher DoddD-CT-2
  • Rep. Gillis LongD-LA-8
  • Rep. Lindy BoggsD-LA-2
  • Rep. Neal SmithD-IA-4
  • Rep. Norm DicksD-WA-6
  • Rep. Thomas FoleyD-WA-5
  • Rep. Ray ThorntonD-AR-4
  • Rep. Mike McCormackD-WA-4
  • Rep. William CotterD-CT-1
  • Rep. Edward PattisonD-NY-29
  • Rep. James BlanchardD-MI-18
  • Rep. Stanley LundineD-NY-39
  • Rep. Edward BolandD-MA-2
  • Rep. Lunsford PreyerD-NC-6
  • Rep. Robert MollohanD-WV-1
  • Rep. Dale KildeeD-MI-7
  • Rep. Mary OakarD-OH-20
  • Rep. Robert CornellD-WI-8
  • Rep. William NatcherD-KY-2
  • Rep. Cecil HeftelD-HI-1
  • Rep. Matthew McHughD-NY-27
  • Rep. Robert EdgarD-PA-7
  • Rep. Donald PeaseD-OH-13
  • Rep. Robert RoeD-NJ-8
  • Rep. Henry NowakD-NY-37
  • Rep. Joseph GaydosD-PA-20
  • Rep. Robert YoungD-MO-2
  • Rep. Herbert HarrisD-VA-8
  • Rep. Gladys SpellmanD-MD-5
  • Rep. Mark HannafordD-CA-34
  • Rep. James HanleyD-NY-32
  • Rep. Joseph FisherD-VA-10
  • Rep. Koln McKayD-UT-1
  • Rep. John KrebsD-CA-17
  • Rep. Michael BlouinD-IA-2
  • Rep. Albert GoreD-TN-4
  • Rep. Bob CarrD-MI-6
  • Rep. Adam BenjaminD-IN-1
  • Rep. Jerome TraxlerD-MI-8
  • Rep. Glenn AndersonD-CA-32
  • Rep. Kenneth HollandD-SC-5
  • Rep. Leo ZeferettiD-NY-15
  • Rep. Butler DerrickD-SC-3
  • Rep. David CornwellD-IN-8
  • Rep. Lester WolffD-NY-6
  • Rep. Joseph MinishD-NJ-11
  • Rep. Timothy WirthD-CO-2
  • Rep. Dick GephardtD-MO-3
  • Rep. Ed JonesD-TN-7
  • Rep. Berkley BedellD-IA-6
  • Rep. James LloydD-CA-35
  • Rep. Max BaucusD-MT-1
  • Rep. Lee HamiltonD-IN-9
  • Rep. Austin MurphyD-PA-22
  • Rep. Bo GinnD-GA-1
  • Rep. George MahonD-TX-19
  • Rep. John BreckinridgeD-KY-6
  • Rep. Walter JonesD-NC-1
  • Rep. John CavanaughD-NE-2
  • Rep. Ronnie FlippoD-AL-5
  • Rep. Tom HarkinD-IA-5
  • Rep. Clarence LongD-MD-2
  • Rep. Patricia SchroederD-CO-1
  • Rep. Tom BevillD-AL-4
  • Rep. Jake PickleD-TX-10
  • Rep. Ike SkeltonD-MO-4
  • Rep. Mendel DavisD-SC-1
  • Rep. Wyche FowlerD-GA-5
  • Rep. Martha KeysD-KS-2
  • Rep. Romano MazzoliD-KY-3
  • Rep. Joseph EarlyD-MA-3
  • Rep. Ed JenkinsD-GA-9
  • Rep. Jerome AmbroD-NY-3
  • Rep. Walter FlowersD-AL-7
  • Rep. Leon PanettaD-CA-16
  • Rep. Samuel StrattonD-NY-28
  • Rep. Don FuquaD-FL-2
  • Rep. Jack HightowerD-TX-13
  • Rep. Theodore RisenhooverD-OK-2
  • Rep. James MattoxD-TX-5
  • Rep. Jamie WhittenD-MS-1
  • Rep. Abraham KazenD-TX-23
  • Rep. Peter KostmayerD-PA-8
  • Rep. Les AuCoinD-OR-1
  • Rep. Philip SharpD-IN-10
  • Rep. Paul RogersD-FL-11
  • Rep. Gus YatronD-PA-6
  • Rep. Norman D’AmoursD-NH-1
  • Rep. Ike AndrewsD-NC-4
  • Rep. Bill HefnerD-NC-8
  • Rep. Carroll HubbardD-KY-1
  • Rep. Floyd FithianD-IN-2
  • Rep. Billy EvansD-GA-8
  • Rep. Vonno GudgerD-NC-11
  • Rep. Robert KruegerD-TX-21
  • Rep. James MannD-SC-4
  • Rep. Kika de la GarzaD-TX-15
  • Rep. Allen ErtelD-PA-17
  • Rep. Druie BarnardD-GA-10
  • Rep. Charles WhitleyD-NC-3
  • Rep. Otis PikeD-NY-1
  • Rep. Richard WhiteD-TX-16
  • Rep. William HughesD-NJ-2
  • Rep. David BowenD-MS-2
  • Rep. Thomas LukenD-OH-2
  • Rep. James JonesD-OK-1
  • Rep. Marilyn LloydD-TN-3
  • Rep. Jack BrinkleyD-GA-3
  • Rep. Elliott LevitasD-GA-4
  • Rep. William ChappellD-FL-4
  • Rep. William NicholsD-AL-3
  • Rep. Daniel GlickmanD-KS-4
  • Rep. John BreauxD-LA-7
  • Rep. Wes WatkinsD-OK-3
  • Rep. Thomas HuckabyD-LA-5
  • Rep. Lawrence FountainD-NC-2
  • Rep. Robert GammageD-TX-22
  • Rep. Dale MilfordD-TX-24
  • Rep. David EvansD-IN-6
  • Rep. Glenn EnglishD-OK-6
  • Rep. William PoageD-TX-11
  • Rep. Sam HallD-TX-1
  • Rep. John FlyntD-GA-6
  • Rep. Sonny MontgomeryD-MS-3
  • Rep. Andrew JacobsD-IN-11
  • Rep. Ronald MottlD-OH-23
  • Rep. David SatterfieldD-VA-3

Republicans who voted yea(89)

  • Rep. Charles WhalenR-OH-3
  • Rep. Bill GreenR-NY-18
  • Rep. Newton SteersR-MD-8
  • Rep. Silvio ConteR-MA-1
  • Rep. Pete McCloskeyR-CA-12
  • Rep. Stewart McKinneyR-CT-4
  • Rep. Frank HortonR-NY-34
  • Rep. Matthew RinaldoR-NJ-12
  • Rep. Harold HollenbeckR-NJ-9
  • Rep. Margaret HecklerR-MA-10
  • Rep. Benjamin GilmanR-NY-26
  • Rep. Joseph McDadeR-PA-10
  • Rep. Marc MarksR-PA-24
  • Rep. Tim CarterR-KY-5
  • Rep. John BuchananR-AL-6
  • Rep. Donald MitchellR-NY-31
  • Rep. William WalshR-NY-33
  • Rep. Millicent FenwickR-NJ-5
  • Rep. Thomas RailsbackR-IL-19
  • Rep. Mark AndrewsR-ND
  • Rep. John AndersonR-IL-16
  • Rep. Joel PritchardR-WA-1
  • Rep. Jack EdwardsR-AL-1
  • Rep. Jim JohnsonR-CO-4
  • Rep. Jim JeffordsR-VT
  • Rep. Hamilton FishR-NY-25
  • Rep. Paul FindleyR-IL-20
  • Rep. Carl PursellR-MI-2
  • Rep. William WamplerR-VA-9
  • Rep. Ronald SarasinR-CT-5
  • Rep. William HarshaR-OH-6
  • Rep. Don YoungR-AK
  • Rep. David EmeryR-ME-1
  • Rep. Harold SawyerR-MI-5
  • Rep. Philip RuppeR-MI-11
  • Rep. Bruce CaputoR-NY-23
  • Rep. Ralph RegulaR-OH-16
  • Rep. George O’BrienR-IL-17
  • Rep. Donald ClausenR-CA-2
  • Rep. Thomas EvansR-DE
  • Rep. John DuncanR-TN-2
  • Rep. Jim LeachR-IA-1
  • Rep. John RhodesR-AZ-1
  • Rep. Robert McEwenR-NY-30
  • Rep. Charles ThoneR-NE-1
  • Rep. Chalmers WylieR-OH-15
  • Rep. William MooreR-LA-6
  • Rep. James QuillenR-TN-1
  • Rep. Tennyson GuyerR-OH-4
  • Rep. Paul TribleR-VA-1
  • Rep. Guy Vander JagtR-MI-9
  • Rep. Norman LentR-NY-4
  • Rep. Clair BurgenerR-CA-43
  • Rep. Larry WinnR-KS-3
  • Rep. Edward DerwinskiR-IL-4
  • Rep. Floyd SpenceR-SC-2
  • Rep. Robert CoughlinR-PA-13
  • Rep. Robert McCloryR-IL-13
  • Rep. Marion SnyderR-KY-4
  • Rep. Robin BeardR-TN-6
  • Rep. Willis GradisonR-OH-1
  • Rep. James ClevelandR-NH-2
  • Rep. Robert KastenR-WI-9
  • Rep. Thomas CorcoranR-IL-15
  • Rep. Charles WigginsR-CA-39
  • Rep. William FrenzelR-MN-3
  • Rep. John ErlenbornR-IL-14
  • Rep. Bob WilsonR-CA-41
  • Rep. James BroyhillR-NC-10
  • Rep. Skip BafalisR-FL-10
  • Rep. Manley ButlerR-VA-6
  • Rep. Robert LagomarsinoR-CA-19
  • Rep. Arlan StangelandR-MN-7
  • Rep. David MarriottR-UT-2
  • Rep. James MartinR-NC-9
  • Rep. Garry BrownR-MI-3
  • Rep. Robert MichelR-IL-18
  • Rep. Jack KempR-NY-38
  • Rep. Clarence BrownR-OH-7
  • Rep. John CunninghamR-WA-7
  • Rep. Richard SchulzeR-PA-5
  • Rep. Chuck GrassleyR-IA-3
  • Rep. William SteigerR-WI-6
  • Rep. Barber ConableR-NY-35
  • Rep. William GoodlingR-PA-19
  • Rep. Thomas KindnessR-OH-8
  • Rep. Carlos MoorheadR-CA-22
  • Rep. Robert DornanR-CA-27
  • Rep. Robert WalkerR-PA-16
Data notes

The House’s recorded vote on the final version of the law (roll call 1518 in Voteview), matched to the vote the record cites and checked against its totals. Positions are each member’s DW-NOMINATE score for that Congress, as on the Ideology page; left to right is more liberal to more conservative. Paired and announced yea votes count as yea. Lists follow the compass, most liberal first. A name links to a profile only for members of the current Congress. A law passed by voice vote or unanimous consent has no member list, and neither does a vote Voteview has not yet recorded.

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Committees

The committees the bill was sent to, and what each did with it.

Data notes

A committee links to its page only where it exists in the current Congress; older and renamed committees are named without a link.

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Timeline

From introduction to signing, newest first: the committees, the floor and the president. 21 actions.

  1. Nov 1, 1978Became lawBecame law · Signed by President.
  2. PresidentPresident · Public Law 95-559.
  3. Oct 30, 1978PresidentPresident · Measure presented to President.
  4. Oct 15, 1978PresidentPresident · Measure enrolled in Senate.
  5. PresidentPresident · Measure enrolled in House.
  6. Oct 14, 1978Resolving differencesResolving differences · Senate agreed to conference report.
  7. Resolving differencesResolving differences · Conference report agreed to in Senate: Senate agreed to conference report.
  8. Oct 13, 1978Resolving differencesResolving differences · House agreed to conference report, roll call #919 (309-33).House roll call 919
  9. Resolving differencesResolving differences · Conference report agreed to in House: House agreed to conference report, roll call #919 (309-33).House roll call 919
  10. Resolving differencesResolving differences · Conference report filed in House, H. Rept. 95-1784.
  11. Resolving differencesResolving differences · Conference report filed: Conference report filed in House, H. Rept. 95-1784.
  12. Oct 11, 1978Resolving differencesResolving differences · Conference scheduled in House.
  13. Oct 9, 1978Resolving differencesResolving differences · Conference scheduled in Senate.
  14. Sep 25, 1978FloorFloor · Measure passed House, amended, in lieu of H.R. 13655 (Inserted text of H.R. 12460 as passed House).
  15. FloorFloor · Measure called up by unanimous consent in House.
  16. Jul 25, 1978CommitteeCommittee · Referred to House Energy and Commerce Committee
  17. Jul 21, 1978FloorFloor · Measure passed Senate, amended, roll call #235 (71-1).Senate roll call 235
  18. FloorFloor · Measure called up by unanimous consent in Senate.
  19. May 15, 1978CommitteeCommittee · Reported by Senate Health, Education, Labor, and Pensions Committee
  20. Feb 10, 1978CommitteeCommittee · Referred to Senate Health, Education, Labor, and Pensions Committee
  21. IntroducedIntroduced · Introduced in the Senate
Data notes

Shows the introduction, each committee and subcommittee step the source dates (referral, hearings, markup, report, discharge), and the floor, conference, presidential and became-law steps. Calendar placements, messages between the chambers, amendments and committee report numbers are not shown for laws before the 108th Congress. Two entries the source lists twice are shown once.

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Official record

The bill’s full text and every action, including introduction and committee steps, are on Congress.gov. Data through Oct 7, 2026.