Increase the tax on distributions from a health savings account or an Archer MSA that are not used for qualified medical expenses to 20% of the disbursed amount.

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Exclude the costs for over-the-counter drugs not prescribed by a doctor from being reimbursed through an HRA or health FSA and from being reimbursed on a tax-free basis through an HSA or Archer Medical Savings Account.

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Impose new annual fees on the pharmaceutical manufacturing sector.

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Establish Teaching Health Centers to provide payments for primary care residency programs in community-based ambulatory care providers.

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Improve access to care by increasing funding by $11 billion for community health centers and the National Health Service Corps over five years; establish new programs to support school-based health centers and nurse-managed health clinics.

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Establish a new trauma center program to strengthen emergency department and trauma center capacity.

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Establish the Community-based Collaborative Care Network Program to support consortiums of health care providers to coordinate and integrate health care services, for low-income uninsured and underinsured populations.

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Develop a national quality improvement strategy that includes priorities to improve the delivery of health care services, patient health outcomes, and population health.

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Establish the Community First Choice Option in Medicaid to provide community-based attendant support services to certain people with disabilities.

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Create the State Balancing Incentive Program in Medicaid to provide enhanced federal matching payments to increase non-institutionally based long-term care services.

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