Title 42 — The Public Health and WelfareRelease 119-73
§300e–7 General provisions relating to loan guarantees and loans
Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER XI— - HEALTH MAINTENANCE ORGANIZATIONS › § 300e–7
Summary
The Secretary may only approve loan guarantees or direct loans if the terms protect the United States’ money and are reasonable. For guarantees, the Secretary must check that the repayment plan, security (if any), and interest rate are fair compared to similar private loans, and that the loan would not be available on reasonable terms without the guarantee. If the government pays under a guarantee, it can recover that amount from the applicant unless the Secretary waives recovery for good cause. After paying, the United States gets the borrower’s rights to collect from others. The Secretary can change guarantee or loan terms when needed to protect the government’s financial interest. Guarantees are final for borrowers and lenders who relied on them unless the borrower or lender committed fraud or lied. The Secretary can add other conditions to make sure the law’s goals are met. For direct loans, the Secretary must be satisfied the borrower can pay principal and interest when due and has enough extra funds to finish the project. Loans must have appropriate security, a maturity date, repayment installments, and an interest rate comparable to U.S. marketable obligations of similar maturity on the loan date (adjusted for administrative costs). The Secretary may change the interest rate for later disbursements to match the rate on that later date. The Secretary may sell loans and, if sold, may guarantee the sale, act as agent to collect payments for the buyer, or agree to repurchase the loan. Interest received by a purchaser of a sold public health maintenance organization loan must be included in that purchaser’s gross income for purposes of chapter 1 of title 26. Money from loan sales or repayments goes into a loan fund in the Treasury. A separate loan guarantee fund in the Treasury is set up to cover guarantee payments; amounts are appropriated as needed. If guarantee funds are short for guarantees issued before October 1, 1986, the Secretary may issue notes to the Treasury, which will buy them. If a borrower defaults, the Secretary may take action to protect the United States, including taking and using pledged real property.
Full Legal Text
Title 42, §300e–7
The Public Health and Welfare — Source: USLM XML via OLRC
(a)(1)The Secretary may not approve an application for a loan guarantee under this subchapter unless he determines that (A) the terms, conditions, security (if any), and schedule and amount of repayments with respect to the loan are sufficient to protect the financial interests of the United States and are otherwise reasonable, including a determination that the rate of interest does not exceed such per centum per annum on the principal obligation outstanding as the Secretary determines to be reasonable, taking into account the range of interest rates prevailing in the private market for loans with similar maturities, terms, conditions, and security and the risks assumed by the United States, and (B) the loan would not be available on reasonable terms and conditions without the guarantee under this subchapter.
(2)(A)The United States shall be entitled to recover from the applicant for a loan guarantee under this subchapter the amount of any payment made pursuant to such guarantee, unless the Secretary for good cause waives such right of recovery; and, upon making any such payment, the United States shall be subrogated to all of the rights of the recipient of the payments with respect to which the guarantee was made.
(B)To the extent permitted by subparagraph (C), any terms and conditions applicable to a loan guarantee under this subchapter (including terms and conditions imposed under subparagraph (D)) may be modified by the Secretary to the extent he determines it to be consistent with the financial interest of the United States.
(C)Any loan guarantee made by the Secretary under this subchapter shall be incontestable (i) in the hands of an applicant on whose behalf such guarantee is made unless the applicant engaged in fraud or misrepresentation in securing such guarantee, and (ii) as to any person (or his successor in interest) who makes or contracts to make a loan to such applicant in reliance thereon unless such person (or his successor in interest) engaged in fraud or misrepresentation in making or contracting to make such loan.
(D)Guarantees of loans under this subchapter shall be subject to such further terms and conditions as the Secretary determines to be necessary to assure that the purposes of this subchapter will be achieved.
(b)(1)The Secretary may not approve an application for a loan under this subchapter unless—
(A)the Secretary is reasonably satisfied that the applicant therefor will be able to make payments of principal and interest thereon when due, and
(B)the applicant provides the Secretary with reasonable assurances that there will be available to it such additional funds as may be necessary to complete the project or undertaking with respect to which such loan is requested.
(2)Any loan made under this subchapter shall (A) have such security, (B) have such maturity date, (C) be repayable in such installments, (D) on the date the loan is made, bear interest at a rate comparable to the rate of interest prevailing on such date with respect to marketable obligations of the United States of comparable maturities, adjusted to provide for appropriate administrative charges, and (E) be subject to such other terms and conditions (including provisions for recovery in case of default) as the Secretary determines to be necessary to carry out the purposes of this subchapter while adequately protecting the financial interests of the United States. On the date disbursements are made under a loan after the initial disbursement under the loan, the Secretary may change the rate of interest on the amount of the loan disbursed on that date to a rate which is comparable to the rate of interest prevailing on the date the subsequent disbursement is made with respect to marketable obligations of the United States of comparable maturities, adjusted to provide for appropriate administrative charges.
(3)The Secretary may, for good cause but with due regard to the financial interests of the United States, waive any right of recovery which he has by reason of the failure of a borrower to make payments of principal of and interest on a loan made under this subchapter, except that if such loan is sold and guaranteed, any such waiver shall have no effect upon the Secretary’s guarantee of timely payment of principal and interest.
(c)(1)The Secretary may from time to time, but with due regard to the financial interests of the United States, sell loans made by him under this subchapter.
(2)The Secretary may agree, prior to his sale of any such loan, to guarantee to the purchaser (and any successor in interest of the purchaser) compliance by the borrower with the terms and conditions of such loan. Any such agreement shall contain such terms and conditions as the Secretary considers necessary to protect the financial interests of the United States or as otherwise appropriate. Any such agreement may (A) provide that the Secretary shall act as agent of any such purchaser for the purpose of collecting from the borrower to which such loan was made and paying over to such purchaser, any payments of principal and interest payable by such organization under such loan; and (B) provide for the repurchase by the Secretary of any such loan on such terms and conditions as may be specified in the agreement. The full faith and credit of the United States is pledged to the payment of all amounts which may be required to be paid under any guarantee under this paragraph.
(3)After any loan under this subchapter to a public health maintenance organization has been sold and guaranteed under this subsection, interest paid on such loan which is received by the purchaser thereof (or his successor in interest) shall be included in the gross income of the purchaser of the loan (or his successor in interest) for the purpose of chapter 1 of title 26.
(4)Amounts received by the Secretary as proceeds from the sale of loans under this subsection shall be deposited in the loan fund established under subsection (e).
(5)Any reference in this subchapter (other than in this subsection and in subsection (d)) to a loan guarantee under this subchapter does not include a loan guarantee made under this subsection.
(d)(1)There is established in the Treasury a loan guarantee fund (hereinafter in this subsection referred to as the “fund”) which shall be available to the Secretary without fiscal year limitation, in such amounts as may be specified from time to time in appropriation Acts, to enable him to discharge his responsibilities under loan guarantees issued by him under this subchapter and to take the action authorized by subsection (f). There are authorized to be appropriated from time to time such amounts as may be necessary to provide the sums required for the fund. To the extent authorized in appropriation Acts, there shall also be deposited in the fund amounts received by the Secretary in connection with loan guarantees under this subchapter and other property or assets derived by him from his operations respecting such loan guarantees, including any money derived from the sale of assets.
(2)If at any time the sums in the funds are insufficient to enable the Secretary to discharge his responsibilities under guarantees issued by him before October 1, 1986, under this subchapter and to take the action authorized by subsection (f), he is authorized to issue to the Secretary of the Treasury notes or other obligations in such forms and denominations, bearing such maturities, and subject to such terms and conditions, as may be prescribed by the Secretary with the approval of the Secretary of the Treasury. Such notes or other obligations shall bear interest at a rate determined by the Secretary of the Treasury, taking into consideration the current average market yield on outstanding marketable obligations of the United States of comparable maturities during the month preceding the issuance of the notes or other obligations. The Secretary of the Treasury shall purchase any notes and other obligations issued under this paragraph and for that purpose he may use as a public debt transaction the proceeds from the sale of any securities issued under chapter 31 of title 31, and the purposes for which the securities may be issued under that chapter are extended to include any purchase of such notes and obligations. The Secretary of the Treasury may at any time sell any of the notes or other obligations acquired by him under this paragraph. All redemptions, purchases, and sales by the Secretary of the Treasury of such notes or other obligations shall be treated as public debt transactions of the United States. Sums borrowed under this paragraph shall be deposited in the fund and redemption of such notes and obligations shall be made by the Secretary from the fund.
(e)There is established in the Treasury a loan fund (hereinafter in this subsection referred to as the “fund”) which shall be available to the Secretary without fiscal year limitation, in such amounts as may be specified from time to time in appropriation Acts, to enable him to make loans under this subchapter and to take the action authorized by subsection (f). There shall also be deposited in the fund amounts received by the Secretary as interest payments and repayment of principal on loans made under this subchapter and other property or assets derived by him from his operations respecting such loans, from the sale of loans under subsection (c) of this section, or from the sale of assets.
(f)The Secretary may take such action as he deems appropriate to protect the interest of the United States in the event of a default on a loan made or guaranteed under this subchapter, including taking possession of, holding, and using real property pledged as security for such a loan or loan guarantee.
Legislative History
Notes & Related Subsidiaries
Editorial Notes
Codification In subsec. (d)(2), “chapter 31 of title 31” and “that chapter” substituted for “the Second Liberty Bond Act” and “that Act”, respectively, on authority of Pub. L. 97–258, § 4(b), Sept. 13, 1982, 96 Stat. 1067, the first section of which enacted Title 31, Money and Finance.
Amendments
1986—Subsec. (c)(3). Pub. L. 99–514 substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text. Subsec. (d)(2). Pub. L. 99–660 inserted “before October 1, 1986,” after “guarantees issued by him”. 1981—Subsec. (b)(2). Pub. L. 97–35 inserted provisions relating to changes in the rate of interest by the Secretary, and in cl. (D) made changes in nomenclature. 1978—Subsec. (d). Pub. L. 95–559, § 4(c)(2)(A), in pars. (1) and (2) inserted “and to take the action authorized by subsection (f)” after “by him under this subchapter”. Subsec. (e). Pub. L. 95–559, § 4(c)(2)(B), inserted “and to take the action authorized by subsection (f)” after “loans under this subchapter”. Subsec. (f). Pub. L. 95–559, § 4(c)(1), added subsec. (f). 1976—Subsec. (a)(1)(A). Pub. L. 94–460, § 109(c)(1), substituted “for loans with similar maturities, terms, conditions, and security” for “for similar loans”. Subsec. (b)(2)(D). Pub. L. 94–460, § 109(c)(2), substituted “marketable obligations of the United States of comparable maturities, adjusted to provide for appropriate administrative charges” for “loans guaranteed under this subchapter”. Subsec. (c)(5). Pub. L. 94–460, § 109(b)(2), added par. (5).
Statutory Notes and Related Subsidiaries
Effective Date
of 1986 AmendmentAmendment by Pub. L. 99–660 effective Oct. 1, 1985, see section 815(a) of Pub. L. 99–660, set out as an Effective and Termination Dates of 1986 Amendment note under section 300e–1 of this title.
Effective Date
of 1978 AmendmentAmendment by Pub. L. 95–559 effective only for fiscal years beginning on or after October 1, 1978, see section 4(d) of Pub. L. 95–559, set out as a note under section 300e–4 of this title.
Effective Date
of 1976 AmendmentAmendment by Pub. L. 94–460 effective Oct. 8, 1976, except that the amendment by section 109(c) of Pub. L. 94–460 applicable with respect to loan guarantees made under section 300e–4 of this title after Sept. 30, 1976, see section 118 of Pub. L. 94–460, set out as a note under section 300e of this title.
Reference
Citations & Metadata
Citation
42 U.S.C. § 300e–7
Title 42 — The Public Health and Welfare
Last Updated
Apr 6, 2026
Release point: 119-73