[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5404 Introduced in House (IH)]
110th CONGRESS
2d Session
H. R. 5404
To amend the Public Health Service Act to establish a Federal grant
program to provide increased health care coverage to and access for
uninsured and underinsured workers and families in the commercial
fishing industry, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2008
Mr. Frank of Massachusetts (for himself, Mr. Young of Alaska, Mr.
Tierney, Mr. Gilchrest, Mr. Delahunt, Mr. Kennedy, and Mr. Allen)
introduced the following bill; which was referred to the Committee on
Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to establish a Federal grant
program to provide increased health care coverage to and access for
uninsured and underinsured workers and families in the commercial
fishing industry, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This act may be cited as the ``Commercial Fishing Industry Health
Care Coverage Act of 2008''.
SEC. 2. GRANTS FOR QUALIFIED COMMERCIAL FISHING INDUSTRY HEALTH CARE
COVERAGE DEMONSTRATION PROGRAMS.
Part B of title III of the Public Health Service Act is amended by
adding at the end the following new section:
``SEC. 320B. GRANTS FOR QUALIFIED COMMERCIAL FISHING INDUSTRY HEALTH
CARE COVERAGE DEMONSTRATION PROGRAMS.
``(a) Establishment of Program.--
``(1) In general.--The Secretary, through the Health
Resources and Services Administration, shall establish a grant
program (in this section referred to as the `grant program')
for the purpose of assisting commercial fishing States to
establish, or strengthen existing, programs to expand health
care coverage and access for uninsured or underinsured workers
and their families in the commercial fishing industry.
``(2) Types of grants.--Under the grant program, the
Secretary shall provide--
``(A) program planning grants under subsection (b)
for commercial fishing States and organizations within
such States; and
``(B) implementation and administration grants
under subsection (c) for no more than 15 commercial
fishing States.
``(3) Application required.--No grant may be awarded under
this section except pursuant to an application that is made in
such form and manner, and containing such information, as the
Secretary may require.
``(b) Program Planning Grants.--
``(1) In general.--Under the grant program the Secretary
may award grants to one or more commercial fishing States (or
to organizations with a history of active involvement in the
commercial fishing industry in such a State, including
knowledge of economic and social aspects of such industry), not
to exceed $200,000 for each year and for no more than two
years, to conduct initial research and planning for the
development of a qualified health care coverage program in the
State. Any grantee under this subsection shall--
``(A) conduct a demographic survey of the State's
commercial fishing industry and such industry's health
care needs; and
``(B) develop a strategic plan, including a
detailed financial plan, for implementation of a
qualified health care coverage program within the
State.
``(2) Consultation with states.--Before awarding a grant
under this subsection to an organization, the Secretary shall
consult with States where the organization is located in order
to assist in a determination as to whether the organization--
``(A) has the necessary familiarity with and
knowledge of the commercial fishing industry in the
State to fulfill the purposes of the grant; and
``(B) has a history of fraudulent or abusive
practices that would disqualify the organization from
carrying out the grant.
``(3) Actions following completion of planning grants.--
Based on the research findings, financial plan, and other
recommendations developed by the State or organization under
paragraph (1), a State may submit an application for program
implementation and administration grants under subsection (c).
``(c) Implementation and Program Administration Grants.--
``(1) In general.--Under the grant program, subject to the
succeeding provisions of this subsection, the Secretary may
award the following grants to commercial fishing States:
``(A) Initial implementation grants.--A grant, not
to exceed $2,000,000 for each year and for no more than
two years, for initial implementation of a qualified
health care coverage program.
``(B) Program administration grants.--A grant, not
to exceed $3,000,000 for each year and for no more than
five years, for administration of a qualified health
care coverage program.
``(C) Continued administration grants.--A grant,
not to exceed $3,000,000 for each year, for continued
administration of a qualified health care coverage
program in a State that has been awarded administration
grants for 5 years under subparagraph (B) and that has
satisfactorily administered such program using the
funds provided by such grants for at least 5 years, if
the economic conditions of the fishing industry in the
program's service area (or the condition of fish stocks
that are important to the fishing industry in such
area) jeopardize the ability of the program to continue
providing affordable health care coverage.
A grant may be made for a qualified health care coverage
program under subparagraph (A) or (B) regardless of whether or
not the program was developed with a program planning grant
under subsection (b) or was implemented under a grant under
subparagraph (A), respectively, and regardless of whether the
program was developed or initially implemented before the date
of the enactment of this section.
``(2) Eligibility requirements.--The Secretary may not
award a grant under this subsection to a commercial fishing
State for implementation or administration of a health care
coverage program unless--
``(A) the State demonstrates that the program--
``(i) is a qualified health care coverage
program and enrolls fishing industry members
and their families if they were uninsured or
underinsured; and
``(ii) requires Federal funding for its
operation; and
``(B) the State provides assurances satisfactory to
the Secretary that--
``(i) if the program is an expansion of an
existing health care coverage program, the
State will use the grant funding to expand the
enrolled population of uninsured or
underinsured commercial fishing industry
members and their families, or modify coverage
to comply with qualified health care coverage,
under the program and to supplement, and not
supplant, State provided funding for such
program; or
``(ii) if the program is a new qualified
health care coverage program, the State will
ensure the program's continued success through
the implementation of appropriate financial and
consumer protection regulations, controls,
licensing, or oversight policies, including (as
determined by the State) any of the following:
``(I) Protection against
insolvency, fraud and abuse.
``(II) State-based stop-loss
protection.
``(III) Reinsurance.
``(IV) Receivership/liquidation
protection against insolvency for
individuals.
``(V) Another demonstration of
State financial commitment.
``(3) Requirement of matching funds.--
``(A) In general.--A grant may be made under this
subsection only if the State agrees to make available
(directly or through donations from public or private
entities) non-Federal contributions toward such costs
in an amount that is not less than $1 for each $2 of
Federal funds provided in the grant.
``(B) Determination of amount contributed.--Non-
Federal contributions required in subparagraph (A) may
be in cash or in kind, fairly evaluated, including
plant, equipment, or services. Amounts provided by the
Federal Government, or services assisted or subsidized
to any significant extent by the Federal Government,
may not be included in determining the amount of such
non-Federal contributions.
``(4) Contracting authority.--
``(A) In general.--A commercial fishing State may
enter into a contract with one or more eligible non-
profit organizations or companies for the purpose of
conducting activities under an implementation or
administration grant under this subsection and may not
enter into such a contract with an organization or
company which is not eligible under subparagraph (C).
``(B) Subcontracting arrangements.--A contractor
described in subparagraph (A) may subcontract with one
or more eligible non-profit organizations or companies
for the purpose of conducting activities under such an
implementation or administration grant, if the State
approves such subcontracting arrangements.
``(C) Eligibility standards.--The Secretary shall
issue regulations establishing eligibility standards
for organizations and companies under this paragraph.
Such standards shall include requirements that States
review whether prospective contractors or
subcontractors under this paragraph--
``(i) have a history of fraudulent or
abusive practices that would disqualify them
from participating in a contract or
subcontract;
``(ii) have the capability and experience
to assist in the management of a qualified
health care coverage program; and
``(iii) in the case of commercial fishing
organizations, have an appropriate level of
familiarity with, and knowledge of, the
commercial fishing industry.
``(d) Definitions.--For purposes of this section:
``(1) Commercial fishing state.--The term `commercial
fishing State' means a State (as defined in section 2(f)) with
a significant commercial fishing population or a significant
commercial fishing industry. The Secretary shall accept a
State's self-certification that it is a commercial fishing
State if the State demonstrates to the Secretary that--
``(A) such self-certification is based on
consultation by the State with local organizations
familiar with the commercial fishing industry in the
State; and
``(B) the State has a significant commercial
fishing population or a significant commercial fishing
industry.
``(2) Commercial fishing industry member.--The term
`commercial fishing industry member' means a fisherman,
crewmember, boat owner, captain, shore side business owner,
employee of a company that provides shore side support,
harvester, or other individual performing commercial fishing
industry-related work, if more than half of such individual's
income derives from such work at the time the individual
enrolls in a qualified health care coverage program.
``(3) Qualified health care coverage program.--The term
`qualified health care coverage program' means a program that
provides qualified health care coverage to commercial fishing
industry members and their families consistent with the
following:
``(A) Eligibility for enrollment of such members
and families is only restricted by capacity, based on a
first come, first served basis when space is limited,
and health status related factors (as defined in
section 2702), age, and gender may not be used as a
basis for determining eligibility.
``(B) The program does not include any preexisting
condition exclusion (as defined in section 2701) or any
coverage elimination rider that permanently excludes
from coverage an existing medical condition.
``(C) Premium rates under the program are computed
based on a community rate, and may be adjusted only for
income and family size.
``(4) Qualified health care coverage.--The term `qualified
health care coverage' means coverage that meets any of the
following conditions:
``(A) FEHBP coverage.--The coverage is actuarially
equivalent to the coverage provided under the health
benefits plan, under chapter 89 of title 5, United
States Code, which has the largest enrollment, either
in the United States or in the State involved.
``(B) State employees coverage.--The coverage is
actuarially equivalent to the coverage provided under
the health benefits plan, that is offered by the State
to State government employees, which has the largest
enrollment of such plans in the State.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to the Secretary for the purpose of carrying out this
section--
``(1) $5,000,000 for fiscal year 2009;
``(2) $5,000,000 for fiscal year 2010;
``(3) $10,000,000 for fiscal year 2011;
``(4) $10,000,000 for fiscal year 2012; and
``(5) $20,000,000 for fiscal year 2013.''.
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