[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6806 Introduced in House (IH)]
110th CONGRESS
2d Session
H. R. 6806
To establish a Citizens Congressional Health Benefits Program, based on
the Federal employees health benefits program, to provide health
insurance coverage for the President, Vice President, and Members of
Congress, and citizens not eligible for coverage under the Federal
employees health benefits program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
August 1, 2008
Mr. Goode introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committees on
Oversight and Government Reform and House Administration, for a period
to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To establish a Citizens Congressional Health Benefits Program, based on
the Federal employees health benefits program, to provide health
insurance coverage for the President, Vice President, and Members of
Congress, and citizens not eligible for coverage under the Federal
employees health benefits program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Citizenship Should
Count for Something Act''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Establishment of Citizens Congressional Health Benefits Program
(CCHBP).
Sec. 3. Eligibility; enrollment.
Sec. 4. Qualified health plans; benefits; premiums.
Sec. 5. Government contribution.
Sec. 6. Administration.
Sec. 7. Definitions.
SEC. 2. ESTABLISHMENT OF CITIZENS CONGRESSIONAL HEALTH BENEFITS PROGRAM
(CCHBP).
(a) In General.--There is established under this title a program
(to be known as the ``Citizens Congressional Health Benefits Program'')
to provide comprehensive health insurance coverage to Federal elected
officials and to all other citizens who are not covered under the
Federal Employees Health Benefits Program (FEHBP). The coverage shall
be provided in a manner similar to the manner in which coverage has
been provided to Members of Congress and Federal Government employees
and retirees and their dependents under the Federal Employees Health
Benefits Program (FEHBP).
(b) Effective Date.--Benefits shall first be made available under
this title for items and services furnished on or after January 1,
2010.
(c) Non-Preemption of Existing Collective Bargaining Agreements.--
Nothing in this Act shall be construed as preempting any collective
bargaining agreement that is in effect as of the date of the enactment
of this Act, during the period in which such agreement is in effect
(without regard to any extension of such agreement effected as such
date of enactment).
SEC. 3. ELIGIBILITY; ENROLLMENT.
(a) Eligibility.--
(1) In general.--Each CCHBP-eligible individual (as defined
in paragraph (2)) is eligible to enroll in accordance with this
title in a qualified health plan offered under this title.
(2) CCHBP-eligible individual defined.--For purposes of
this title, the term ``CCHBP-eligible individual'' means
elected Federal officials (including the President, Vice
President, and Members of Congress) and any other individual
residing in the United States who--
(A) is a citizen or national of the United States;
and
(B) is not enrolled under the Federal employees
health benefits program under chapter 89 of title 5,
United States Code.
(3) Conforming elimination of fehbp eligibility for federal
elected officials.--Effective for benefits for items and
services furnished on or after January 1, 2010, section 8901 of
title 5, United States Code, is amended--
(A) by striking subparagraphs (B) and (D); and
(B) in the matter following subparagraph (J)--
(i) by striking ``or'' at the end of clause
(iii);
(ii) by striking the period at the end of
clause (iv) and inserting ``; or''; and
(iii) by adding at the end the following
new clause:
``(v) the President, the Vice President, or a
Member of Congress as defined in section 2106 of this
title.''.
(b) Enrollment.--
(1) In general.--The Director shall establish a process for
CCHBP-eligible individuals to enroll in qualified health plans.
Such process shall be based on the enrollment process used
under FEHBP and shall provide for the dissemination of
information to CCHBP-eligible individuals on qualified health
plans being offered.
(2) Changes in enrollment.--The Director shall establish
enrollment procedures that include an annual open season and
permit changes in enrollment with qualified health plans at
other times (such as by reason of changes in marital or
dependent status or eligibility). Such procedures shall be
based on the enrollment procedures established under FEHBP.
(3) Limitations.--CCHBP-eligible individuals may be
enrolled in a qualified health plan under this title only
during enrollment periods specified by the Director.
(c) Treatment of Family Members.--Enrollment under this title
includes both individual and family enrollment, in a manner similar to
that provided under FEHBP. To the extent consistent with eligibility
under subsection (a), the Director shall provide rules similar to the
rules under FEHBP for the enrollment of family members who are CCHBP-
eligible individuals in the same plan.
(d) Changes in Plan Enrollment.--The Director shall provide for and
permit changes in the qualified health plan in which an individual or
family is enrolled under this section in a manner similar to the manner
in which such changes are provided or permitted under FEHBP. The
Director shall provide for termination of such enrollment for an
individual at the time the individual is no longer an CCHBP-eligible
individual.
(e) Enrollment Guides.--The Director shall provide for the broad
dissemination of information on qualified health plans offered under
this title. Such information shall be provided in a comparative manner,
similar to that used under FEHBP, and shall include information,
collected through surveys of enrollees, on measures of enrollee
satisfaction with the different plans.
SEC. 4. QUALIFIED HEALTH PLANS; BENEFITS; PREMIUMS.
(a) Offering of Plans.--
(1) Contracts.--The Director shall enter into contracts
with entities for the offering of qualified health plans in
accordance with this title. Such contracts shall be entered
into in a manner similar to the process by which the Director
is authorized to enter into contracts with health benefits
plans under FEHBP.
(2) Requirements for entities offering plans.--No such
contract shall be entered into with an entity for the offering
of a qualified health plan in a region unless the entity--
(A) is licensed as a health maintenance
organization in that State or is licensed to sell group
health insurance coverage in that State; and
(B) meets such requirements, similar to
requirements under FEHBP, as the Director may establish
relating to solvency, organization, structure,
governance, access, quality, and minimum loss-ratios.
(b) FEHBP Scope of Benefits.--
(1) Comprehensive benefits.--Qualified health plans shall
provide for the same scope and type of comprehensive benefits
that have been provided under FEHBP, including the types of
benefits described in section 8904 of title 5, United States
Code and including benefits previously required by regulation
or direction (such as preventive benefits, including childhood
immunization and cancer screening, and mental health parity)
under FEHBP.
(2) No exclusion for pre-existing conditions.--Qualified
health plans shall not impose pre-existing condition exclusions
or otherwise discriminate against any enrollee based on the
health status of such enrollee (including genetic information
relating to such enrollee).
(3) Other consumer protections.--Qualified health plans
also shall meet consumer and patient protection requirements
that the Director establishes, based on similar requirements
previously imposed under FEHBP, including protections of
patients' rights previously effected pursuant to Executive
Memorandum.
(4) Collective bargaining agreements.--Nothing in this Act
shall be construed as preventing a collectively bargained
agreement from providing coverage that is additional to, or
supplementary of, benefits provided under this Act.
(c) Community-Rated Premiums.--
(1) Application.--The premiums established for a qualified
health plan under this title for individual or family coverage
shall be community-rated and shall not vary based on gender,
health status (including genetic information), or other
factors.
(2) Collection process.--The Director shall establish a
process for the timely and accurate collection of premiums owed
by enrollees, taking into account any Government contribution
under section 5(a). Such process shall include methods for
payment through payroll withholding, as well as payment through
automatic debiting of accounts with financial institutions, and
shall be coordinated with the application of section 59B of the
Internal Revenue Code of 1986.
(d) Marketing Practices and Costs.--The Director shall monitor
marketing practices with respect to qualified health plans in order to
assure--
(1) the accuracy of the information disseminated regarding
such plans; and
(2) that costs of marketing are reasonable and do not
exceed a percentage of total costs that is specified by the
Director and that takes into account costs of market entry for
new qualified health plans.
SEC. 5. GOVERNMENT CONTRIBUTION.
(a) Amount Established Biannually by Congress.--The Director shall
provide each year (beginning with 2010) for a contribution under this
subsection towards the coverage provided under this title for CCHBP-
eligible individuals. The amount of such contribution shall be
determined biannually by Congress
(b) Plan Payment.--
(1) In general.--The Director shall provide for payment of
qualified health plans of the premiums for such plans, as
adjusted under this subsection.
(2) Risk adjusted payment.--The payment to a qualified
health plan under this subsection shall be adjusted in a
budget-neutral manner specified by the Director to reflect the
actuarial risk of the enrollees in the plan compared to an
average actuarial risk.
(3) Reduction for administrative expenses and contingency
reserve.--The Director may provide for a uniform percentage
reduction in payment otherwise made to a qualified health plan
under this subsection in order to provide for a contingency
reserve and for Federal administrative costs in carrying out
this title.
SEC. 6. ADMINISTRATION.
(a) Application of FEHBP Rules.--
(1) In general.--Except as otherwise provided in this
title, the program under this title shall be administered in
the same manner as FEHBP.
(2) Specific provisions.--In carrying out this title, the
Director pursuant to paragraph (1) shall provide for the
following:
(A) Approval and disapproval of plans as qualified
health plans.
(B) Negotiation of plan benefits (including cost-
sharing) and plan premiums.
(b) Duties.--
(1) In general.--The Director shall administer the program
under this title.
(2) Establishment of cchbp regions.--For purposes of
carrying out this title, the Director shall divide the United
States into, and establish, CCHBP regions.
(c) Rulemaking.--The Director is authorized to issue such
regulations as may be required to carry out this title.
(d) Use of Regional and Field Offices.--The Director shall
establish such regional and field offices as may be appropriate for the
convenient and efficient administration of this title.
(e) Coverage of Administration Costs.--The Director shall provide
for the collection of administrative costs of offering coverage under
this title from entities offering qualified health plans in the same
manner as FEHBP provides for coverage of its administrative costs.
(f) Contingency Reserves.--
(1) CCHBP contingency reserve.--The Director is authorized
to establish and maintain a contingency reserve for purposes of
carrying out this title and is authorized to impose under
section 5(b)(3)(A) a premium surcharge of up to three percent
in order to provide financing for such reserve.
(2) Plan reserves.--A qualified health plan may establish
contingency reserves, that are in addition to the reserve
described in paragraph (1), in a manner similar to that
permitted under FEHBP.
SEC. 7. DEFINITIONS.
For purposes of this Act:
(1) The term ``CCHBP-eligible individual'' means an
individual described in section 3(a)(2).
(2) The term ``CCHBP region'' means a region as specified
by the Director under section 6(c)(2).
(3) The term ``Director'' means the Director of the Office
of Personnel Management.
(4) The term ``FEHBP'' means the program under chapter 89
of title 5, United States Code.
(5) The term ``qualified health plan'' means such a plan
offered under this title.
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