To provide for premium assistance for COBRA continuation coverage for certain individuals and to permit States to provide temporary Medicaid coverage for certain uninsured employees.

January 8, 2003

Mr. BOUCHER (for himself and Mr. GOODE) introduced the following bill; which was referred to the Committee on Education and the Workforce, and in addition to the Committees on Energy and Commerce and Ways and Means, 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

To provide for premium assistance for COBRA continuation coverage for certain individuals and to permit States to provide temporary Medicaid coverage for certain uninsured employees.

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 `Health Care Coverage Assistance for the Unemployed Act of 2003'.

SEC. 2. PREMIUM ASSISTANCE FOR COBRA CONTINUATION COVERAGE.

(a) ESTABLISHMENT-

(1) IN GENERAL- Not later than 60 days after the date of enactment of this Act, the Secretary of Labor shall establish a program under which premium assistance for COBRA continuation coverage shall be provided for qualified individuals under this section.

(2) QUALIFIED INDIVIDUALS- For purposes of this section, a qualified individual is an individual who--

(A) establishes that the individual--

(i) on or after January 1, 2001, and before January 1, 2004, became entitled to elect COBRA continuation coverage (other than solely on the basis described in paragraph (3), (4), (5), or (6) of section 603 of the Employee Retirement Income Security Act of 1974); and

(ii) has elected such coverage; and

(B) enrolls in the premium assistance program under this section by not later than December 31, 2003.

(b) LIMITATION OF PERIOD OF PREMIUM ASSISTANCE- Premium assistance provided under this subsection shall end with respect to an individual on the earlier of--

(1) the date the individual is no longer covered under COBRA continuation coverage; or

(2) 18 months after the date the individual is first enrolled in the premium assistance program established under this section.

(c) PAYMENT, AND CREDITING OF ASSISTANCE-

(1) AMOUNT OF ASSISTANCE- Premium assistance provided under this section shall be equal to 75 percent of the amount of the premium required for the COBRA continuation coverage.

(2) PROVISION OF ASSISTANCE- Premium assistance provided under this section shall be provided through the establishment of direct payment arrangements with the administrator of the group health plan (or other entity) that provides or administers the COBRA continuation coverage. It shall be a fiduciary duty of such administrator (or other entity) to enter into such arrangements under this section.

(3) PREMIUMS PAYABLE BY QUALIFIED INDIVIDUAL REDUCED BY AMOUNT OF ASSISTANCE- Premium assistance provided under this section shall be credited by such administrator (or other entity) against the premium otherwise owed by the individual involved for such coverage.

(d) CHANGE IN COBRA NOTICE-

(1) GENERAL NOTICE-

(A) IN GENERAL- In the case of notices provided under sections 606 of the Employee Retirement Income Security Act of 1974, section 2206 of the Public Health Service Act, and section 4980B(f)(6) of the Internal Revenue Code of 1986 with respect to individuals who, on or after January 1, 2001, and before January 1, 2004, become entitled to elect COBRA continuation coverage, such notices shall include an additional notification to the recipient of the availability of premium assistance for such coverage under this section.

(B) ALTERNATIVE NOTICE- In the case of COBRA continuation coverage to which the notice provisions described in subparagraph (A) do not apply, the Secretary of Labor shall, in coordination with administrators of the group health plans (or other entities) that provide or administer the COBRA continuation coverage involved, assure provision of such notice.

(C) FORM- The requirement of the additional notification under this paragraph may be met by amendment of existing notice forms or by inclusion of a separate document with the notice otherwise required.

(2) SPECIFIC REQUIREMENTS- Each additional notification under paragraph (1) shall include--

(A) the forms necessary for establishing eligibility under subsection (a)(2)(A) and enrollment under subsection (a)(2)(B) in connection with the coverage with respect to each covered employee or other qualified beneficiary;

(B) the name, address, and telephone number necessary to contact the plan administrator and any other person maintaining relevant information in connection with the premium assistance; and

(C) the following statement displayed in a prominent manner:

`You may be eligible to receive assistance with payment of 75 percent of your COBRA continuation coverage premiums for a duration of not to exceed 18 months.'.

(3) NOTICE RELATING TO RETROACTIVE COVERAGE- In the case of such notices previously transmitted before the date of the enactment of this Act in the case of an individual described in paragraph (1) who has elected (or is still eligible to elect) COBRA continuation coverage as of the date of the enactment of this Act, the administrator of the group health plan (or other entity) involved or the Secretary of Labor (in the case described in the paragraph (1)(B)) shall provide (within 60 days after the date of the enactment of this Act) for the additional notification required to be provided under paragraph (1).

(4) MODEL NOTICES- The Secretary of Labor shall prescribe models for the additional notification required under this subsection.

(e) OBLIGATION OF FUNDS- This section constitutes budget authority in advance of appropriations Acts and represents the obligation of the Federal Government to provide for the payment of premium assistance under this section.

(f) PROMPT ISSUANCE OF GUIDANCE- The Secretary of Labor shall issue guidance under this section not later than 30 days after the date of the enactment of this Act.

(g) DEFINITIONS- In this Act:

(1) ADMINISTRATOR- The term `administrator' has the meaning given such term in section 3(16) of the Employee Retirement Income Security Act of 1974.

(2) COBRA CONTINUATION COVERAGE- The term `COBRA continuation coverage' means continuation coverage provided pursuant to title XXII of the Public Health Service Act, section 4980B of the Internal Revenue Code of 1986 (other than subsection (f)(1) of such section insofar as it relates to pediatric vaccines), part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (other than under section 609), section 8905a of title 5, United States Code, or under a State program that provides continuation coverage comparable to such continuation coverage.

(3) GROUP HEALTH PLAN- The term `group health plan' has the meaning given such term in section 9832(a) of the Internal Revenue Code of 1986.

(4) STATE- The term `State' includes the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands.

SEC. 3. OPTIONAL TEMPORARY MEDICAID COVERAGE FOR UNINSURED ELIGIBLE EMPLOYEES.

(a) IN GENERAL- Notwithstanding any other provision of law, a State may elect to provide, under its medicaid program under title XIX of the Social Security Act, medical assistance in the case of an individual who is eligible for unemployment benefits, who is not eligible for COBRA continuation coverage, and who is uninsured. For purposes of this section, an individual is considered to be uninsured if the individual is not covered under a group health plan, health insurance coverage, or under such program or a program under title XVIII or XXI of such Act.

(b) LIMITATION TO 18 MONTHS OF COVERAGE- Assistance under this section shall end with respect to an individual on the earlier of--

(1) the date the individual is no longer uninsured; or

(2) 18 months after the date the individual is first determined to be eligible for medical assistance under this section.

(c) SPECIAL RULES- In the case of medical assistance provided under this section--

(1) the Federal medical assistance percentage under section 1905(b) of the Social Security Act shall be 100 percent;

(2) a State may elect to disregard any income, asset, or resource limitation imposed under the State medicaid plan or under title XIX of such Act, except, notwithstanding any other provision of law, a State shall condition eligibility for assistance under this section upon the payment of a monthly premium approximating 25 percent of the average cost of providing the assistance under this section;

(3) such medical assistance shall not be provided for periods before the date the individual is determined eligible for such assistance;

(4) a State may elect to make eligible for such assistance a dependent spouse or children of an individual eligible for medical assistance under subsection (a), if such spouse or children are uninsured; and

(5) individuals eligible for medical assistance under this section shall be deemed to be described in the list of individuals described in the matter preceding paragraph (1) of section 1905(a) of such Act.

END