HR 5404
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.
`(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.'.
END
