S 2630
110th CONGRESS
2d Session
S. 2630
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 SENATE OF THE UNITED STATES
February 13, 2008
Mr. KENNEDY (for himself, Mr. STEVENS, Mr. KERRY, and Ms. MURKOWSKI)
introduced the following bill; which was read twice and referred to
the Committee on Health, Education, Labor, and Pensions
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 (42 U.S.C. 243
et seq.) 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.'.
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