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S. 1936 (is) To suspend temporarily the duty on certain chemicals used in the formulation of anti-cancer drugs. ...
108th CONGRESS 1st Session S. 1935 To amend the Public Health Service Act to require employers to offer health care coverage for all employees, to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2001, and for other purposes. _______________________________________________________________________ IN THE SENATE OF THE UNITED STATES November 23, 2003 Mr. Corzine introduced the following bill; which was read twice and referred to the Committee on Finance _______________________________________________________________________ A BILL To amend the Public Health Service Act to require employers to offer health care coverage for all employees, to amend the Social Security Act to guarantee comprehensive health care coverage for all children born after 2001, 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; FINDINGS. (a) Short Title.--This Act may be cited as the ``Universal Secure Access to Health Care Act of 2003''. (b) Findings.-- (1) In 2002, 43,600,000 Americans, nearly 17.2 percent of the total nonelderly population, were uninsured. (2) The number of uninsured has grown by nearly 10,000,000 over the past decade. (3) While 61 percent of Americans receive health insurance coverage through their employers, millions of Americans lack access to such coverage either because their employer does not offer such coverage or the employer cannot afford to pay for such coverage. (4) Today, fewer Americans have health insurance through their employment to cover themselves and their dependents than 10 years ago. (5) Eighty-two percent of the individuals that are uninsured in the United States are in working families. (6) Low-wage workers have more difficulty obtaining affordable health care coverage since such workers are less likely than high-wage workers to have such coverage offered as a benefit by an employer, and prohibitive premiums for individually purchased coverage often prevents such workers from purchasing such coverage independently. (7) The consequences of our nation's significant uninsured population are devastating. (8) The uninsured are significantly more likely to delay or forego needed health care. (9) The uninsured are less likely to receive preventive health care. (10) Delaying or foregoing health care treatment when such treatment is needed can produce unnecessarily dire and expensive results. More severe health care conditions may arise and more expensive health care treatments, such as costly hospitalizations, may be necessary even though such conditions or treatments could have been avoided by the initial provision of adequate and timely health care. The uninsured, for example, are more likely to be hospitalized for conditions that could have been avoided, such as pneumonia and uncontrolled diabetes, than the insured. The uninsured with various forms of cancer are also more likely to be diagnosed with late stage cancer than the insured. SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT. The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by adding at the end the following: ``TITLE XXVIII--UNIVERSAL HEALTH INSURANCE COVERAGE ``Subtitle A--Employer Mandated Health Insurance Coverage ``SEC. 2801. EMPLOYER MANDATED HEALTH INSURANCE COVERAGE. ``(a) In General.--Each employer shall offer to enroll each of its employees and their families in a standard health benefit plan. ``(b) Standard Health Benefit Plan.--For purposes of this title, the term `standard health benefit plan' means a plan that provides benefits for health care items and services that are actuarily equivalent or greater in value than the benefits offered as of January 1, 2000, under the Blue Cross/Blue Shield Standard Option Plan provided under the Federal Employees Health Benefit Program under chapter 89 of title 5, United States Code. ``(c) Part-Time Employees.--Subsection (a) shall apply to part-time employees. ``SEC. 2802. TYPE OF COVERAGE. ``(a) In General.--Each standard health benefit plan offered by an employer under section 2801(a) shall conform to the requirements of this section. ``(b) Prohibition Against Discrimination.--A standard health benefit plan offered by an employer under section 2801(a) shall not establish rules for eligibility of any individual to enroll under the plan or exclude or otherwise limit any individual from coverage under the plan based on-- ``(1) medical history; ``(2) health status; ``(3) a preexisting medical condition, disease, or disorder; or ``(4) genetic information. ``(c) Open Enrollment.--A standard health benefit plan offered by an employer under section 2801(a) shall offer an annual open enrollment period during which an individual may change enrollment from such plan to another standard health benefit plan offered by such employer. ``(d) Medically Necessary Services.--A standard health benefit plan offered by an employer under section 2801(a) shall, if such plan provides coverage for a certain health care item or service, provide coverage for such item or service if a doctor determines that such item or service is medically necessary. ``(e) Date of Initial Coverage.--In the case of an employee enrolled in a standard health benefit plan provided by an employer under section 2801(a), the coverage under such plan shall commence not later than 5 days after the day on which the employee first performs an hour of service as an employee of that employer. No waiting period beyond this initial 5-day period may be imposed regarding such coverage. ``SEC. 2803. PREMIUMS. ``(a) In General.--Each employer shall-- ``(1) contribute to the cost of any standard health benefit plan that an employee has enrolled in in accordance with this section; and ``(2) withhold from wages of an employee, the employee share of the premium assessed for coverage under the standard health benefit plan. ``(b) Contribution.-- ``(1) Employer share.-- ``(A) Full-time employees.--Each employer who has enrolled an employee in a standard health benefit plan shall contribute not less than 72 percent of the monthly premium for such employee. ``(B) Part-time employees.-- ``(i) Pro-rated portion paid.--Each employer who has enrolled a part-time employee in a standard health benefit plan shall pay a portion of the monthly premium for such employee that is pro-rated to correspond with the number of hours of work that such employee has provided during the past month. ``(ii) Exception.--No employer contribution is required under this section with respect to an employee who works less than 10 hours per week. ``(2) Employee share.-- ``(A) In general.--Each employee enrolled in a standard health benefit plan under section 2801(a) shall pay the remaining portion of the monthly premium after payment by the employer as required under subsection (a). ``(B) Part-time employees.--An employee who is enrolled in a standard health benefit plan under section 2801(a) and works for such employer for not more than 30 hours and not less than 10 hours per week shall be eligible for a subsidy to aid such employee in paying his or her portion of the monthly premium. ``(3) Low-income employees.--An employee who is enrolled in a standard health benefit plan under section 2801(a) whose family income does not exceed 250 percent of the poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2)) as applicable to a family of the size involved, shall be eligible to receive a subsidy from the State as described in subtitle B to aid in payment of premiums. ``SEC. 2804. ENFORCEMENT. ``(a) State Ineligibility for Public Health Service Act Funds.--An employer that is a State or political subdivision of a State or an agency or instrumentality of a State or political subdivision that does not comply with the requirements of this title shall not be eligible to receive a grant, contract, cooperative agreement, loan, or loan guarantee under this Act. ``(b) Civil Penalty for Private Employers.-- ``(1) In general.--Any nongovernmental employer that does not comply with this title shall be subject to a civil penalty of not more than 10 percent of the total amount of the employer's expenditures for wages for employees in that year. ``(2) Assessment procedure.--A civil money penalty under this section shall be assessed by the Secretary and collected in a civil action brought by the United States in a United States district court. The Secretary shall not assess such a penalty on an employer until the employer has been given notice and an opportunity to present its views on such charge. ``(3) Amount of penalty.--In determining the amount of the penalty, or the amount agreed to in compromise, the Secretary shall consider the gravity of the noncompliance and the demonstrated good faith of the employer charged in attempting to achieve rapid compliance after notification of a violation of this title. ``SEC. 2805. DEFINITIONS. ``In this title: ``(1) Employer.--The term `employer' means, with respect to a calendar year and plan year, an employer that employed an average of at least 50 full-time employees on business days during the preceding calendar year and employs not less than 50 employees on the first day of the plan year. ``(2) Part-time employee.--The term `part-time employee' means any individual employed by an employer who works less than 40 hours a week. ``(3) Waiting period.--The term `waiting period' means, with respect to a plan and an individual who is a potential beneficiary or participant in the plan, the period that must pass with respect to the individual before the individual is eligible to be covered for benefits under the terms of the plan.noncompliance by the Secretary. ``SEC. 2806. EFFECTIVE DATE. ``This title shall take effect 2 years after the date of enactment of the Universal Secure Access to Health Care Act of 2003. ``Subtitle B--Individual and Employer Subsidies ``SEC. 2811. SUBSIDY PROGRAM. ``(a) In General.--The Secretary shall establish a Federal program to award grants to States for State premium assistance programs. ``(b) Federal Program.-- ``(1) In general.--The Secretary shall establish a Federal program that shall set all standards for administration of State programs, receive applications from States for the establishment of such programs, and receive reports from States regarding the developments of such programs. ``(2) Regulations.--The Secretary shall promulgate regulations specifying requirements for State programs under this subtitle, including-- ``(A) standards for determining eligibility for premium assistance; ``(B) standards for States operating programs under this subtitle which ensure that such programs are operated in a uniform manner with respect to application procedures, data processing systems, and such other administrative activities as the Secretary determines to be necessary; and ``(C) standards for accepting reports regarding developments of such programs. ``(3) Content.--The regulations described in paragraph (2) shall require that a State program-- ``(A) enable an individual to file an application for assistance with an agency designated by the State at any time, in person, by mail, or online; ``(B) provide for the use of an application form developed by the Secretary; ``(C) make applications accessible at locations where individuals are most likely to obtain the applications; ``(D) require individuals to submit revised applications to reflect changes in estimated family incomes, including changes in employment status of family members, during the year, and the State shall revise the amount of any premium assistance based on such a revised application; and ``(E) provide for verification of the information supplied in applications under this subtitle, including examining return information disclosed to the State. ``(4) Application.--The Secretary shall develop an application form for assistance to be used by a State which shall-- ``(A) be simple in form and understandable to the average individual; ``(B) require the provision of information necessary to make a determination as to whether an individual is eligible for assistance, including a declaration of estimated income by the individual based, at the election of the individual-- ``(I) on multiplying by a factor of 4 the individual's family income for the 3-month period immediately preceding the month in which the application is made; or ``(II) on estimated income for the entire year for which the application is submitted; and ``(C) require attachment of such documentation as
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