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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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