| Home > 106th Congressional Bills > S. 2546 (is) To amend the Clean Air Act to prohibit the use of methyl tertiary butyl ether, to provide flexibility within the oxygenate requirement of the reformulated gasoline program of the Environmental Protection Agency, to promote the use of renewabl...
S. 2546 (is) To amend the Clean Air Act to prohibit the use of methyl tertiary butyl ether, to provide flexibility within the oxygenate requirement of the reformulated gasoline program of the Environmental Protection Agency, to promote the use of renewabl...
108th CONGRESS 2d Session S. 2544 To provide for the certification of programs to provide uninsured employees of small businesses access to health coverage, and for other purposes. _______________________________________________________________________ IN THE SENATE OF THE UNITED STATES June 17, 2004 Ms. Stabenow (for herself, Mrs. Lincoln, and Mr. Levin) introduced the following bill; which was read twice and referred to the Committee on Finance _______________________________________________________________________ A BILL To provide for the certification of programs to provide uninsured employees of small businesses access to health coverage, 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 ``Health Care Access for Small Businesses Act of 2004''. SEC. 2. THREE-SHARE PROGRAMS. The Social Security Act (42 U.S.C. 301 et seq.) is amended by adding at the end the following: ``TITLE XXII--PROVIDING FOR THE UNINSURED ``SEC. 2201. THREE-SHARE PROGRAMS. ``(a) Pilot Programs.--The Secretary, acting through the Administrator, shall award grants under this section for the startup and operation of 50 eligible three-share pilot programs for a 5-year period. ``(b) Grants for Three-Share Programs.-- ``(1) Establishment.--The Administrator may award grants to eligible entities-- ``(A) to establish three-share programs; ``(B) to provide for contributions to the premiums assessed for coverage under a three-share program as provided for in subsection (c)(2)(B)(iii); and ``(C) to establish risk pools. ``(2) Three-share program plan.--Each entity desiring a grant under this subsection shall develop a plan for the establishment and operation of a three-share program that meets the requirements of paragraphs (2) and (3) of subsection (c). ``(3) Application.--Each entity desiring a grant under this subsection shall submit an application to the Administrator at such time, in such manner and containing such information as the Administrator may require, including-- ``(A) the three-share program plan described in paragraph (2); and ``(B) an assurance that the eligible entity will-- ``(i) determine a benefit package; ``(ii) recruit businesses and employees for the three-share program; ``(iii) build and manage a network of health providers or contract with an existing network or licensed insurance provider; ``(iv) manage all administrative needs; and ``(v) establish relationships among community, business, and provider interests. ``(4) Priority.--In awarding grants under this section the Secretary shall give priority to an applicant-- ``(A) that is an existing three-share program; ``(B) that is an eligible three-share program that has demonstrated community support; or ``(C) that is located in a State with insurance laws and regulations that permit three-share program expansion. ``(c) Grant Eligibility.-- ``(1) In general.--The Secretary, acting through the Administrator, shall promulgate regulations providing for the eligibility of three-share programs for participation in the pilot program under this section. ``(2) Three-share program requirements.-- ``(A) In general.--To be determined to be an eligible three-share program for purposes of participation in the pilot program under this section a three-share program shall-- ``(i) be either a non-profit or local governmental entity; ``(ii) define the region in which such program will provide services; ``(iii) have the capacity to carry out administrative functions of managing health plans, including monthly billings, verification/enrollment of eligible employers and employees, maintenance of membership rosters, development of member materials (such as handbooks and identification cards), customer service, and claims processing; and ``(iv) have demonstrated community involvement. ``(B) Payment.--To be eligible under paragraph (1), a three-share program shall pay the costs of services provided under subparagraph (A)(ii) by charging a monthly premium for each covered individual to be divided as follows: ``(i) Not more than 30 percent of such premium shall be paid by a qualified employee desiring coverage under the three-share program. ``(ii) Not more than 30 percent of such premium shall be paid by the qualified employer of such a qualified employee. ``(iii) At least 40 percent of such premium shall be paid from amounts provided under a grant under this section. ``(iv) Any remaining amount shall be paid by the three-share program from other public, private, or charitable sources. ``(C) Program flexibility.--A three-share program may set an income eligibility guideline for enrollment purposes. ``(3) Coverage.-- ``(A) In general.--To be an eligible three-share program under this section, the three-share program shall provide at least the following benefits: ``(i) Physicians services. ``(ii) In-patient hospital services. ``(iii) Out-patient services. ``(iv) Emergency room visits. ``(v) Emergency ambulance services. ``(vi) Diagnostic lab fees and x-rays. ``(vii) Prescription drug benefits. ``(B) Limitation.--Nothing in subparagraph (A) shall be construed to require that a three-share program provide coverage for services performed outside the region described in paragraph (2)(A)(i). ``(C) Preexisting conditions.--A program described in subparagraph (A) shall not be an eligible three- share program under paragraph (1) if any individual can be excluded from coverage under such program because of a preexisting health condition. ``(d) Grants for Existing Three-Share Programs To Meet Certification Requirements.-- ``(1) In general.--The Administrator may award grants to three-share programs that are operating on the date of enactment of this section. ``(2) Application.--Each eligible entity desiring a grant under this subsection shall submit an application to the Administrator at such time, in such manner, and containing such information as the Administrator may require. ``(e) Application of State Laws.--Nothing in this section shall be construed to preempt State law. ``(f) Distressed Business Formula.-- ``(1) In general.--Not later than 60 days after the date of enactment of this section, the Administrator of the Health Resources and Services Administration shall develop a formula to determine which businesses qualify as distressed businesses for purposes of this section. ``(2) Effect on insurance market.--Granting eligibility to a distressed business using the formula under paragraph (1) shall not interfere with the insurance market. Any business found to have reduced benefits to qualify as a distressed business under the formula under paragraph (1) shall not be eligible to be a three-share program for purposes of this section. ``(g) Definitions.--In this section: ``(1) Administrator.--The term `Administrator' means the Administrator of the Health Resources and Services Administration. ``(2) Covered individual.--The term `covered individual' means-- ``(A) a qualified employee; or ``(B) a child under the age of 23 or a spouse of such qualified employee who-- ``(i) lacks access to health care coverage through their employment or employer; ``(ii) lacks access to health coverage through a family member; ``(iii) is not eligible for coverage under the medicare program under title XVIII or the medicaid program under title XIX; and ``(iv) does not qualify for benefits under the State Children's Health Insurance Program under title XXI. ``(3) Distressed business.--The term `distressed business' means a business that-- ``(A) in light of economic hardship and rising health care premiums may be forced to discontinue or scale back its health care coverage; and ``(B) qualifies as a distressed business according to the formula under subsection (g). ``(4) Eligible entity.--The term `eligible entity' means an entity that meets the requirements of subsection (a)(2)(A). ``(5) Qualified employee.--The term `qualified employee' means any individual employed by a qualified employer who meets certain criteria including-- ``(A) lacking access to health coverage through a family member or common law partner; ``(B) not being eligible for coverage under the medicare program under title XVIII or the medicaid program under title XIX; and ``(C) agreeing that the share of fees described in subsection (a)(2)(B)(i) shall be paid in the form of payroll deductions from the wages of such individual. ``(6) Qualified employer.--The term `qualified employer' means an employer as defined in section 3(d) of the Fair Labor Standards Act of 1938 (29 U.S.C. 203(d)) who-- ``(A) is a small business concern as defined in section 3(a) of the Small Business Act (15 U.S.C. 632); ``(B) is located in the region described in subsection (a)(2)(A)(i); and ``(C) has not contributed to the health care benefits of its employees for at least 12 months consecutively or currently provides insurance but is classified as a distressed business. ``(h) Evaluation.--Not later than 90 days after the end of the 5- year period during which grants are available under this section, the General Accounting Office shall submit to the Secretary and the appropriate committees of Congress a report concerning-- ``(1) the effectiveness of the programs established under this section; ``(2) the number of individuals covered under such programs; ``(3) any resulting best practices; and ``(4) the level of community involvement. ``(i) Authorization of Appropriations.--There are authorized to be appropriated to carry out this section $100,000,000 for each of fiscal years 2005 through 2010.''. <all>
Other Popular 106th Congressional Bills Documents:
|GovRecords.org presents information on various agencies of the United States Government. Even though all information is believed to be credible and accurate, no guarantees are made on the complete accuracy of our government records archive. Care should be taken to verify the information presented by responsible parties. Please see our reference page for congressional, presidential, and judicial branch contact information. GovRecords.org values visitor privacy. Please see the privacy page for more information.|
Supreme Court Decisions
104th Congressional Documents
105th Congressional Documents
106th Congressional Documents
107th Congressional Documents
108th Congressional Documents
1994 Presidential Documents