Requires that such health insurance coverage be provided: (1) without regard to health status, preexisting condition, or location of residency within a State; (2) through employer-sponsored health insurance or by buying into Medicaid or SCHIP; (3) at a specified level of actuarial equivalence; and (4) for a nominal amount of an employee's income.
Limits eligibility to lawful U.S. residents (and their spouses and dependents) who are otherwise not entitled to benefits under the Medicaid or SCHIP and are employed by a small business that does not offer affordable (or any) health insurance.
[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4021 Introduced in House (IH)]
107th CONGRESS
2d Session
H. R. 4021
To provide incentives to States to apply for section 1115 waivers to
use Federal funds to provide for affordable employer-based health
insurance coverage for the uninsured workers of small businesses in the
State.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 20, 2002
Mr. Allen (for himself, Mr. Baldacci, Mr. Barrett of Wisconsin, Ms.
Carson of Indiana, Mr. Cummings, Mr. Conyers, Mr. Frost, Mr. Langevin,
and Mr. Shows) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To provide incentives to States to apply for section 1115 waivers to
use Federal funds to provide for affordable employer-based health
insurance coverage for the uninsured workers of small businesses in the
State.
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 ``Small Business
Health Insurance Relief Act of 2002''.
(b) Findings.--The Congress finds the following:
(1) Of the 39,000,000 uninsured Americans, 72 percent are
either full-time workers or dependents of those workers.
(2) Of the uninsured working population, 56 percent are
employed by small businesses.
(3) Of the working population, more than 74 percent are
covered by employer-sponsored health insurance.
(4) Small businesses are less likely to offer health
insurance to their employees, and employees of those small
businesses are less likely to participate in a health plan when
it is offered to them, when compared with larger businesses and
employees of larger businesses.
(5) Implementation of the policy set forth in this Act in
participating States will reduce the number of low-income
workers without health insurance in those States.
(6) Because individuals without health insurance do not
seek preventive care or early intervention, when those
individuals suffer from a serious medical condition, they are
often faced with large medical bills which they cannot pay.
(7) The costs of unpaid medical bills by individuals
without health insurance are often shifted to private and
Government payers.
(8) By increasing access to affordable health insurance for
low-income workers, this Act will contribute to the health and
well-being of those individuals, as well as reduce costs for
those who bear the burden of uncompensated care.
SEC. 2. INCENTIVES TO PROVIDE HEALTH INSURANCE COVERAGE FOR THE WORKING
UNINSURED.
(a) In General.--For each State that applies for a waiver under
section 1115 of the Social Security Act (42 U.S.C. 1315) that includes,
as a part of that waiver, the use of funds otherwise paid to the State
under the medicaid program or the State children's health insurance
program to provide eligible uninsured employees health insurance
coverage that meets the requirements of subsection (b), the Secretary
may award the State, upon approval of that waiver, an incentive payment
(not to exceed $1,000,000) to assist the State in carrying out the
waiver.
(b) Requirements.--To be eligible for an incentive payment under
subsection (a), an application for a section 1115 waiver, with respect
to health insurance coverage, shall meet the following requirements:
(1) Coverage.--Provide a process and a timeline for
achieving coverage of all eligible uninsured employees
statewide, without regard to health status or preexisting
condition, or location of residency within the State.
(2) Manner of provision of health insurance coverage.--
Provide health insurance coverage through employer-sponsored
health insurance or by buying into the medicaid or the State
children's health insurance programs, including the provision
of wraparound health benefits.
(3) Benefits.--
(A) Actuarial equivalence.--(i) In the case of
health insurance coverage provided through employer-
sponsored health insurance coverage or by purchasing
coverage through the State children's health insurance
programs, provides for a benefit package that is at
least actuarially equivalent to the required scope of
health insurance coverage under section 2103 of the
Social Security Act (42 U.S.C. 1397cc) (relating to
coverage requirements for children's health insurance
under the State children's health insurance program).
(ii) In the case of health insurance coverage
provided by purchasing coverage through the medicaid
program, provides for a benefit package that is at
least actuarially equivalent to the required scope of
medical assistance (as defined in section 1905(a) of
the Social Security Act (42 U.S.C. 1396d(a)) under the
State plan of the State.
(B) Limit on employee cost sharing.--Provide that
an employee covered under the program pay no more than
a nominal amount of the employee's income (as
determined by the State) for costs of premiums,
deductibles, coinsurance, and copayments under the
plan.
(4) Consultation with affected entities.--Provide for
consultation with representatives of affected entities and
organizations, both public and private, in developing a plan to
provide such health insurance coverage.
(5) Outreach mechanisms.--Describe the outreach mechanisms
to be used to assure coverage of all eligible individuals,
including measures to assure coverage of individuals in hard-
to-reach populations and to assure benefits are provided to
eligible individuals located in underserved areas.
(6) Quality assurance.--Provide, and describe, mechanisms
to be used to assure, monitor, and maintain the quality of
items and services furnished under the waiver.
(7) Maintenance of effort.--Provide that employers who, as
of the date of the enactment of this Act, offer health
insurance coverage to or pay a percentage of premiums for such
health insurance coverage for employees and who participate
under the demonstration project maintain or increase levels of
coverage or contributions to employees health insurance over
those levels in effect before the implementation of the waiver.
(8) Budget.--Incorporate a budget. Such budget shall
include a description (and an estimate of costs) of
transitional activities to be undertaken in implementing the
proposed plan.
(9) Implementation.--Describe the method (including a
timetable and period of transition) for implementing the
waiver.
(c) Construction.--Nothing in this Act shall be construed as
preempting State laws that provide greater protections or benefits than
the protections or benefits required under this Act.
(d) Definitions.--As used in this Act:
(1) Eligible uninsured employees.--The term ``eligible
uninsured employees'' means--
(A) any resident of the United States--
(i) who is a citizen or national of the
United States, or lawful resident alien;
(ii) who resides in any particular State;
(iii) who is employed in a work site of an
employer that is a small business located in
the State;
(iv)(I) whose employer does not offer
employer-sponsored health insurance; or
(II) whose employer offers such insurance
but at a cost that is not affordable for the
resident (as determined by the State); and
(v) who is not entitled to benefits under
title XIX or XXI of the Social Security Act
based on eligibility requirements under those
titles in effect on or after the date of the
enactment of this Act; and
(B) the spouse and dependent children of such
resident
(2) Lawful resident alien.--The term ``lawful resident
alien'' means an alien lawfully admitted for permanent
residence and any other alien lawfully residing permanently in
the United States under color of law, including an alien
granted asylum or with lawful temporary resident status under
section 210, 210A, or 245A of the Immigration and Nationality
Act.
(3) Small business.--The term ``small business'' means an
employer who employs 50 or fewer employees.
(4) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(5) State.--The term ``State'' means a State, the District
of Columbia, the Commonwealth of Puerto Rico, the United States
Virgin Islands, Guam, American Samoa, and the Commonwealth of
the Northern Mariana Islands.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
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