Allows a State to elect to provide temporary Medicaid coverage under title XIX of the Social Security Act for individuals who are: (1) eligible for unemployment benefits; (2) not eligible for COBRA continuation coverage; and (3) not covered under a group health plan, health insurance, Medicare, or Medicaid.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 256 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 256
To provide for premium assistance for COBRA continuation coverage for
certain individuals and to permit States to provide temporary Medicaid
coverage for certain uninsured employees.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 8, 2003
Mr. Boucher (for himself and Mr. Goode) introduced the following bill;
which was referred to the Committee on Education and the Workforce, and
in addition to the Committees on Energy and Commerce and 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 for premium assistance for COBRA continuation coverage for
certain individuals and to permit States to provide temporary Medicaid
coverage for certain uninsured employees.
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 Coverage Assistance for
the Unemployed Act of 2003''.
SEC. 2. PREMIUM ASSISTANCE FOR COBRA CONTINUATION COVERAGE.
(a) Establishment.--
(1) In general.--Not later than 60 days after the date of
enactment of this Act, the Secretary of Labor shall establish a
program under which premium assistance for COBRA continuation
coverage shall be provided for qualified individuals under this
section.
(2) Qualified individuals.--For purposes of this section, a
qualified individual is an individual who--
(A) establishes that the individual--
(i) on or after January 1, 2001, and before
January 1, 2004, became entitled to elect COBRA
continuation coverage (other than solely on the
basis described in paragraph (3), (4), (5), or
(6) of section 603 of the Employee Retirement
Income Security Act of 1974); and
(ii) has elected such coverage; and
(B) enrolls in the premium assistance program under
this section by not later than December 31, 2003.
(b) Limitation of Period of Premium Assistance.--Premium assistance
provided under this subsection shall end with respect to an individual
on the earlier of--
(1) the date the individual is no longer covered under
COBRA continuation coverage; or
(2) 18 months after the date the individual is first
enrolled in the premium assistance program established under
this section.
(c) Payment, and Crediting of Assistance.--
(1) Amount of assistance.--Premium assistance provided
under this section shall be equal to 75 percent of the amount
of the premium required for the COBRA continuation coverage.
(2) Provision of assistance.--Premium assistance provided
under this section shall be provided through the establishment
of direct payment arrangements with the administrator of the
group health plan (or other entity) that provides or
administers the COBRA continuation coverage. It shall be a
fiduciary duty of such administrator (or other entity) to enter
into such arrangements under this section.
(3) Premiums payable by qualified individual reduced by
amount of assistance.--Premium assistance provided under this
section shall be credited by such administrator (or other
entity) against the premium otherwise owed by the individual
involved for such coverage.
(d) Change in COBRA Notice.--
(1) General notice.--
(A) In general.--In the case of notices provided
under sections 606 of the Employee Retirement Income
Security Act of 1974, section 2206 of the Public Health
Service Act, and section 4980B(f)(6) of the Internal
Revenue Code of 1986 with respect to individuals who,
on or after January 1, 2001, and before January 1,
2004, become entitled to elect COBRA continuation
coverage, such notices shall include an additional
notification to the recipient of the availability of
premium assistance for such coverage under this
section.
(B) Alternative notice.--In the case of COBRA
continuation coverage to which the notice provisions
described in subparagraph (A) do not apply, the
Secretary of Labor shall, in coordination with
administrators of the group health plans (or other
entities) that provide or administer the COBRA
continuation coverage involved, assure provision of
such notice.
(C) Form.--The requirement of the additional
notification under this paragraph may be met by
amendment of existing notice forms or by inclusion of a
separate document with the notice otherwise required.
(2) Specific requirements.--Each additional notification
under paragraph (1) shall include--
(A) the forms necessary for establishing
eligibility under subsection (a)(2)(A) and enrollment
under subsection (a)(2)(B) in connection with the
coverage with respect to each covered employee or other
qualified beneficiary;
(B) the name, address, and telephone number
necessary to contact the plan administrator and any
other person maintaining relevant information in
connection with the premium assistance; and
(C) the following statement displayed in a
prominent manner:
``You may be eligible to receive assistance with payment of 75
percent of your COBRA continuation coverage premiums for a duration of
not to exceed 18 months.''.
(3) Notice relating to retroactive coverage.--In the case
of such notices previously transmitted before the date of the
enactment of this Act in the case of an individual described in
paragraph (1) who has elected (or is still eligible to elect)
COBRA continuation coverage as of the date of the enactment of
this Act, the administrator of the group health plan (or other
entity) involved or the Secretary of Labor (in the case
described in the paragraph (1)(B)) shall provide (within 60
days after the date of the enactment of this Act) for the
additional notification required to be provided under paragraph
(1).
(4) Model notices.--The Secretary of Labor shall prescribe
models for the additional notification required under this
subsection.
(e) Obligation of Funds.--This section constitutes budget authority
in advance of appropriations Acts and represents the obligation of the
Federal Government to provide for the payment of premium assistance
under this section.
(f) Prompt Issuance of Guidance.--The Secretary of Labor shall
issue guidance under this section not later than 30 days after the date
of the enactment of this Act.
(g) Definitions.--In this Act:
(1) Administrator.--The term ``administrator'' has the
meaning given such term in section 3(16) of the Employee
Retirement Income Security Act of 1974.
(2) COBRA continuation coverage.--The term ``COBRA
continuation coverage'' means continuation coverage provided
pursuant to title XXII of the Public Health Service Act,
section 4980B of the Internal Revenue Code of 1986 (other than
subsection (f)(1) of such section insofar as it relates to
pediatric vaccines), part 6 of subtitle B of title I of the
Employee Retirement Income Security Act of 1974 (other than
under section 609), section 8905a of title 5, United States
Code, or under a State program that provides continuation
coverage comparable to such continuation coverage.
(3) Group health plan.--The term ``group health plan'' has
the meaning given such term in section 9832(a) of the Internal
Revenue Code of 1986.
(4) State.--The term ``State'' includes the District of
Columbia, the Commonwealth of Puerto Rico, the Virgin Islands,
Guam, American Samoa, and the Commonwealth of the Northern
Mariana Islands.
SEC. 3. OPTIONAL TEMPORARY MEDICAID COVERAGE FOR UNINSURED ELIGIBLE
EMPLOYEES.
(a) In General.--Notwithstanding any other provision of law, a
State may elect to provide, under its medicaid program under title XIX
of the Social Security Act, medical assistance in the case of an
individual who is eligible for unemployment benefits, who is not
eligible for COBRA continuation coverage, and who is uninsured. For
purposes of this section, an individual is considered to be uninsured
if the individual is not covered under a group health plan, health
insurance coverage, or under such program or a program under title
XVIII or XXI of such Act.
(b) Limitation to 18 Months of Coverage.--Assistance under this
section shall end with respect to an individual on the earlier of--
(1) the date the individual is no longer uninsured; or
(2) 18 months after the date the individual is first
determined to be eligible for medical assistance under this
section.
(c) Special Rules.--In the case of medical assistance provided
under this section--
(1) the Federal medical assistance percentage under section
1905(b) of the Social Security Act shall be 100 percent;
(2) a State may elect to disregard any income, asset, or
resource limitation imposed under the State medicaid plan or
under title XIX of such Act, except, notwithstanding any other
provision of law, a State shall condition eligibility for
assistance under this section upon the payment of a monthly
premium approximating 25 percent of the average cost of
providing the assistance under this section;
(3) such medical assistance shall not be provided for
periods before the date the individual is determined eligible
for such assistance;
(4) a State may elect to make eligible for such assistance
a dependent spouse or children of an individual eligible for
medical assistance under subsection (a), if such spouse or
children are uninsured; and
(5) individuals eligible for medical assistance under this
section shall be deemed to be described in the list of
individuals described in the matter preceding paragraph (1) of
section 1905(a) of such Act.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Education and the Workforce, and in addition to the Committees on Energy and Commerce, and 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 Education and the Workforce, and in addition to the Committees on Energy and Commerce, and 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 Education and the Workforce, and in addition to the Committees on Energy and Commerce, and 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 Education and the Workforce, and in addition to the Committees on Energy and Commerce, and 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.
Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman.
Referred to the Subcommittee on Employer-Employee Relations.
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