[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4418 Introduced in House (IH)]







105th CONGRESS
  2d Session
                                H. R. 4418

  To amend title 5, United States Code, to make the Federal Employees 
Health Benefits Program available to the general public, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 6, 1998

  Mr. Klink introduced the following bill; which was referred to the 
              Committee on Government Reform and Oversight

_______________________________________________________________________

                                 A BILL


 
  To amend title 5, United States Code, to make the Federal Employees 
Health Benefits Program available to the general public, 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 ``Same Insurance as Congress Act of 
1998''.

SEC. 2. PROVISIONS TO MAKE FEHBP COVERAGE AVAILABLE TO INDIVIDUALS AND 
              SMALL EMPLOYERS.

    (a) In General.--Chapter 89 of title 5, United States Code, is 
amended by adding at the end the following:
``Sec. 8915. Expanded access to coverage
    ``(a) In General.--A contract may not be made or a plan approved 
unless the carrier agrees to offer to eligible individuals, throughout 
each term for which the contract or approval remains effective, the 
same benefits (subject to the same maximums, limitations, exclusions, 
and other similar terms or conditions and the same guidelines as are 
applied by the Office of Personnel Management) as would be offered 
under such contract or plan to employees and annuitants and their 
family members.
    ``(b) Eligible Individuals.--An individual shall be eligible to 
enroll under a plan or contract under this chapter pursuant to 
subsection (a) if such individual--
            ``(1) is not eligible to be enrolled in a group health plan 
        (as such term is defined in section 2791(a) of the Public 
        Health Service Act (42 U.S.C. 300gg-1(a));
            ``(2) is not eligible for benefits under the medicare 
        program under title XVIII of the Social Security Act (42 U.S.C. 
        1395 et seq.), for medical assistance under a State medicaid 
        plan under title XIX of such Act (42 U.S.C. 1396 et seq.), or 
        child health assistance under a State children's health 
        insurance program under title XXI of such Act (42 U.S.C. 1397aa 
        et seq.); and
            ``(3) meets such other requirements as the Office, by 
        regulation, may impose.
    ``(c) Enrollment.--The Office shall provide for the implementation 
of procedures to provide for an annual open enrollment period during 
which individuals may enroll with a plan or contract for coverage under 
this section.
    ``(d) Premiums.--Premiums for coverage under this section shall be 
established by the carriers in conformance with such requirements as 
the Office shall by regulation prescribe, including provisions to 
ensure conformance with generally accepted standards and practices 
associated with community rating. Nothing in this section shall be 
construed as providing or requiring that the premiums so established 
shall be the same as the premiums established for coverage offered 
under this chapter other than under this section.
    ``(e) Contributions and Benefits.--In no event shall the enactment 
of this section result in--
            ``(1) any increase in the level of individual contributions 
        by employees or annuitants as required under section 8906 or 
        under any other provision of this chapter, including copayments 
        or deductibles;
            ``(2) the payment by the Government of any premiums 
        associated with coverage under this section;
            ``(3) any decrease in the types of benefits offered under 
        this chapter; or
            ``(4) any other change that would adversely affect the 
        coverage afforded under this chapter to employees and 
        annuitants and their family members.
    ``(f) Exclusion of Certain Carriers.--
            ``(1) In general.--A carrier may file an application with 
        the Office setting forth reasons why such carrier, or a plan 
        provided by such carrier, should be excluded from the 
        requirements of this section.
            ``(2) Consideration of factors.--In reviewing an 
        application under paragraph (1), the Office may consider such 
        factors as--
                    ``(A) any bona fide enrollment restrictions which 
                would make the application of this section 
                inappropriate, including those common to plans which 
                are limited to individuals having a past or current 
                employment relationship with a particular agency or 
                other authority of the Government;
                    ``(B) whether compliance with this section would 
                jeopardize the financial solvency of the plan or 
                carrier, or otherwise compromise its ability to offer 
                health benefits under the preceding provisions of this 
                chapter; and
                    ``(C) the anticipated duration of the requested 
                exclusion and what efforts the plan or carrier proposes 
                to take in order to be able to comply with this 
                section.
    ``(g) Application of Section.--Except as the Office may by 
regulation prescribe, any reference to this chapter (or any requirement 
of this chapter), made in any provision of law, shall not be considered 
to include this section (or any requirement of this section).
    ``(h) Termination.--This section shall terminate on the date that 
is 10 years after the date of enactment of this section.''.
    (b) Clerical Amendment.--The table of sections for such is amended 
by adding at the end the following:

``8915. Expanded access to coverage.''.
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