II 109th CONGRESS 1st Session S. 288 IN THE SENATE OF THE UNITED STATES February 3, 2005 Mr. Gregg (for himself, Mr. Baucus, Mr. DeWine, Mr. Bingaman, Mr. Roberts, Mr. Lieberman, and Mr. Cochran) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To extend Federal funding for operation of State high risk health insurance pools.

1.

Short title

This Act may be cited as the State High Risk Pool Funding Extension Act of 2005.

2.

Extension of funding for operation of State high risk health insurance pools

(a)

Extension of seed grants

Section 2745 of the Public Health Service Act (42 U.S.C. 300gg–45) is amended— (1)in subsection (a), in the subsection heading by inserting Extension of before Seed; and (2)in subsection (c)(1), by striking $20,000,000 and all that follows through 2003 and inserting $15,000,000 for the period of fiscal years 2005 and 2006. (b)

Funds for operations

Section 2745 of the Public Health Service Act (42 U.S.C. 300gg–45) is amended— (1)in subsection (b)— (A)in the subsection heading by striking Matching; and (B)by striking paragraph (2) and inserting the following: (2)

Allotment

The amounts appropriated under subsection (c)(2) for a fiscal year shall be made available to the States (or the entities that operate the high risk pool under applicable State law) as follows: (A)An amount equal to 50 percent of the appropriated amount for the fiscal year shall be allocated in equal amounts among each eligible State that applies for assistance under this subsection. (B)An amount equal to 25 percent of the appropriated amount for the fiscal year shall be allocated among the States so that the amount provided to a State bears the same ratio to such available amount as the number of uninsured individuals in the State bears to the total number of uninsured individuals in all States (as determined by the Secretary). (C)An amount equal to 25 percent of the appropriated amount for the fiscal year shall be allocated among the States so that the amount provided to a State bears the same ratio to such available amount as the number of individuals enrolled in health care coverage through the qualified high risk pool of the State bears to the total number of individuals so enrolled through qualified high risk pools in all States (as determined by the Secretary). ; and (2)in subsection (c)(2), by striking $40,000,000 and all that follows through the period and inserting $75,000,000 for each of fiscal years 2005 through 2009 to make allotments under subsection (b)(2).. (c)

Definitions

Section 2745 of the Public Health Service Act (42 U.S.C. 300gg–45) is amended— (1)in subsection (d), by inserting after 2744(c)(2) the following: , except that with respect to subparagraph (A) of such section a State may elect to provide for the enrollment of eligible individuals through an acceptable alternative mechanism,; and (2)by adding at the end the following: (e)

Standard risk rate

In subsection (b)(1)(A), the term standard risk rate means a rate— (1)determined under the State high risk pool by considering the premium rates charged by other health insurers offering health insurance coverage to individuals in the insurance market served; (2)that is established using reasonable actuarial techniques; and (3)that reflects anticipated claims experience and expenses for the coverage involved. .