[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5404 Introduced in House (IH)]







110th CONGRESS
  2d Session
                                H. R. 5404

  To amend the Public Health Service Act to establish a Federal grant 
  program to provide increased health care coverage to and access for 
   uninsured and underinsured workers and families in the commercial 
               fishing industry, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 13, 2008

   Mr. Frank of Massachusetts (for himself, Mr. Young of Alaska, Mr. 
   Tierney, Mr. Gilchrest, Mr. Delahunt, Mr. Kennedy, and Mr. Allen) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend the Public Health Service Act to establish a Federal grant 
  program to provide increased health care coverage to and access for 
   uninsured and underinsured workers and families in the commercial 
               fishing industry, 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 ``Commercial Fishing Industry Health 
Care Coverage Act of 2008''.

SEC. 2. GRANTS FOR QUALIFIED COMMERCIAL FISHING INDUSTRY HEALTH CARE 
              COVERAGE DEMONSTRATION PROGRAMS.

    Part B of title III of the Public Health Service Act is amended by 
adding at the end the following new section:

``SEC. 320B. GRANTS FOR QUALIFIED COMMERCIAL FISHING INDUSTRY HEALTH 
              CARE COVERAGE DEMONSTRATION PROGRAMS.

    ``(a) Establishment of Program.--
            ``(1) In general.--The Secretary, through the Health 
        Resources and Services Administration, shall establish a grant 
        program (in this section referred to as the `grant program') 
        for the purpose of assisting commercial fishing States to 
        establish, or strengthen existing, programs to expand health 
        care coverage and access for uninsured or underinsured workers 
        and their families in the commercial fishing industry.
            ``(2) Types of grants.--Under the grant program, the 
        Secretary shall provide--
                    ``(A) program planning grants under subsection (b) 
                for commercial fishing States and organizations within 
                such States; and
                    ``(B) implementation and administration grants 
                under subsection (c) for no more than 15 commercial 
                fishing States.
            ``(3) Application required.--No grant may be awarded under 
        this section except pursuant to an application that is made in 
        such form and manner, and containing such information, as the 
        Secretary may require.
    ``(b) Program Planning Grants.--
            ``(1) In general.--Under the grant program the Secretary 
        may award grants to one or more commercial fishing States (or 
        to organizations with a history of active involvement in the 
        commercial fishing industry in such a State, including 
        knowledge of economic and social aspects of such industry), not 
        to exceed $200,000 for each year and for no more than two 
        years, to conduct initial research and planning for the 
        development of a qualified health care coverage program in the 
        State. Any grantee under this subsection shall--
                    ``(A) conduct a demographic survey of the State's 
                commercial fishing industry and such industry's health 
                care needs; and
                    ``(B) develop a strategic plan, including a 
                detailed financial plan, for implementation of a 
                qualified health care coverage program within the 
                State.
            ``(2) Consultation with states.--Before awarding a grant 
        under this subsection to an organization, the Secretary shall 
        consult with States where the organization is located in order 
        to assist in a determination as to whether the organization--
                    ``(A) has the necessary familiarity with and 
                knowledge of the commercial fishing industry in the 
                State to fulfill the purposes of the grant; and
                    ``(B) has a history of fraudulent or abusive 
                practices that would disqualify the organization from 
                carrying out the grant.
            ``(3) Actions following completion of planning grants.--
        Based on the research findings, financial plan, and other 
        recommendations developed by the State or organization under 
        paragraph (1), a State may submit an application for program 
        implementation and administration grants under subsection (c).
    ``(c) Implementation and Program Administration Grants.--
            ``(1) In general.--Under the grant program, subject to the 
        succeeding provisions of this subsection, the Secretary may 
        award the following grants to commercial fishing States:
                    ``(A) Initial implementation grants.--A grant, not 
                to exceed $2,000,000 for each year and for no more than 
                two years, for initial implementation of a qualified 
                health care coverage program.
                    ``(B) Program administration grants.--A grant, not 
                to exceed $3,000,000 for each year and for no more than 
                five years, for administration of a qualified health 
                care coverage program.
                    ``(C) Continued administration grants.--A grant, 
                not to exceed $3,000,000 for each year, for continued 
                administration of a qualified health care coverage 
                program in a State that has been awarded administration 
                grants for 5 years under subparagraph (B) and that has 
                satisfactorily administered such program using the 
                funds provided by such grants for at least 5 years, if 
                the economic conditions of the fishing industry in the 
                program's service area (or the condition of fish stocks 
                that are important to the fishing industry in such 
                area) jeopardize the ability of the program to continue 
                providing affordable health care coverage.
        A grant may be made for a qualified health care coverage 
        program under subparagraph (A) or (B) regardless of whether or 
        not the program was developed with a program planning grant 
        under subsection (b) or was implemented under a grant under 
        subparagraph (A), respectively, and regardless of whether the 
        program was developed or initially implemented before the date 
        of the enactment of this section.
            ``(2) Eligibility requirements.--The Secretary may not 
        award a grant under this subsection to a commercial fishing 
        State for implementation or administration of a health care 
        coverage program unless--
                    ``(A) the State demonstrates that the program--
                            ``(i) is a qualified health care coverage 
                        program and enrolls fishing industry members 
                        and their families if they were uninsured or 
                        underinsured; and
                            ``(ii) requires Federal funding for its 
                        operation; and
                    ``(B) the State provides assurances satisfactory to 
                the Secretary that--
                            ``(i) if the program is an expansion of an 
                        existing health care coverage program, the 
                        State will use the grant funding to expand the 
                        enrolled population of uninsured or 
                        underinsured commercial fishing industry 
                        members and their families, or modify coverage 
                        to comply with qualified health care coverage, 
                        under the program and to supplement, and not 
                        supplant, State provided funding for such 
                        program; or
                            ``(ii) if the program is a new qualified 
                        health care coverage program, the State will 
                        ensure the program's continued success through 
                        the implementation of appropriate financial and 
                        consumer protection regulations, controls, 
                        licensing, or oversight policies, including (as 
                        determined by the State) any of the following:
                                    ``(I) Protection against 
                                insolvency, fraud and abuse.
                                    ``(II) State-based stop-loss 
                                protection.
                                    ``(III) Reinsurance.
                                    ``(IV) Receivership/liquidation 
                                protection against insolvency for 
                                individuals.
                                    ``(V) Another demonstration of 
                                State financial commitment.
            ``(3) Requirement of matching funds.--
                    ``(A) In general.--A grant may be made under this 
                subsection only if the State agrees to make available 
                (directly or through donations from public or private 
                entities) non-Federal contributions toward such costs 
                in an amount that is not less than $1 for each $2 of 
                Federal funds provided in the grant.
                    ``(B) Determination of amount contributed.--Non-
                Federal contributions required in subparagraph (A) may 
                be in cash or in kind, fairly evaluated, including 
                plant, equipment, or services. Amounts provided by the 
                Federal Government, or services assisted or subsidized 
                to any significant extent by the Federal Government, 
                may not be included in determining the amount of such 
                non-Federal contributions.
            ``(4) Contracting authority.--
                    ``(A) In general.--A commercial fishing State may 
                enter into a contract with one or more eligible non-
                profit organizations or companies for the purpose of 
                conducting activities under an implementation or 
                administration grant under this subsection and may not 
                enter into such a contract with an organization or 
                company which is not eligible under subparagraph (C).
                    ``(B) Subcontracting arrangements.--A contractor 
                described in subparagraph (A) may subcontract with one 
                or more eligible non-profit organizations or companies 
                for the purpose of conducting activities under such an 
                implementation or administration grant, if the State 
                approves such subcontracting arrangements.
                    ``(C) Eligibility standards.--The Secretary shall 
                issue regulations establishing eligibility standards 
                for organizations and companies under this paragraph. 
                Such standards shall include requirements that States 
                review whether prospective contractors or 
                subcontractors under this paragraph--
                            ``(i) have a history of fraudulent or 
                        abusive practices that would disqualify them 
                        from participating in a contract or 
                        subcontract;
                            ``(ii) have the capability and experience 
                        to assist in the management of a qualified 
                        health care coverage program; and
                            ``(iii) in the case of commercial fishing 
                        organizations, have an appropriate level of 
                        familiarity with, and knowledge of, the 
                        commercial fishing industry.
    ``(d) Definitions.--For purposes of this section:
            ``(1) Commercial fishing state.--The term `commercial 
        fishing State' means a State (as defined in section 2(f)) with 
        a significant commercial fishing population or a significant 
        commercial fishing industry. The Secretary shall accept a 
        State's self-certification that it is a commercial fishing 
        State if the State demonstrates to the Secretary that--
                    ``(A) such self-certification is based on 
                consultation by the State with local organizations 
                familiar with the commercial fishing industry in the 
                State; and
                    ``(B) the State has a significant commercial 
                fishing population or a significant commercial fishing 
                industry.
            ``(2) Commercial fishing industry member.--The term 
        `commercial fishing industry member' means a fisherman, 
        crewmember, boat owner, captain, shore side business owner, 
        employee of a company that provides shore side support, 
        harvester, or other individual performing commercial fishing 
        industry-related work, if more than half of such individual's 
        income derives from such work at the time the individual 
        enrolls in a qualified health care coverage program.
            ``(3) Qualified health care coverage program.--The term 
        `qualified health care coverage program' means a program that 
        provides qualified health care coverage to commercial fishing 
        industry members and their families consistent with the 
        following:
                    ``(A) Eligibility for enrollment of such members 
                and families is only restricted by capacity, based on a 
                first come, first served basis when space is limited, 
                and health status related factors (as defined in 
                section 2702), age, and gender may not be used as a 
                basis for determining eligibility.
                    ``(B) The program does not include any preexisting 
                condition exclusion (as defined in section 2701) or any 
                coverage elimination rider that permanently excludes 
                from coverage an existing medical condition.
                    ``(C) Premium rates under the program are computed 
                based on a community rate, and may be adjusted only for 
                income and family size.
            ``(4) Qualified health care coverage.--The term `qualified 
        health care coverage' means coverage that meets any of the 
        following conditions:
                    ``(A) FEHBP coverage.--The coverage is actuarially 
                equivalent to the coverage provided under the health 
                benefits plan, under chapter 89 of title 5, United 
                States Code, which has the largest enrollment, either 
                in the United States or in the State involved.
                    ``(B) State employees coverage.--The coverage is 
                actuarially equivalent to the coverage provided under 
                the health benefits plan, that is offered by the State 
                to State government employees, which has the largest 
                enrollment of such plans in the State.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretary for the purpose of carrying out this 
section--
            ``(1) $5,000,000 for fiscal year 2009;
            ``(2) $5,000,000 for fiscal year 2010;
            ``(3) $10,000,000 for fiscal year 2011;
            ``(4) $10,000,000 for fiscal year 2012; and
            ``(5) $20,000,000 for fiscal year 2013.''.
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