[Congressional Record Volume 153, Number 157 (Wednesday, October 17, 2007)]
[Senate]
[Pages S12997-S12998]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SMITH (for himself, Mr. Bingaman, Mr. Salazar, and Mr. 
        Sanders):
  S. 2186. A bill to permit individuals who are employees of a grantee 
that is receiving funds under section 330 of the Public Health Service 
Act to enroll in health insurance coverage provided under the Federal 
Employees Health Benefits Program; to the Committee on Homeland 
Security and Governmental Affairs.
  Mr. SMITH. Mr. President, today I am introducing the Community Health 
Center Employee Health Coverage Act of 2007, a bill that will help 
provide community health centers, or CHCs, better access to more 
affordable health insurance for their employees. I am pleased to have 
my colleagues Senators Bingaman, Salazar and Sanders join me as 
original cosponsors on this important proposal.
  CHCs form the backbone of the Nation's health care safety net. They 
provide essential medical services to some of our most vulnerable 
citizens, including the uninsured and Medicaid and Medicare 
beneficiaries. In my home State of Oregon, health centers provide over 
130 points of access, where upwards of 180,000 individuals receive care 
each year. Approximately 41 percent of those served are uninsured and 
36 percent are on Medicaid, and most all reside in either a rural or 
economically depressed area. Clearly, CHCs have an important role in 
ensuring that those who otherwise might be unable to afford health 
coverage have access to the care they need.
  CHCs also serve their patients in a very efficient manner. Studies 
have shown that care provided Medicaid patients at CHCs costs 30 
percent less than care provided in other settings. This is mainly due 
to a lower number of specialty referrals and fewer overall hospital 
admissions. CHCs effectively demonstrate how focusing on primary and 
preventive care can help keep individuals healthier, which ultimately 
enhances their lives and saves the broader health care system money. 
Above and beyond the efficiencies CHCs have achieved in service 
delivery, patients report overwhelming satisfaction for the treatment 
they are provided. Health care providers across the spectrum would be 
well-served by emulating CHCs' example of delivering affordable, high-
quality health care in an efficient manner.
  Given the enormous value CHCs have to the U.S. health care system, I 
believe Congress should do all it can to support their mission. I 
commend President Bush's commitment to increasing funding for health 
center expansion in recent years. I am pleased the administration's 
request for $180

[[Page S12998]]

million in new funding in fiscal year 2007 was included in the Senate's 
version of the budget resolution. As the appropriations process 
continues to move forward, I hope that those much-needed funds are 
ultimately approved by Congress.
  The bill I am filing today will compliment the increased funding CHCs 
have received in recent years. Just like businesses across the nation, 
health centers are coping with the rising cost of providing health 
benefit to their employees. Premiums for private health insurance grew 
by 9.5 percent in 2005, the fifth consecutive year of increases over 9 
percent. Because CHCs operate on very limited budgets, it has become 
more and more difficult for them to absorb these increased costs while 
continuing to provide affordable health care to their patients.
  It is important to note that CHCs rely upon the Federal Government 
for more than half of their operating revenues. Each year, health 
centers receive 26 percent of their funding from direct Federal grants 
and another 36 percent from the Medicaid Program. Because CHCs are 
predominantly a Federal enterprise, I believe it makes sense for them 
to be able to reap many of the same benefits of other Federal entities. 
That is why the bill I am filing today would allow CHCs to purchase 
more affordable health insurance coverage for their employees through 
the Federal Employee Health Benefits Program, FEHBP.
  Allowing federally funded entities to purchase health coverage 
through FEHBP is not unprecedented. Employees of Gallaudet University 
and certain U.S. Department of Agriculture grantees already are able to 
participate in FEHBP as if they were directly employed by the Federal 
Government. Considering that CHC providers are already deemed ``Federal 
employees'' for the purpose of receiving medical liability protection 
through the Federal Government, it is a logical next step to allow them 
to purchase health coverage through FEHBP. In doing so, we will be able 
to provide CHCs much needed security in knowing that their employees 
will have steady access to affordable health insurance.
  I believe that in the long run, CHCs will be able to achieve a great 
deal of savings by purchasing health coverage for their employees 
through FEHBP. Premiums for policies purchased through FEHBP 
consistently grow at a much slower rate than other commercial policies. 
Every dollar CHCs save in employee benefit costs can be redirected into 
medical care for the vulnerable populations they serve. Access to FEHBP 
coverage also may help some CHCs provide health benefits to their 
employees for the first time. This could help recruit much needed 
medical personnel in underserved and rural communities. I am hopeful 
health centers in rural parts of my State will be able to attract the 
physicians they so desperately need by offering them FEHBP coverage.
  There is wide support for CHCs in the Senate, as evidenced by the 
development of a number of CHC-related measures. Earlier this year, I 
joined a group of bipartisan Senators in filing the Community Health 
Center Reauthorization Act, to ensure that vulnerable populations have 
access to basic health care for the next several years. I hope the 
Senate's leadership will move these bills quickly through the process, 
as a sign of appreciation for the important role CHCs play in the U.S. 
health care system.
  I ask unanimous consent that full text of the bill be printed in the 
Record.

                                S. 2186

       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 ``Community Health Center 
     Employee Health Coverage Act of 2007''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Federally Qualified Health Centers (referred to in this 
     section as ``FQHCs'') are required under section 330 of the 
     Public Health Service Act (42 U.S.C. 254b) to be located in, 
     and serve, a community that is designated as ``medically 
     underserved''.
       (2) FQHCs are required under such section 330 to make its 
     services available to all residents of the community, without 
     regard to ability to pay, and to make those services 
     affordable by discounting charges for otherwise uncovered 
     care to low-income families in accordance with family income.
       (3) FQHCs are required under such section 330 to provide 
     comprehensive primary health care services, including 
     preventive care, care for illness or injury, services which 
     improve the accessibility of care, and the effectiveness of 
     care.
       (4) FQHCs are required under such section 330 to be 
     governed by a board of directors, a majority of whose members 
     are active, registered patients of the health center, thus 
     ensuring that the center is responsive to the health care 
     needs of the community it serves.
       (5) FQHCs delivered comprehensive primary and preventive 
     care to more than 16,000,000 people in 2006, more than 
     6,000,000 of whom had no health insurance coverage.
       (6) FQHCs employ nearly 100,000 people across the United 
     States.
       (7) FQHCs are being challenged by increasing financial 
     pressures that jeopardize their ability to provide health 
     services to medically underserved populations, including the 
     elderly, the uninsured, and lower-income individuals.
       (8) Health insurance costs in the small employer market 
     have risen more than 30 percent in the past 2 years, forcing 
     many FQHCs to use additional Federal funding to continue to 
     provide health insurance coverage for their employees.
       (9) The Federal Government negotiates premiums with health 
     insurance companies for millions of Federal employees, 
     thereby ensuring the best possible rates under the Federal 
     Employee Health Benefit Program (referred to in this section 
     as ``FEHBP'').
       (10) Last year FEHBP premiums increased 6.6 percent, far 
     less than that of even large employers.
       (11) FQHCs receive Federal grants from the Health Resource 
     and Services Administration that help cover the cost of 
     providing high quality, affordable health care for everyone 
     in their communities, including the uninsured.
       (12) FQHCs use a portion of their Federal grant to cover 
     the cost of health insurance for their employees.
       (13) As health insurance premiums rise, FQHCs may be forced 
     to reduce health insurance coverage for their own employees, 
     or reduce the availability of care in their communities.
       (14) Last year, almost 1,400,000 Americans joined the ranks 
     of the uninsured--bringing our Nation's total to more than 
     47,000,000 people without health insurance, while another 
     30,000,000 or more are underinsured.
       (15) The uninsured are in significantly worse health than 
     those with health insurance, receive fewer preventive 
     services, are less likely to receive regular care for chronic 
     diseases, and are more likely to be hospitalized for a 
     condition that could have been treated more effectively with 
     timely access to ambulatory care.
       (16) Adding FQHC employees to the list of those covered 
     under the FEHBP would help control rising health insurance 
     costs, reduce the cost of providing health insurance to their 
     employees, and enable centers to use scarce funds to continue 
     providing care in their communities.

     SEC. 3. ADDITION OF HEALTH CENTER EMPLOYEES TO FEHBP.

       (a) Definitions.--Section 8901(l) of title 5, United States 
     Code, is amended--
       (1) in subparagraph (H), by striking ``and'' at the end;
       (2) in subparagraph (I), by striking the period and 
     inserting ``; and''; and
       (3) by adding at the end the following:
       ``(J) an individual who is an employee of a federally 
     qualified health center (as defined in section 1905(l)(2)(B) 
     of the Social Security Act (42 U.S.C. 1396d(l)(2)(B))) that 
     has elected to offer coverage under this chapter or who is an 
     employee of a grantee that is receiving funds under section 
     330(l) of the Public Health Service Act (42 U.S.C. 254b(l)) 
     that has elected to offer coverage under this chapter.''.
       (b) Employees Health Benefits Fund.--Section 8909 of title 
     5, United States Code, is amended by adding at the end the 
     following:
       ``(h) An individual who is an employee of a federally 
     qualified health center (as defined in section 1905(l)(2)(B) 
     of the Social Security Act (42 U.S.C. 1396d(l)(2)(B))) who 
     has elected coverage under this chapter or who is an employee 
     of a grantee that is receiving funds under section 330(l) of 
     the Public Health Service Act (42 U.S.C. 254b(l)) who has 
     elected coverage under this chapter shall be required to pay 
     currently into the Employees Health Benefits Fund, under 
     arrangements satisfactory to the Office, an amount equal to 
     the sum of--
       ``(1) the employee and agency contributions which would be 
     required in the case of an employee enrolled in the same 
     health benefits plan and level of benefits; and
       ``(2) an amount, determined under regulations prescribed by 
     the Office, necessary for administrative expenses, but not to 
     exceed 2 percent of the total amount under clause (i).''.
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