[Congressional Record Volume 154, Number 24 (Wednesday, February 13, 2008)]
[Senate]
[Pages S977-S979]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KENNEDY (for himself, Mr. Stevens, Mr. Kerry, and Ms. 
        Murkowski):
  S. 2630. 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; to the Committee 
on Health, Education, Labor, and Pensions.
  Mr. KENNEDY. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 2630

       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 (42 
     U.S.C. 243 et seq.) 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--

[[Page S978]]

       ``(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.''.

  Mr. STEVENS. Mr. President, I come to the floor to support the 
Commercial Fishing Industry Healthcare Coverage Act of 2008. My good 
friend Senator Kennedy and I, along with Senators Kerry and Murkowski, 
are introducing this bill to improve healthcare options for our 
Nation's fishermen and fishing families.
  Few things are more Alaskan than fishing. Long before Alaska was even 
a U.S territory, our people were fishing for their livelihood. The 
first Alaskans, Alaska Natives depended on subsistence fishing, as many 
do today. Russian settlers built salteries to preserve their catch 
through our long, harsh winters. In the 1800s, the first canneries were 
built in Sitka and Klawock, marking the birth of Alaska's modern 
commercial fishing industry.
  Today, Alaska's seafood industry is the State's largest private 
employer and a fundamental part of Alaskan culture. All around our 
State, from Ketchikan, at the Southern end of the panhandle, to 
Kotzebue, above the Arctic Circle, fishermen brave the elements so all 
Americans may enjoy the bounty of Alaskan waters. Their work is vital 
to the economies of numerous communities in our State.

[[Page S979]]

  While Alaskans have fishing in their blood, skyrocketing costs have 
made it increasingly difficult for these hard-working men and women to 
earn a living. One of the major challenges our commercial fishermen 
face is obtaining affordable healthcare.
  The problem is not unique to my State. Lack of health coverage is a 
dilemma for fishermen in other coastal States. Surveys conducted in 
different parts of the country show fishing families are significantly 
more likely to be uninsured than other Americans.
  The commercial fishing industry produces billions of dollars for the 
U.S. economy each year. Despite their contributions, the seasonal and 
dangerous nature of their profession bars many commercial fishermen 
from obtaining health insurance; most work for themselves or for small 
employers. Fishermen are forced to pay high premiums and deductibles, 
which can effectively put health insurance out of reach.
  In my State, fishermen face additional complications when looking for 
affordable health insurance. A study by the United Fishermen of Alaska 
found that our fishermen are more likely to work and live in 
communities without a hospital. Also, fewer private insurance companies 
offer individual or small business medical coverage in Alaska than in 
other States. And, most fishermen simply cannot afford the rates 
charged by these providers.
  That lack of basic health services impacts everyone in our fishing 
fleet, from our older fishermen, who may be most in need of health 
coverage, to the younger generation of fishermen, who find the lack of 
affordable healthcare a barrier to entering the profession.
  As one fisherman from Juneau put it:

       I've applied with two different major health insurance 
     providers, and both have declined me coverage because of my 
     occupation . . . living and working without health insurance 
     is like living on borrowed time. I constantly feel I am 
     pushing my luck, and a single illness or injury could mean 
     bankruptcy for me.

  With the high cost of individual health insurance and the lack of 
proximity to healthcare facilities in Alaska families are less likely 
to seek preventive care, resulting in medical emergencies that could 
have been avoided. When uninsured fishermen end up in emergency rooms 
with serious diseases and injuries, taxpayers often absorb the costs.
  Our bill is inspired by the successful fishermen's healthcare plan 
adopted by Senator Kennedy's home State of Massachusetts, which has 
proven that health insurance can be made affordable for fishing 
families. This legislation will establish a grant program to help 
States and fishing organizations create and administer group health 
insurance programs for fishermen and fishing families.
  Americans are consuming more and more seafood as they discover its 
great taste and considerable health benefits. We cannot forget where 
these fish come from. They come from the labor of men and women working 
up and down the coasts of this country, many struggling to earn a 
living and preserve a tradition that has spanned generations.
  This measure would help put affordable medical care within their 
reach. I encourage my fellow Senators to support the bill.
                                 ______