[Congressional Record Volume 164, Number 107 (Tuesday, June 26, 2018)]
[Senate]
[Pages S4440-S4441]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 3167. Mr. SANDERS submitted an amendment intended to be proposed 
by him to the bill H.R. 2, to provide for the reform and continuation 
of agricultural and other programs of the Department of Agriculture 
through fiscal year 2023, and for other purposes; which was ordered to 
lie on the table; as follows:

       At the appropriate place, insert the following:

     SEC. ___. HEALTH CARE FOR FARMERS AND RANCHERS.

       (a) In General.--The Secretary of Agriculture (referred to 
     in this section as the ``Secretary'') shall award grants to 
     States and nonprofit entities to establish and support 
     programs to mitigate the financial risk posed to farms and 
     ranches by high health costs by--
       (1) providing information and services to assist farmers 
     and ranchers to determine their eligibility for comprehensive 
     health coverage;
       (2) subsidizing out-of-pocket health expenditures for 
     farmers and ranchers who are enrolled in comprehensive health 
     coverage and have annual household incomes below 500 percent 
     of the Federal poverty rate; and
       (3) subsidizing the purchase of comprehensive health 
     coverage for farmers and ranchers who are described in 
     section 1902(a)(10)(A)(i)(VIII) of the Social Security Act 
     (42 U.S.C. 1396a(a)(10)(A)(i)(VIII)) but who reside in a 
     State that has not elected to provide coverage under the 
     State Medicaid plan under title XIX of such Act (or a waiver 
     of such plan) to individuals described in such section.
       (b) Definitions.--In this section:
       (1) Farmers and ranchers.--The term ``farmers and 
     ranchers'' means individuals who work as farmers or ranchers, 
     and any spouse or dependant (as defined in section 152 of the 
     Internal Revenue Code of 1986) of such an individual.
       (2) Comprehensive health coverage.--The term 
     ``comprehensive health coverage'' means public or private 
     health insurance coverage that--
       (A) offers--
       (i) benefits that are at least equivalent to the essential 
     health benefits package under section 1302(a) of the Patient 
     Protection and Affordable Care Act (42 U.S.C. 18022(a)); and
       (ii) consumer protections that are at least equivalent to 
     the consumer protections required under such Act and under 
     title XXVII of the Public Health Service Act (42 U.S.C. 300gg 
     et seq.), including protections for individuals with pre-
     existing conditions; or
       (B) meets the requirements for being minimum essential 
     coverage under section 5000A(f)(1) of the Internal Revenue 
     Code of 1986, as in effect on June 1, 2018.
       (3) Out-of-pocket health expenditures.--The term ``out-of-
     pocket health expenditures'' means health insurance 
     deductibles, copayments, coinsurance, or other cost-sharing 
     incurred by individuals and families enrolled in 
     comprehensive health insurance benefits.
       (c) Number of Awards.--The Secretary shall make awards 
     under this section to eligible applicants located in not 
     fewer than 10 States.
       (d) Grant Period.--Grants under this section shall be 
     awarded for not longer than a 5-year period and may be 
     renewed at the Secretary's discretion.
       (e) Selection Priority.--In awarding grants under this 
     section, the Secretary shall--
       (1) give priority to States and nonprofit entities located 
     in States where, according to the most recent Census of 
     Agriculture the primary occupation of not less than half of 
     principal farm operators is farming; and
       (2) ensure that grantees and grant funds are distributed 
     across Census of Agriculture regions and divisions.
       (f) Supplement Not Supplant.--Funds made available under 
     this section shall be used to supplement, and not supplant, 
     other Federal, State, or private funds that are made 
     available for the purposes described in subsection (a).
       (g) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Secretary to carry out this section 
     $20,000,000 for each of fiscal years 2019 through 2023, to 
     remain available until expended.

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