S. 3701Senate109th Congress (2005-2007)In Committee

Catastrophic Health Coverage Promotion Act

Introduced July 20, 2006

Legislative Activity

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2 earlier actions
SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance.

July 20, 2006

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SenateIntro Referral

Introduced in Senate

July 20, 2006

SenateIntro Referral

Sponsor introductory remarks on measure. (CR S8060)

July 20, 2006

SenateIntro Referral

Read twice and referred to the Committee on Finance.

July 20, 2006

Floor Debate

22 members

What members said about S. 3701 on the floor

9 Republicans13 Democrats
Patrick J. Leahy
Sen. Patrick J. LeahyD-VT · Jul 20, 2006

Mr. President pro tempore, my dear friend, the senior Senator from Alaska, I see the majority leader on the floor. Is he seeking recognition? Mr. President, before I begin, I assume we will go back…

Edward M. Kennedy
Sen. Edward M. KennedyD-MA · Jul 20, 2006

Mr. President, this is an historic day. In the quietness of the moment, on the floor of the Senate, we are talking about a major piece of legislation that is basic to the fabric of what America is…

Christopher J. Dodd
Sen. Christopher J. DoddD-CT · Jul 20, 2006

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. Mr. President, it is with a great sense of pride and privilege that I rise today in strong, strong support of…

Richard J. Durbin
Sen. Richard J. DurbinD-IL · Jul 20, 2006

Mr. President, if you are a student of history, this is a moment that you should reflect on and savor. Just a short time ago, I came to the floor and sat in the back row and listened as Senator Ted…

John Cornyn
Sen. John CornynR-TX · Jul 20, 2006

Mr. President, I add that I share the views of my colleague from Arizona. Like he, I represent a State that is covered by section 5 of the Voting Rights Act which is one of the sections that is being…

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Arlen Specter
Sen. Arlen SpecterR-PA · Jul 20, 2006

Are we prepared to proceed at this time with the consideration of the Voting Rights Act? Mr. President, this is a historic day for the Senate and really a historic day for America as we move forward…

Hillary Rodham Clinton
Sen. Hillary Rodham ClintonD-NY · Jul 20, 2006

Mr. President, I am also here to voice my support for the Fannie Lou Hamer, Rosa Parks, and Coretta Scott King Voting Rights Act Reauthorization and Amendments Act of 2006. It is so fitting that this…

Jeff Sessions
Sen. Jeff SessionsR-AL · Jul 20, 2006

Mr. President, I rise to voice my support for reauthorizing the Voting Rights Act of 1965. H.R. 9, the bill to reauthorize the Voting Rights Act, is an important piece of legislation. I wish to take…

Barbara Boxer
Sen. Barbara BoxerD-CA · Jul 20, 2006

Mr. President, before Senator Kerry leaves the floor, I want to thank him. The issues he raised absolutely have to be a part of this debate. I will address them after he leaves. The reason I stood up…

William H. Frist
Sen. William H. FristR-TN · Jul 20, 2006

Mr. President, this morning we are proceeding directly to H.R. 9, the voting rights reauthorization bill. We have a unanimous consent order that provides for up to 8 hours of debate today, although I…

John F. Kerry
Sen. John F. KerryD-MA · Jul 20, 2006

Mr. President, I ask unanimous consent that I be permitted to proceed for 10 minutes and, following me, Senator Boxer be permitted to proceed for 15 minutes, and following her, Senator Schumer for 5…

Mitch McConnell
Sen. Mitch McConnellR-KY · Jul 20, 2006

Mr. President, the reauthorization of the Voting Rights Act brings back a lot of memories of my early life and childhood. When I was born in the Deep South, in Alabama, segregation, regretfully, was…

Ron Wyden
Sen. Ron WydenD-OR · Jul 20, 2006

Mr. President, I also congratulate our colleagues who have worked tirelessly to ensure the authorization of the exceptionally important Voting Rights ct. This law plays a critical role in ensuring…

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Ron Wyden
Sen. Ron WydenD-OR · Jul 20, 2006

Mr. President, how much time remains under the Smith unanimous consent request for a half hour? Thank you, Mr. President. Mr. President, I have come to the floor today to join my colleague at this…

Ron Wyden
Sen. Ron WydenD-OR · Jul 20, 2006

Mr. President, how much time remains under the Smith unanimous consent request for a half hour? Thank you, Mr. President. Mr. President, I have come to the floor today to join my colleague at this…

Ken Salazar
Sen. Ken SalazarD-CO · Jul 20, 2006

Mr. President, at the outset of this historic day in the Senate, let me give my accolades to Senator Specter and to Senator Leahy for their leadership in the reauthorization of the Voting Rights Act.…

Mel Martinez
Sen. Mel MartinezR-FL · Jul 20, 2006

Mr. President, today I rise with my colleagues, Senators Feinstein, Nelson of Florida, Hutchison, and Bingaman, on the 37th anniversary of the lunar landing when American astronauts Neil Armstrong…

Tom Coburn
Sen. Tom CoburnR-OK · Jul 20, 2006

Mr. President, the 15th amendment of the United States Constitution provides ``[t]he right of citizens of the United States to vote shall not be denied or abridged by the United States or by any…

Dianne Feinstein
Sen. Dianne FeinsteinD-CA · Jul 20, 2006

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded. Mr. President, the right of a citizen to vote is the most basic right in any democracy. At the signing of the…

Robert Menendez
Sen. Robert MenendezD-NJ · Jul 20, 2006

Mr. President, I rise as an original cosponsor and strong supporter of the Voting Rights Act reauthorization. One of the most fundamental of American values is the right to cast a meaningful vote in…

Barack Obama
Sen. Barack ObamaD-IL · Jul 20, 2006

Thank you, Mr. President. Mr. President, I rise today both humbled and honored by the opportunity to express my support for renewal of the expiring provisions of the Voting Rights Act of 1965. I…

Harry Reid
Sen. Harry ReidD-NV · Jul 20, 2006

Will the Senator from Delaware indicate how much more time he needs? I yield the Senator 3 minutes. Mr. President, how much time did the Senator from Delaware use? Mr. President, I yield to the…

James M. Inhofe
Sen. James M. InhofeR-OK · Jul 20, 2006

Mr. President, I rise today to introduce a bill to establish medicare health savings accounts, HSAs. This bill will make HSAs available under Medicare in lieu of Medicare medical savings accounts,…

Jon Kyl
Sen. Jon KylR-AZ · Jul 20, 2006

Mr. President, I rise today with my colleagues Senators Cornyn and Hatch from the Judiciary Committee--Senator Hatch having chaired the committee for several years--and the assistant majority leader…

Bill Text

Latest available legislative text

Reading Mode
Latest
Introduced in SenateIssued July 20, 2006

II

109th CONGRESS

2d Session

S. 3701

IN THE SENATE OF THE UNITED STATES

July 20, 2006

Mr. Smith (for himself and Mr. Wyden) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To determine successful methods to provide protection from catastrophic health expenses for individuals who have exceeded health insurance lifetime limits, to provide catastrophic health insurance coverage for uninsured individuals, and for other purposes.

1.

Short title

This Act may be cited as the Catastrophic Health Coverage Promotion Act.

2.

Demonstration projects

(a)

In general

Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services (referred to in this Act as the Secretary) shall establish not more than 6 demonstration projects in accordance with the provisions of this section to provide—

(1)

in conjunction with the program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), health insurance coverage for individuals who—

(A)

are not eligible for benefits under Medicare or Medicaid program and who have exceeded $10,500 in out-of-pocket health care costs in a year, or an adjusted amount based on the average out-of-pocket costs of individuals with catastrophic illnesses in a State for the year, but in no case less than $8,000 and not more than $15,000 in out-of-pocket health care costs during such year; or

(B)

were receiving benefits under Medicare or Medicaid but who have exhausted their eligibility for such benefits and any additional private health insurance coverage; and

(2)

in conjunction with the program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), health insurance coverage for catastrophic health care expenses, including prevention benefits, to individuals who do not have health insurance coverage.

(b)

Design of demonstration projects

The Secretary shall ensure that the demonstration projects carried out under this section are conducted in a manner that will, to the greatest extent practicable, allow for comparisons of the information resulting from the evaluations of such programs under subsection (e).

(c)

Number and requirements for demonstration projects

(1)

Number

The Secretary shall establish, in accordance with this subsection—

(A)

not less than 2 demonstration projects to provide health insurance coverage under subsection (a)(1);

(B)

not less than 2 demonstration projects to provide catastrophic coverage under subsection (a)(2); and

(C)

if funds remain available after complying with subparagraphs (A) and (B), additional demonstration projects under subsection (a).

(2)

Requirements for projects under subsection (a)(1)

In designing the demonstration projects under subsection (a)(1), the Secretary shall—

(A)

use State risk pools;

(B)

use reinsurance mechanisms for small businesses;

(C)

use public or private arrangements for the provision of affordable health insurance coverage to cover catastrophic health care expenses; and

(D)

use any combination of such arrangements.

(3)

Requirements for projects under subsection (a)(2)

(A)

In general

In designing the demonstration projects under subsection (a)(2) the Secretary shall—

(i)

use a catastrophic health insurance product administered by private health plans that shall—

(I)

be sold in both the individual and small group insurance markets;

(II)

offer a deductible of not less than $5,000 for an individual and $7,500 for a family, a deductible that is indexed to the individual's or family's income level, or an adjusted deductible amount based on the average out-of-pocket costs of individuals or families, but in no case lower than $2,500 for an individual and $5,000 for a family;

(III)

include preventive health services based on recommendations made by the United States Preventive Task Force, including not less than 1 primary care provider's office visit; and

(IV)

require reasonable co-insurance as determined by the State administering the demonstration project, in consultation with the Secretary;

(ii)

subsidize such catastrophic coverage to provide an affordable product and may provide subsidies on sliding scale, to offer a more affordable product for individuals in the individual and group market earning below 200 percent of the Federal poverty level; and

(iii)

consider subsidizing the cost of such catastrophic coverage for small businesses that do not offer employer-sponsored insurance by using reinsurance mechanisms or other public and private partnerships.

(B)

Eligibility

An individual or small business shall be eligible to participate in a demonstration project under subsection (a)(2) only if—

(i)

such individual did not have health insurance coverage within the 1-year period immediately prior to applying for coverage under the demonstration project; or

(ii)

such small business did not offer employer-sponsored health insurance coverage within such 1-year period.

(d)

Duration; Evaluation

(1)

Duration

The Secretary shall complete the demonstration projects established under this section not later than 6 and 1/2 years after the date of enactment of this Act.

(2)

Evaluation

During the 18-month period beginning after the date that is 5 years after the date the demonstration projects have all been established under this section, the Secretary shall complete an evaluation of such demonstration projects established to determine—

(A)

the ability of individuals and small businesses to access health insurance coverage;

(B)

the length of time individuals participated in and maintained such coverage;

(C)

with respect to each geographic area of a demonstration project—

(i)

the impact on the amount of charity or other uncompensated care provided by health care providers who participated in the demonstration projects;

(ii)

the impact on insurance rates in the commercial market; and

(iii)

the impact on the number of medical related bankruptcies; and

(D)

if additional information is needed and whether the projects should be continued or modified, as the Secretary determines appropriate.

(e)

Application; Site selection

(1)

Application

A State may submit an application to the Secretary to participate in any of the demonstration projects established under this section at such time, in such manner, and containing such information as the Secretary may require.

(2)

In general

In selecting States to participate in a demonstration project, the Secretary shall—

(A)

consider the current structure of a State’s programs to assist individuals with catastrophic health care costs and individuals that do not have health insurance coverage;

(B)

determine what parameters for the demonstration project will be least intrusive to the State’s existing such structures; and

(C)

consider the overall health status of the State, the age demographics of individuals with high health care costs and of individuals who do not have health insurance coverage, and the historical health care costs and efficiency of the State’s health care system.

(3)

Specific site

The Secretary shall select as a demonstration project site the State in which (according to the Hospital Referral Region of Residence, 1994–1995, as listed in the Dartmouth Atlas of Health Care 1998) the largest metropolitan areas of the State had the lowest percentage of Medicare beneficiary deaths in a hospital when compared to the largest metropolitan areas of each other State and the percentage of enrollees who experienced intensive care during the last 6 months of life was 21.5 percent.

(f)

Funding

(1)

In general

Notwithstanding sections 1901, 1903(a)(1) and 1923 of the Social Security Act (42 U.S.C. 1396, 1396a(a)(13)(A)(iv), 1396b(a)(1), 1396r–4), the Secretary shall expend not less than $50,000,000 of the total amount of unexpended State DSH allotments under section 1923 of such Act for each of fiscal years 2007 through 2012 for purposes of carrying out the demonstration projects authorized under this section.

(2)

Use of other funding sources

A State may contribute other public funds (other than otherwise obligated Federal funds), and an employer may contribute private funds, to a demonstration project funded under this section.

(g)

Reports to congress

(1)

Preliminary report

Not later than 3 years after the date of enactment of this Act, the Secretary shall submit to the Committee on Finance of the Senate and the Committee on Ways and Means of the House of Representatives a preliminary report on the progress made in the demonstration projects established under this section.

(2)

Interim report

Not later than 30 months after the implementation of the demonstration projects established under this section, the Secretary, in consultation with the participants in such demonstration projects, shall submit to the Committees described in paragraph (1), an interim report on such demonstration projects.

(3)

Final report

Not later than the date on which all demonstration projects established under this section end, the Secretary shall submit to the Committees described in paragraph (1) a final report on such demonstration projects that includes the results of the evaluation conducted under subsection (f) and recommendations for appropriate legislative changes.