To establish a Citizens Congressional Health Benefits Program, based on the Federal employees health benefits program, to provide health insurance coverage for the President, Vice President, and Members of Congress, and citizens not eligible for coverage under the Federal employees health benefits program.

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Citizenship Should 
Count for Something Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Establishment of Citizens Congressional Health Benefits Program 
                            (CCHBP).
Sec. 3. Eligibility; enrollment.
Sec. 4. Qualified health plans; benefits; premiums.
Sec. 5. Government contribution.
Sec. 6. Administration.
Sec. 7. Definitions.

SEC. 2. ESTABLISHMENT OF CITIZENS CONGRESSIONAL HEALTH BENEFITS PROGRAM 
              (CCHBP).

    (a) In General.--There is established under this title a program 
(to be known as the ``Citizens Congressional Health Benefits Program'') 
to provide comprehensive health insurance coverage to Federal elected 
officials and to all other citizens who are not covered under the 
Federal Employees Health Benefits Program (FEHBP). The coverage shall 
be provided in a manner similar to the manner in which coverage has 
been provided to Members of Congress and Federal Government employees 
and retirees and their dependents under the Federal Employees Health 
Benefits Program (FEHBP).
    (b) Effective Date.--Benefits shall first be made available under 
this title for items and services furnished on or after January 1, 
2010.
    (c) Non-Preemption of Existing Collective Bargaining Agreements.--
Nothing in this Act shall be construed as preempting any collective 
bargaining agreement that is in effect as of the date of the enactment 
of this Act, during the period in which such agreement is in effect 
(without regard to any extension of such agreement effected as such 
date of enactment).

SEC. 3. ELIGIBILITY; ENROLLMENT.

    (a) Eligibility.--
            (1) In general.--Each CCHBP-eligible individual (as defined 
        in paragraph (2)) is eligible to enroll in accordance with this 
        title in a qualified health plan offered under this title.
            (2) CCHBP-eligible individual defined.--For purposes of 
        this title, the term ``CCHBP-eligible individual'' means 
        elected Federal officials (including the President, Vice 
        President, and Members of Congress) and any other individual 
        residing in the United States who--
                    (A) is a citizen or national of the United States; 
                and
                    (B) is not enrolled under the Federal employees 
                health benefits program under chapter 89 of title 5, 
                United States Code.
            (3) Conforming elimination of fehbp eligibility for federal 
        elected officials.--Effective for benefits for items and 
        services furnished on or after January 1, 2010, section 8901 of 
        title 5, United States Code, is amended--
                    (A) by striking subparagraphs (B) and (D); and
                    (B) in the matter following subparagraph (J)--
                            (i) by striking ``or'' at the end of clause 
                        (iii);
                            (ii) by striking the period at the end of 
                        clause (iv) and inserting ``; or''; and
                            (iii) by adding at the end the following 
                        new clause:
                    ``(v) the President, the Vice President, or a 
                Member of Congress as defined in section 2106 of this 
                title.''.
    (b) Enrollment.--
            (1) In general.--The Director shall establish a process for 
        CCHBP-eligible individuals to enroll in qualified health plans. 
        Such process shall be based on the enrollment process used 
        under FEHBP and shall provide for the dissemination of 
        information to CCHBP-eligible individuals on qualified health 
        plans being offered.
            (2) Changes in enrollment.--The Director shall establish 
        enrollment procedures that include an annual open season and 
        permit changes in enrollment with qualified health plans at 
        other times (such as by reason of changes in marital or 
        dependent status or eligibility). Such procedures shall be 
        based on the enrollment procedures established under FEHBP.
            (3) Limitations.--CCHBP-eligible individuals may be 
        enrolled in a qualified health plan under this title only 
        during enrollment periods specified by the Director.
    (c) Treatment of Family Members.--Enrollment under this title 
includes both individual and family enrollment, in a manner similar to 
that provided under FEHBP. To the extent consistent with eligibility 
under subsection (a), the Director shall provide rules similar to the 
rules under FEHBP for the enrollment of family members who are CCHBP-
eligible individuals in the same plan.
    (d) Changes in Plan Enrollment.--The Director shall provide for and 
permit changes in the qualified health plan in which an individual or 
family is enrolled under this section in a manner similar to the manner 
in which such changes are provided or permitted under FEHBP. The 
Director shall provide for termination of such enrollment for an 
individual at the time the individual is no longer an CCHBP-eligible 
individual.
    (e) Enrollment Guides.--The Director shall provide for the broad 
dissemination of information on qualified health plans offered under 
this title. Such information shall be provided in a comparative manner, 
similar to that used under FEHBP, and shall include information, 
collected through surveys of enrollees, on measures of enrollee 
satisfaction with the different plans.

SEC. 4. QUALIFIED HEALTH PLANS; BENEFITS; PREMIUMS.

    (a) Offering of Plans.--
            (1) Contracts.--The Director shall enter into contracts 
        with entities for the offering of qualified health plans in 
        accordance with this title. Such contracts shall be entered 
        into in a manner similar to the process by which the Director 
        is authorized to enter into contracts with health benefits 
        plans under FEHBP.
            (2) Requirements for entities offering plans.--No such 
        contract shall be entered into with an entity for the offering 
        of a qualified health plan in a region unless the entity--
                    (A) is licensed as a health maintenance 
                organization in that State or is licensed to sell group 
                health insurance coverage in that State; and
                    (B) meets such requirements, similar to 
                requirements under FEHBP, as the Director may establish 
                relating to solvency, organization, structure, 
                governance, access, quality, and minimum loss-ratios.
    (b) FEHBP Scope of Benefits.--
            (1) Comprehensive benefits.--Qualified health plans shall 
        provide for the same scope and type of comprehensive benefits 
        that have been provided under FEHBP, including the types of 
        benefits described in section 8904 of title 5, United States 
        Code and including benefits previously required by regulation 
        or direction (such as preventive benefits, including childhood 
        immunization and cancer screening, and mental health parity) 
        under FEHBP.
            (2) No exclusion for pre-existing conditions.--Qualified 
        health plans shall not impose pre-existing condition exclusions 
        or otherwise discriminate against any enrollee based on the 
        health status of such enrollee (including genetic information 
        relating to such enrollee).
            (3) Other consumer protections.--Qualified health plans 
        also shall meet consumer and patient protection requirements 
        that the Director establishes, based on similar requirements 
        previously imposed under FEHBP, including protections of 
        patients' rights previously effected pursuant to Executive 
        Memorandum.
            (4) Collective bargaining agreements.--Nothing in this Act 
        shall be construed as preventing a collectively bargained 
        agreement from providing coverage that is additional to, or 
        supplementary of, benefits provided under this Act.
    (c) Community-Rated Premiums.--
            (1) Application.--The premiums established for a qualified 
        health plan under this title for individual or family coverage 
        shall be community-rated and shall not vary based on gender, 
        health status (including genetic information), or other 
        factors.
            (2) Collection process.--The Director shall establish a 
        process for the timely and accurate collection of premiums owed 
        by enrollees, taking into account any Government contribution 
        under section 5(a). Such process shall include methods for 
        payment through payroll withholding, as well as payment through 
        automatic debiting of accounts with financial institutions, and 
        shall be coordinated with the application of section 59B of the 
        Internal Revenue Code of 1986.
    (d) Marketing Practices and Costs.--The Director shall monitor 
marketing practices with respect to qualified health plans in order to 
assure--
            (1) the accuracy of the information disseminated regarding 
        such plans; and
            (2) that costs of marketing are reasonable and do not 
        exceed a percentage of total costs that is specified by the 
        Director and that takes into account costs of market entry for 
        new qualified health plans.

SEC. 5. GOVERNMENT CONTRIBUTION.

    (a) Amount Established Biannually by Congress.--The Director shall 
provide each year (beginning with 2010) for a contribution under this 
subsection towards the coverage provided under this title for CCHBP-
eligible individuals. The amount of such contribution shall be 
determined biannually by Congress
    (b) Plan Payment.--
            (1) In general.--The Director shall provide for payment of 
        qualified health plans of the premiums for such plans, as 
        adjusted under this subsection.
            (2) Risk adjusted payment.--The payment to a qualified 
        health plan under this subsection shall be adjusted in a 
        budget-neutral manner specified by the Director to reflect the 
        actuarial risk of the enrollees in the plan compared to an 
        average actuarial risk.
            (3) Reduction for administrative expenses and contingency 
        reserve.--The Director may provide for a uniform percentage 
        reduction in payment otherwise made to a qualified health plan 
        under this subsection in order to provide for a contingency 
        reserve and for Federal administrative costs in carrying out 
        this title.

SEC. 6. ADMINISTRATION.

    (a) Application of FEHBP Rules.--
            (1) In general.--Except as otherwise provided in this 
        title, the program under this title shall be administered in 
        the same manner as FEHBP.
            (2) Specific provisions.--In carrying out this title, the 
        Director pursuant to paragraph (1) shall provide for the 
        following:
                    (A) Approval and disapproval of plans as qualified 
                health plans.
                    (B) Negotiation of plan benefits (including cost-
                sharing) and plan premiums.
    (b) Duties.--
            (1) In general.--The Director shall administer the program 
        under this title.
            (2) Establishment of cchbp regions.--For purposes of 
        carrying out this title, the Director shall divide the United 
        States into, and establish, CCHBP regions.
    (c) Rulemaking.--The Director is authorized to issue such 
regulations as may be required to carry out this title.
    (d) Use of Regional and Field Offices.--The Director shall 
establish such regional and field offices as may be appropriate for the 
convenient and efficient administration of this title.
    (e) Coverage of Administration Costs.--The Director shall provide 
for the collection of administrative costs of offering coverage under 
this title from entities offering qualified health plans in the same 
manner as FEHBP provides for coverage of its administrative costs.
    (f) Contingency Reserves.--
            (1) CCHBP contingency reserve.--The Director is authorized 
        to establish and maintain a contingency reserve for purposes of 
        carrying out this title and is authorized to impose under 
        section 5(b)(3)(A) a premium surcharge of up to three percent 
        in order to provide financing for such reserve.
            (2) Plan reserves.--A qualified health plan may establish 
        contingency reserves, that are in addition to the reserve 
        described in paragraph (1), in a manner similar to that 
        permitted under FEHBP.

SEC. 7. DEFINITIONS.

    For purposes of this Act:
            (1) The term ``CCHBP-eligible individual'' means an 
        individual described in section 3(a)(2).
            (2) The term ``CCHBP region'' means a region as specified 
        by the Director under section 6(c)(2).
            (3) The term ``Director'' means the Director of the Office 
        of Personnel Management.
            (4) The term ``FEHBP'' means the program under chapter 89 
        of title 5, United States Code.
            (5) The term ``qualified health plan'' means such a plan 
        offered under this title.

Summary: Citizenship Should Count for Something Act - Establishes the Citizens Congressional Health Benefits Program to provide comprehensive health insurance coverage to federal elected officials and to all other citizens who are not covered under the Federal Employees Health Benefits Program (FEHBP). Requires such coverage to be provided in a manner similar to the manner in which coverage has been provided under FEHBP. Eliminates eligibility of the President, Vice-President, and members of Congress for FEHBP. Requires the Director of the Office of Personnel Management (OPM) to: (1) establish a process for eligible individuals to enroll in qualified health plans, (2) provide for the dissemination of information on such plans. And (3) enter into contracts with entities to offer such plans. Requires qualified health plans to: (1) provide for the same scope and type of comprehensive benefits that have been provided under FEHBP. And (2) meet consumer and patient protections. Prohibits qualified health plans from imposing preexisting condition exclusions or otherwise discriminating against an enrollee based on health status. Requires premiums established for a qualified health plan to be community-rated and not vary based on gender, health status, or other factors. Requires the Director to: (1) establish a process for the collection of premiums owed by enrollees. (2) monitor marketing practices to assure the accuracy of information disseminated and reasonable costs for such marketing. And (3) provide for an annual contribution towards the coverage provided under this Act for eligible individuals. Authorizes the Director to establish a contingency reserve and to impose a premium surcharge to provide financing for such reserve.