I 

111TH CONGRESS 

1ST SESSION H. R. 3741 

To provide Federal matching funding for State insurance expenditures for 

high-risk pools. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 7, 2009 

Mr. HOEKSTRA introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To provide Federal matching funding for State insurance 

expenditures for high-risk pools. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Assuring Coverage for 

5 Americans with Pre-existing Conditions Act of 2009’’. 

6 SEC. 2. FEDERAL MATCHING FUNDING FOR STATE INSUR7 ANCE EXPENDITURES. 

8 (a) IN GENERAL.—Subject to the succeeding provi9 sions of this section, each State shall receive from the Sec10 retary of Health and Human Services an amount equal 


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1 to 50 percent of the funds expended by the State in pro2 viding for the use, in connection with providing health ben3 efits coverage, of a high-risk pool, a reinsurance pool, or 

4 other risk-adjustment mechanism used for the purpose of 

5 subsidizing the purchase of private health insurance. 

6 (b) FUNDING LIMITATION.—A State shall not receive 

7 under this section for a fiscal year more than a total of 

8 50 cents multiplied by the average number of residents 

9 (as estimated by the Secretary) in the State in the fiscal 

10 year. 

11 (c) ADMINISTRATION.—The Secretary of Health and 

12 Human Services shall provide for the administration of 

13 this section and may establish such terms and conditions, 

14 including the requirement of an application, as may be ap15 propriate to carry out this section. 

16 (d) CONSTRUCTION.—Nothing in this section shall be 

17 construed as requiring a State to operate a reinsurance 

18 pool (or other risk-adjustment mechanism) under this sec19 tion or as preventing a State from operating such a pool 

20 or mechanism through one or more private entities. 

21 (e) HIGH-RISK POOL.—For purposes of this section, 

22 the term ‘‘high-risk pool’’ means any qualified high risk 

23 pool (as defined in section 2744(c)(2) of the Public Health 

24 Service Act). 


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1 (f) REINSURANCE POOL OR OTHER RISK-ADJUST2 MENT MECHANISM DEFINED.—For purposes of this sec3 tion, the term ‘‘reinsurance pool or other risk-adjustment 

4 mechanism’’ means any State-based risk spreading mecha5 nism to subsidize the purchase of private health insurance 

6 for the high-risk population. 

7 (g) HIGH-RISK POPULATION.—For purposes of this 

8 section, the term ‘‘high-risk population’’ means— 

9 (1) individuals who, by reason of the existence 

10 or history of a medical condition, are able to acquire 

11 health coverage only at rates which are at least 150 

12 percent of the standard risk rates for such coverage, 

13 and 

14 (2) individuals who are provided health cov15 erage by a high-risk pool. 

16 (h) STATE DEFINED.—For purposes of this section, 

17 the term ‘‘State’’ includes the District of Columbia, Puer18 to Rico, the Virgin Islands, Guam, American Samoa, and 

19 the Northern Mariana Islands. 

Æ 


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