I 

110TH CONGRESS 

2D SESSION H. R. 5404 

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. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 13, 2008 

Mr. FRANK of Massachusetts (for himself, Mr. YOUNG of Alaska, Mr. 

TIERNEY, Mr. GILCHREST, Mr. DELAHUNT, Mr. KENNEDY, and Mr. 

ALLEN) introduced the following bill; which was referred to the Committee on Energy and Commerce 

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. 

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 ‘‘Commercial Fishing 

5 Industry Health Care Coverage Act of 2008’’. 


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1 SEC. 2. GRANTS FOR QUALIFIED COMMERCIAL FISHING IN2 DUSTRY HEALTH CARE COVERAGE DEM3 ONSTRATION PROGRAMS. 

4 Part B of title III of the Public Health Service Act 

5 is amended by adding at the end the following new section: 

6 ‘‘SEC. 320B. GRANTS FOR QUALIFIED COMMERCIAL FISH7 ING INDUSTRY HEALTH CARE COVERAGE 

8 DEMONSTRATION PROGRAMS. 

9 ‘‘(a) ESTABLISHMENT OF PROGRAM.— 

10 ‘‘(1) IN GENERAL.—The Secretary, through the 

11 Health Resources and Services Administration, shall 

12 establish a grant program (in this section referred to 

13 as the ‘grant program’) for the purpose of assisting 

14 commercial fishing States to establish, or strengthen 

15 existing, programs to expand health care coverage 

16 and access for uninsured or underinsured workers 

17 and their families in the commercial fishing indus18 try. 

19 ‘‘(2) TYPES OF GRANTS.—Under the grant pro20 gram, the Secretary shall provide— 

21 ‘‘(A) program planning grants under sub22 section (b) for commercial fishing States and 

23 organizations within such States; and 

24 ‘‘(B) implementation and administration 

25 grants under subsection (c) for no more than 

26 15 commercial fishing States. 


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1 ‘‘(3) APPLICATION REQUIRED.—No grant may 

2 be awarded under this section except pursuant to an 

3 application that is made in such form and manner, 

4 and containing such information, as the Secretary 

5 may require. 

6 ‘‘(b) PROGRAM PLANNING GRANTS.— 

7 ‘‘(1) IN GENERAL.—Under the grant program 

8 the Secretary may award grants to one or more 

9 commercial fishing States (or to organizations with 

10 a history of active involvement in the commercial 

11 fishing industry in such a State, including knowl12 edge of economic and social aspects of such indus13 try), not to exceed $200,000 for each year and for 

14 no more than two years, to conduct initial research 

15 and planning for the development of a qualified 

16 health care coverage program in the State. Any 

17 grantee under this subsection shall— 

18 ‘‘(A) conduct a demographic survey of the 

19 State’s commercial fishing industry and such 

20 industry’s health care needs; and 

21 ‘‘(B) develop a strategic plan, including a 

22 detailed financial plan, for implementation of a 

23 qualified health care coverage program within 

24 the State. 


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1 ‘‘(2) CONSULTATION WITH STATES.—Before 

2 awarding a grant under this subsection to an organi3 zation, the Secretary shall consult with States where 

4 the organization is located in order to assist in a de5 termination as to whether the organization— 

6 ‘‘(A) has the necessary familiarity with 

7 and knowledge of the commercial fishing indus8 try in the State to fulfill the purposes of the 

9 grant; and 

10 ‘‘(B) has a history of fraudulent or abusive 

11 practices that would disqualify the organization 

12 from carrying out the grant. 

13 ‘‘(3) ACTIONS FOLLOWING COMPLETION OF

14 PLANNING GRANTS.—Based on the research find15 ings, financial plan, and other recommendations de16 veloped by the State or organization under para17 graph (1), a State may submit an application for 

18 program implementation and administration grants 

19 under subsection (c). 

20 ‘‘(c) IMPLEMENTATION AND PROGRAM ADMINISTRA21 TION GRANTS.— 

22 ‘‘(1) IN GENERAL.—Under the grant program, 

23 subject to the succeeding provisions of this sub24 section, the Secretary may award the following 

25 grants to commercial fishing States: 


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1 ‘‘(A) INITIAL IMPLEMENTATION GRANTS.— 

2 A grant, not to exceed $2,000,000 for each year 

3 and for no more than two years, for initial im4 plementation of a qualified health care coverage 

5 program. 

6 ‘‘(B) PROGRAM ADMINISTRATION

7 GRANTS.—A grant, not to exceed $3,000,000 

8 for each year and for no more than five years, 

9 for administration of a qualified health care 

10 coverage program. 

11 ‘‘(C) CONTINUED ADMINISTRATION

12 GRANTS.—A grant, not to exceed $3,000,000 

13 for each year, for continued administration of a 

14 qualified health care coverage program in a 

15 State that has been awarded administration 

16 grants for 5 years under subparagraph (B) and 

17 that has satisfactorily administered such pro18 gram using the funds provided by such grants 

19 for at least 5 years, if the economic conditions 

20 of the fishing industry in the program’s service 

21 area (or the condition of fish stocks that are 

22 important to the fishing industry in such area) 

23 jeopardize the ability of the program to con24 tinue providing affordable health care coverage. 


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1 A grant may be made for a qualified health care cov2 erage program under subparagraph (A) or (B) re3 gardless of whether or not the program was devel4 oped with a program planning grant under sub5 section (b) or was implemented under a grant under 

6 subparagraph (A), respectively, and regardless of 

7 whether the program was developed or initially im8 plemented before the date of the enactment of this 

9 section. 

10 ‘‘(2) ELIGIBILITY REQUIREMENTS.—The Sec11 retary may not award a grant under this subsection 

12 to a commercial fishing State for implementation or 

13 administration of a health care coverage program 

14 unless— 

15 ‘‘(A) the State demonstrates that the pro16 gram— 

17 ‘‘(i) is a qualified health care coverage 

18 program and enrolls fishing industry mem19 bers and their families if they were unin20 sured or underinsured; and 

21 ‘‘(ii) requires Federal funding for its 

22 operation; and 

23 ‘‘(B) the State provides assurances satis24 factory to the Secretary that— 


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1 ‘‘(i) if the program is an expansion of 

2 an existing health care coverage program, 

3 the State will use the grant funding to ex4 pand the enrolled population of uninsured 

5 or underinsured commercial fishing indus6 try members and their families, or modify 

7 coverage to comply with qualified health 

8 care coverage, under the program and to 

9 supplement, and not supplant, State pro10 vided funding for such program; or 

11 ‘‘(ii) if the program is a new qualified 

12 health care coverage program, the State 

13 will ensure the program’s continued suc14 cess through the implementation of appro15 priate financial and consumer protection 

16 regulations, controls, licensing, or oversight 

17 policies, including (as determined by the 

18 State) any of the following: 

19 ‘‘(I) Protection against insol20 vency, fraud and abuse. 

21 ‘‘(II) State-based stop-loss pro22 tection. 

23 ‘‘(III) Reinsurance. 


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1 ‘‘(IV) Receivership/liquidation 

2 protection against insolvency for indi3 viduals. 

4 ‘‘(V) Another demonstration of 

5 State financial commitment. 

6 ‘‘(3) REQUIREMENT OF MATCHING FUNDS.— 

7 ‘‘(A) IN GENERAL.—A grant may be made 

8 under this subsection only if the State agrees to 

9 make available (directly or through donations 

10 from public or private entities) non-Federal 

11 contributions toward such costs in an amount 

12 that is not less than $1 for each $2 of Federal 

13 funds provided in the grant. 

14 ‘‘(B) DETERMINATION OF AMOUNT CON15 TRIBUTED.—Non-Federal contributions re16 quired in subparagraph (A) may be in cash or 

17 in kind, fairly evaluated, including plant, equip18 ment, or services. Amounts provided by the 

19 Federal Government, or services assisted or 

20 subsidized to any significant extent by the Fed21 eral Government, may not be included in deter22 mining the amount of such non-Federal con23 tributions. 

24 ‘‘(4) CONTRACTING AUTHORITY.— 


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1 ‘‘(A) IN GENERAL.—A commercial fishing 

2 State may enter into a contract with one or 

3 more eligible non-profit organizations or compa4 nies for the purpose of conducting activities 

5 under an implementation or administration 

6 grant under this subsection and may not enter 

7 into such a contract with an organization or 

8 company which is not eligible under subpara9 graph (C). 

10 ‘‘(B) SUBCONTRACTING ARRANGE11 MENTS.—A contractor described in subpara12 graph (A) may subcontract with one or more el13 igible non-profit organizations or companies for 

14 the purpose of conducting activities under such 

15 an implementation or administration grant, if 

16 the State approves such subcontracting ar17 rangements. 

18 ‘‘(C) ELIGIBILITY STANDARDS.—The Sec19 retary shall issue regulations establishing eligi20 bility standards for organizations and compa21 nies under this paragraph. Such standards shall 

22 include requirements that States review whether 

23 prospective contractors or subcontractors under 

24 this paragraph— 


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1 ‘‘(i) have a history of fraudulent or 

2 abusive practices that would disqualify 

3 them from participating in a contract or 

4 subcontract; 

5 ‘‘(ii) have the capability and experi6 ence to assist in the management of a 

7 qualified health care coverage program; 

8 and 

9 ‘‘(iii) in the case of commercial fishing 

10 organizations, have an appropriate level of 

11 familiarity with, and knowledge of, the 

12 commercial fishing industry. 

13 ‘‘(d) DEFINITIONS.—For purposes of this section: 

14 ‘‘(1) COMMERCIAL FISHING STATE.—The term 

15 ‘commercial fishing State’ means a State (as defined 

16 in section 2(f)) with a significant commercial fishing 

17 population or a significant commercial fishing indus18 try. The Secretary shall accept a State’s self-certifi19 cation that it is a commercial fishing State if the 

20 State demonstrates to the Secretary that— 

21 ‘‘(A) such self-certification is based on con22 sultation by the State with local organizations 

23 familiar with the commercial fishing industry in 

24 the State; and 


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1 ‘‘(B) the State has a significant commer2 cial fishing population or a significant commer3 cial fishing industry. 

4 ‘‘(2) COMMERCIAL FISHING INDUSTRY MEM5 BER.—The term ‘commercial fishing industry mem6 ber’ means a fisherman, crewmember, boat owner, 

7 captain, shore side business owner, employee of a 

8 company that provides shore side support, harvester, 

9 or other individual performing commercial fishing in10 dustry-related work, if more than half of such indi11 vidual’s income derives from such work at the time 

12 the individual enrolls in a qualified health care cov13 erage program. 

14 ‘‘(3) QUALIFIED HEALTH CARE COVERAGE PRO15 GRAM.—The term ‘qualified health care coverage 

16 program’ means a program that provides qualified 

17 health care coverage to commercial fishing industry 

18 members and their families consistent with the fol19 lowing: 

20 ‘‘(A) Eligibility for enrollment of such 

21 members and families is only restricted by ca22 pacity, based on a first come, first served basis 

23 when space is limited, and health status related 

24 factors (as defined in section 2702), age, and 


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1 gender may not be used as a basis for deter2 mining eligibility. 

3 ‘‘(B) The program does not include any 

4 preexisting condition exclusion (as defined in 

5 section 2701) or any coverage elimination rider 

6 that permanently excludes from coverage an ex7 isting medical condition. 

8 ‘‘(C) Premium rates under the program 

9 are computed based on a community rate, and 

10 may be adjusted only for income and family 

11 size. 

12 ‘‘(4) QUALIFIED HEALTH CARE COVERAGE.— 

13 The term ‘qualified health care coverage’ means cov14 erage that meets any of the following conditions: 

15 ‘‘(A) FEHBP COVERAGE.—The coverage 

16 is actuarially equivalent to the coverage pro17 vided under the health benefits plan, under 

18 chapter 89 of title 5, United States Code, which 

19 has the largest enrollment, either in the United 

20 States or in the State involved. 

21 ‘‘(B) STATE EMPLOYEES COVERAGE.—The 

22 coverage is actuarially equivalent to the cov23 erage provided under the health benefits plan, 

24 that is offered by the State to State government 


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1 employees, which has the largest enrollment of 

2 such plans in the State. 

3 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated to the Secretary for the 

5 purpose of carrying out this section— 

6 ‘‘(1) $5,000,000 for fiscal year 2009; 

7 ‘‘(2) $5,000,000 for fiscal year 2010; 

8 ‘‘(3) $10,000,000 for fiscal year 2011; 

9 ‘‘(4) $10,000,000 for fiscal year 2012; and 

10 ‘‘(5) $20,000,000 for fiscal year 2013.’’. 

Æ 


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