II 

108TH CONGRESS 

2D SESSION S. 2161

To amend title 5, United States Code, to establish a national health program 

administered by the Office of Personnel Management to offer Federal 

employee health benefits plans to individuals who are not Federal employees, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 3, 2004

Mrs. BOXER introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL

To amend title 5, United States Code, to establish a national 

health program administered by the Office of Personnel 

Management to offer Federal employee health benefits 

plans to individuals who are not Federal employees, 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 ‘‘Universal Access to 

5 Affordable Insurance for all Americans Act of 2004’’. 
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1 SEC. 2. EXTENSION OF FEDERAL EMPLOYEE HEALTH IN2 SURANCE. 

3 (a) IN GENERAL.—Subpart G of part III of title 5, 

4 United States Code, is amended by inserting after chapter 

5 89 the following:

6 ‘‘CHAPTER 89A—HEALTH INSURANCE FOR 

7 NON-FEDERAL EMPLOYEES

‘‘Sec. 

‘‘8951. Definitions. 

‘‘8952. Health insurance for non-Federal employees. 

‘‘8953. Contract requirement. 

‘‘8954. Eligibility of non-Federal employees. 

‘‘8955. Alternative conditions to Federal employee health benefits plans.

8 ‘‘§ 8951. Definitions 

9 ‘‘In this chapter—

10 ‘‘(1) the terms defined under section 8901 shall 

11 have the meanings given such terms under that sec12 tion; and 

13 ‘‘(2) the term ‘Office’ means the Office of Per14 sonnel Management. 

15 ‘‘§ 8952. Health insurance for non-Federal employees 

16 ‘‘(a) The Office of Personnel Management shall ad17 minister a health insurance program for non-Federal em18 ployees in accordance with this chapter. 

19 ‘‘(b) Except as provided under this chapter, the Of20 fice shall prescribe regulations to apply the provisions of 

21 chapter 89 to the greatest extent practicable to eligible 

22 individuals covered under this chapter. 
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1 ‘‘§ 8953. Contract requirement 

2 ‘‘(a) In each calendar year, the Office shall enter into 

3 a contract with 1 or more carriers to make available 1 

4 or more health benefits plans (subject to the provisions 

5 of this chapter) to eligible individuals under this chapter. 

6 ‘‘(b) In carrying out this section, the Office may re7 quire 1 or more carriers to enter into a contract described 

8 in subsection (a), as a condition of entering into a contract 

9 under section 8902. 

10 ‘‘§ 8954. Eligibility of non-Federal employees 

11 ‘‘(a) Except as provided under subsection (b), any in12 dividual may enroll in a health benefits plan under this 

13 section. 

14 ‘‘(b) An individual may not enroll in a health benefits 

15 plan under this chapter, if the individual—

16 ‘‘(1) is 65 years of age or older; 

17 ‘‘(2) is enrolled or eligible to enroll for coverage 

18 under a public health insurance program, including 

19 coverage under title XVIII of the Social Security 

20 Act, coverage under a State plan under title XIX of 

21 such Act, coverage under a State plan under title 

22 XX of such Act, or coverage under any other pro23 gram determined by the Office; 

24 ‘‘(3) is enrolled or eligible to enroll in a plan 

25 under chapter 89; or 
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1 ‘‘(4) is a member of the uniformed services as 

2 defined under section 101(a)(5) of title 10. 

3 ‘‘§ 8955. Alternative conditions to Federal employee 

4 health benefits plans 

5 ‘‘(a) Rates charged and premiums paid for a health 

6 benefits plan under this chapter may differ between or 

7 among geographic regions. 

8 ‘‘(b) No Government contribution shall be made for 

9 any individual under this chapter. 

10 ‘‘(c) In the administration of this chapter, the Office 

11 shall ensure that individuals covered under this chapter 

12 shall be in a risk pool that is separate from the risk pool 

13 maintained for individuals covered under chapter 89.’’. 

14 (b) TECHNICAL AND CONFORMING AMENDMENTS.—

15 (1) CONTRACT REQUIREMENT UNDER CHAPTER

16 89.—Section 8902 of title 5, United States Code, is 

17 amended by adding after subsection (o) the fol18 lowing: 

19 ‘‘(p) Each contract under this chapter may include, 

20 at the discretion of the Office, a provision that the carrier 

21 shall enter into a contract to provide 1 or more health 

22 benefits plans as described under chapter 89A.’’. 

23 (2) TABLE OF CHAPTERS.—The table of chap24 ters for part III of title 5, United States Code, is

25 amended by inserting after the item relating to 
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1 chapter 89 the following:

‘‘89A. Health Insurance for Non-Federal Employees ........... 8951’’.

2 (c) EFFECTIVE DATE.—The amendments made by 

3 this section shall take effect on the date of enactment of 

4 this Act and shall apply to contracts that take effect with 

5 respect to the calendar year following such date of enact6 ment. 

7 SEC. 3. CREDIT FOR HEALTH INSURANCE COSTS OF CER8 TAIN NON-FEDERAL EMPLOYEES. 

9 (a) IN GENERAL.—Subpart C of part IV of sub10 chapter A of chapter 1 of the Internal Revenue Code of 

11 1986 (relating to refundable credits) is amended by redes12 ignating section 36 as section 37 and inserting after sec13 tion 35 the following new section: 

14 ‘‘SEC. 36. HEALTH INSURANCE COSTS OF CERTAIN NON15 FEDERAL EMPLOYEES.

16 ‘‘(a) IN GENERAL.—In the case of an individual, 

17 there shall be allowed as a credit against the tax imposed 

18 by subtitle A for the taxable year an amount equal to the 

19 applicable percentage of the amount paid during such tax20 able year by the taxpayer for coverage of the taxpayer and 

21 family members under the health insurance plan estab22 lished under chapter 89A of title 5, United States Code. 

23 ‘‘(b) APPLICABLE PERCENTAGE.—For purposes of 

24 subsection (a)—
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1 ‘‘(1) IN GENERAL.—The applicable percentage 

2 shall be determined in accordance with the table 

3 under paragraph (2). 

4 ‘‘(2) DETERMINATION OF APPLICABLE PER5 CENTAGE.—

‘‘In the case of any taxpayer 

whose family income is 

the following percentage 

of the poverty line—

The applicable percentage is—

Not more than 100 percent ..................................................... 100 percent

More than 100, but not more than 200 percent ..................... 65 percent

More than 200, but not more than 300 percent ..................... 40 percent

More than 300, but not more than 400 percent ..................... 30 percent

More than 400 percent ............................................................ 0 percent.

6 ‘‘(3) POVERTY LINE.—For purposes of para7 graph (2), the term ‘poverty line’ means the poverty 

8 line as defined in section 673(2) of the Community 

9 Services Block Grant Act, for a family of the size in10 volved.

11 ‘‘(c) SPECIAL RULES.—

12 ‘‘(1) COORDINATION WITH ADVANCE PAYMENTS

13 OF CREDIT.—With respect to any taxable year, the 

14 amount which would (but for this subsection) be al15 lowed as a credit to the taxpayer under subsection 

16 (a) shall be reduced (but not below zero) by the ag17 gregate amount paid on behalf of such taxpayer 

18 under section 7528 for such taxable year. 

19 ‘‘(2) COORDINATION WITH OTHER DEDUC20 TIONS.—Amounts taken into account under sub21 section (a) shall not be taken into account in deter-
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1 mining any deduction allowed under section 162(l) 

2 or 213. 

3 ‘‘(3) TREATMENT OF PAYMENTS.—For pur4 poses of this section, payments made by the Sec5 retary on behalf of any individual under section 

6 7528 (relating to advance payment of credit for 

7 health insurance costs of eligible individuals) shall be 

8 treated as having been made by the taxpayer. 

9 ‘‘(4) REGULATIONS.—The Secretary may pre10 scribe such regulations and other guidance as may 

11 be necessary or appropriate to carry out this section 

12 and section 7528.’’. 

13 (b) ADVANCE PAYMENT OF CREDIT.—Chapter 77 of 

14 the Internal Revenue Code of 1986 (relating to miscella15 neous provisions) is amended by adding at the end the 

16 following new section: 

17 ‘‘SEC. 7528. ADVANCE PAYMENT OF CREDIT FOR HEALTH 

18 INSURANCE COSTS OF CERTAIN NON-FED19 ERAL EMPLOYEES. 

20 ‘‘Not later than August 1, 2004, the Secretary shall 

21 establish a program for making payments on behalf of in22 dividuals described in section 36(a) to the health insur23 ance plan established under chapter 89A of title 5, United 

24 States Code.’’. 

25 (c) CONFORMING AMENDMENTS.—
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1 (1) Paragraph (2) of section 1324(b) of title 

2 31, United States Code, is amended by inserting be3 fore the period ‘‘, or from section 36 of such Code’’. 

4 (2) The table of sections for subpart C of part 

5 IV of chapter 1 of the Internal Revenue Code of 

6 1986 is amended by striking the last item and in7 serting the following new items:

‘‘Sec. 36. Health insurance costs of certain non-Federal employees. 

‘‘Sec. 37. Overpayments of tax.’’.

8 (3) The table of sections for chapter 77 of such 

9 Code is amended by adding at the end the following 

10 new item:

‘‘Sec. 7528. Advance payment of credit for health insurance costs 

of certain non-Federal employees.’’.

11 (d) EFFECTIVE DATE.—The amendments made by 

12 this section shall apply to taxable years beginning after 

13 December 31, 2004. 

14 SEC. 4. PLAN FOR EXTENSION OF FEDERAL EMPLOYEE 

15 HEALTH BENEFITS PROGRAM. 

16 Not later than 6 months after the date of enactment 

17 of this Act and after consultation with appropriate ex18 perts, representatives of affected individuals, and Federal 

19 officers, the Director of the Office of Personnel Manage20 ment shall submit a comprehensive plan to Congress 

21 that—
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1 (1) provides for the orderly implementation of 

2 the amendments made by this Act; and 

3 (2) includes a schedule of actions to be taken 

4 to provide for that implementation.

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