I 

108TH CONGRESS 

2D SESSION S. 2283

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 16, 2004

Referred to the Committee on Energy and Commerce 

AN ACT

To extend Federal funding for operation of State high risk 

health insurance 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 ‘‘State High Risk Pool 

5 Funding Extension Act of 2004’’.
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1 SEC. 2. EXTENSION OF FUNDING FOR OPERATION OF 

2 STATE HIGH RISK HEALTH INSURANCE 

3 POOLS. 

4 (a) EXTENSION OF SEED GRANTS.—Section 2745 of 

5 the Public Health Service Act (42 U.S.C. 300gg–45) is 

6 amended—

7 (1) in subsection (a), in the subsection heading 

8 by inserting ‘‘EXTENSION OF’’ before ‘‘SEED’’; and 

9 (2) in subsection (c)(1), by striking 

10 ‘‘$20,000,000’’ and all that follows through ‘‘2003’’ 

11 and inserting ‘‘$15,000,000 for the period of fiscal 

12 years 2004 and 2005’’. 

13 (b) FUNDS FOR OPERATIONS.—Section 2745 of the 

14 Public Health Service Act (42 U.S.C. 300gg–45) is 

15 amended—

16 (1) in subsection (b)—

17 (A) in the subsection heading by striking 

18 ‘‘MATCHING’’; and 

19 (B) by striking paragraph (2) and insert20 ing the following: 

21 ‘‘(2) ALLOTMENT.—The amounts appropriated 

22 under subsection (c)(2) for a fiscal year shall be 

23 made available to the States (or the entities that op24 erate the high risk pool under applicable State law) 

25 as follows: 
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1 ‘‘(A) An amount equal to 50 percent of the 

2 appropriated amount for the fiscal year shall be 

3 allocated in equal amounts among each eligible 

4 State that applies for assistance under this sub5 section. 

6 ‘‘(B) An amount equal to 25 percent of the 

7 appropriated amount for the fiscal year shall be 

8 allocated among the States so that the amount 

9 provided to a State bears the same ratio to 

10 such available amount as the number of unin11 sured individuals in the State bears to the total 

12 number of uninsured individuals in all States 

13 (as determined by the Secretary). 

14 ‘‘(C) An amount equal to 25 percent of the 

15 appropriated amount for the fiscal year shall be 

16 allocated among the States so that the amount 

17 provided to a State bears the same ratio to 

18 such available amount as the number of individ19 uals enrolled in health care coverage through 

20 the qualified high risk pool of the State bears 

21 to the total number of individuals so enrolled 

22 through qualified high risk pools in all States 

23 (as determined by the Secretary).’’; and 

24 (2) in subsection (c)(2), by striking 

25 ‘‘$40,000,000’’ and all that follows through the pe-
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1 riod and inserting ‘‘$75,000,000 for each of fiscal 

2 years 2005 through 2009 to make allotments under 

3 subsection (b)(2).’’. 

4 (c) DEFINITIONS.—Section 2745 of the Public 

5 Health Service Act (42 U.S.C. 300gg–45) is amended—

6 (1) in subsection (d), by inserting after 

7 ‘‘2744(c)(2)’’ the following: ‘‘, except that with re8 spect to subparagraph (A) of such section a State 

9 may elect to provide for the enrollment of eligible in10 dividuals through an acceptable alternative mecha11 nism,’’; and 

12 (2) by adding at the end the following: 

13 ‘‘(e) STANDARD RISK RATE.—In subsection 

14 (b)(1)(A), the term ‘standard risk rate’ means a rate—

15 ‘‘(1) determined under the State high risk pool 

16 by considering the premium rates charged by other 

17 health insurers offering health insurance coverage to 

18 individuals in the insurance market served; 

19 ‘‘(2) that is established using reasonable actu20 arial techniques; and
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1 ‘‘(3) that reflects anticipated claims experience 

2 and expenses for the coverage involved.’’.

Passed the Senate November 16, 2004. 

Attest: EMILY J. REYNOLDS, 

Secretary.