I 
110TH CONGRESS 
2D SESSION 
H. R. 5918 
To amend the Public Health Service Act to establish a nationwide health 
insurance purchasing pool for small businesses and the self-employed 
that would offer a choice of private health plans and make health cov-
erage more affordable, predictable, and accessible. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 29, 2008 
Mr. BARROW introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Education and Labor, Ways and Means, and Rules, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee con-
cerned 
A BILL 
To amend the Public Health Service Act to establish a na-
tionwide health insurance purchasing pool for small busi-
nesses and the self-employed that would offer a choice 
of private health plans and make health coverage more 
affordable, predictable, and accessible. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Small Business Health 
Options Program Act of 2008’’ or the ‘‘SHOP Act’’. 
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SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE 
ACT. 
The Public Health Service Act (42 U.S.C. 201 et 
seq.) is amended by adding at the end the following: 
‘‘TITLE XXX—SMALL BUSINESS 
HEALTH OPTIONS PROGRAM 
‘‘SEC. 3001. DEFINITIONS. 
‘‘(a) IN GENERAL.—In this title: 
‘‘(1) ADMINISTRATOR.—The term ‘Adminis-
trator’ means the Administrator appointed under 
section 3002(a). 
‘‘(2) SMALL BUSINESS HEALTH BOARD.—The 
term ‘Small Business Health Board’ means the 
Board established under section 3002(d). 
‘‘(3) EMPLOYEE.—The term ‘employee’ has the 
meaning given such term under section 3(6) of the 
Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1002(6)). Such term shall not include an 
employee of the Federal Government. 
‘‘(4) EMPLOYER.—The term ‘employer’ has the 
meaning given such term under section 3(5) of the 
Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1002(5)), except that such term shall in-
clude employers who employed an average of at least 
1 but not more than 100 employees (who worked an 
average of at least 35 hours per week) on business 
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days during the year preceding the date of applica-
tion, and shall include self-employed individuals with 
either not less than $5,000 in net earnings or not 
less than $15,000 in gross earnings from self-em-
ployment in the preceding taxable year. Such term 
shall not include the Federal Government. 
‘‘(5) HEALTH
INSURANCE
COVERAGE.—The 
term ‘health insurance coverage’ has the meaning 
given such term in section 2791. 
‘‘(6) HEALTH INSURANCE ISSUER.—The term 
‘health insurance issuer’ has the meaning given such 
term in section 2791. 
‘‘(7) HEALTH STATUS-RELATED FACTOR.—The 
term ‘health status-related factor’ has the meaning 
given such term in section 2791(d)(9). 
‘‘(8) PARTICIPATING
EMPLOYER.—The term 
‘participating employer’ means an employer that— 
‘‘(A) elects to provide health insurance cov-
erage under this title to its employees; and 
‘‘(B) is not offering other comprehensive 
health insurance coverage to such employees. 
‘‘(b) APPLICATION OF CERTAIN RULES IN DETER-
MINATION OF EMPLOYER SIZE.—For purposes of sub-
section (a)(3): 
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