I 
111TH CONGRESS 
1ST SESSION H. R. 3438 
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 employ-
ees, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 31, 2009 
Mr. ISSA introduced the following bill; which was referred to the Committee 
on Oversight and Government Reform, and in addition to the Committee 
on Ways and Means, 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 concerned 
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. 
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 ‘‘Access to Insurance 
for all Americans Act’’. 
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SEC. 2. EXTENSION OF FEDERAL EMPLOYEE HEALTH IN-
SURANCE. 
(a) IN GENERAL.—Subpart G of part III of title 5, 
United States Code, is amended— 
(1) by redesignating chapters 89A and 89B as 
chapters 89B and 89C, respectively; and 
(2) by inserting after chapter 89 the following: 
‘‘CHAPTER 89A—HEALTH INSURANCE FOR 
NON-FEDERAL EMPLOYEES 
‘‘SEC. 8921. DEFINITIONS. 
‘‘In this chapter— 
‘‘(1) the terms defined under section 8901 shall 
have the meanings given such terms under that sec-
tion; and 
‘‘(2) the term ‘Office’ means the Office of Per-
sonnel Management. 
‘‘SEC. 8922. HEALTH INSURANCE FOR NON-FEDERAL EM-
PLOYEES. 
‘‘(a) The Office shall administer a health insurance 
program for non-Federal employees in accordance with 
this chapter. 
‘‘(b) Except as provided under this chapter, the Of-
fice shall prescribe regulations to apply the provisions of 
chapter 89 to the greatest extent practicable to eligible 
individuals covered under this chapter. 
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‘‘SEC. 8923. CONTRACT REQUIREMENT. 
‘‘(a) For each calendar year, the Office shall enter 
into a contract with 1 or more carriers to make available 
1 or more health benefits plans (subject to the provisions 
of this chapter) to eligible individuals under this chapter. 
‘‘(b) In carrying out this section, the Office may re-
quire 1 or more carriers to enter into a contract described 
in subsection (a), as a condition of entering into a contract 
under section 8902. 
‘‘SEC. 8924. ELIGIBILITY OF NON-FEDERAL EMPLOYEES. 
‘‘(a) Except as provided under subsection (b), any in-
dividual may enroll in a health benefits plan under this 
section. 
‘‘(b) An individual may not enroll in a health benefits 
plan under this chapter if the individual— 
‘‘(1) is enrolled or eligible to enroll for coverage 
under a public health insurance program, includ-
ing— 
‘‘(A) title XVIII of the Social Security Act; 
‘‘(B) a State plan under title XIX of the 
Social Security Act; 
‘‘(C) a State plan under title XX of the 
Social Security Act; or 
‘‘(D) any other program determined by the 
Office; 
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‘‘(2) is enrolled or eligible to enroll in a plan 
under chapter 89; or 
‘‘(3) is a member of the uniformed services as 
defined under section 101(a)(5) of title 10. 
‘‘SEC. 8925. ALTERNATIVE CONDITIONS TO FEDERAL EM-
PLOYEE HEALTH BENEFITS PLANS. 
‘‘(a) Rates charged and premiums paid for a health 
benefits plan under this chapter may differ between or 
among geographic regions. 
‘‘(b) No Government contribution shall be made for 
any individual under this chapter. 
‘‘(c) In the administration of this chapter, the Office 
shall ensure that individuals covered under this chapter 
shall be in a risk pool that is separate from the risk pool 
maintained for individuals covered under chapter 89.’’. 
(b) TECHNICAL AND CONFORMING AMENDMENTS.— 
(1) CONTRACT REQUIREMENT UNDER CHAPTER 
89.—Section 8902 of title 5, United States Code, is 
amended by adding after subsection (o) the fol-
lowing: 
‘‘(p) Any contract under this chapter may include, 
at the discretion of the Office, a provision that the carrier 
shall enter into a contract to provide 1 or more health 
benefits plans as described under chapter 89A.’’. 
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(2) TABLE OF CHAPTERS.—The table of chap-
ters for part III of title 5, United States Code, is 
amended— 
(A) by redesignating the items relating to 
chapters 89A and 89B as chapters 89B and 
89C, respectively; and 
(B) by inserting after the item relating to 
chapter 89 the following: 
‘‘89A. Health Insurance for Non-Federal Employees ........... 8921’’. 
SEC. 3. DEDUCTION FOR PREMIUMS PAID BY FEHBP NON- 
EMPLOYEE ENROLLEES. 
(a) IN GENERAL.—Part VII of subchapter B of chap-
ter 1 of the Internal Revenue Code of 1986 (relating to 
additional itemized deductions) is amended by redesig-
nating section 224 as section 225 and by inserting after 
section 223 the following new section: 
‘‘SEC. 224. PREMIUMS PAID FOR FEHBP COVERAGE. 
‘‘(a) IN GENERAL.—In the case of an individual, 
there shall be allowed as a deduction an amount equal to 
the amount paid as premiums during the taxable year for 
coverage for the taxpayer, his spouse, and dependents 
under health insurance provided pursuant to chapter 89A 
of title 5, United States Code. 
‘‘(b) SPECIAL RULES.— 
‘‘(1) COORDINATION
WITH
MEDICAL
DEDUC-
TION, ETC.—Any amount paid by a taxpayer for in-
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surance to which subsection (a) applies shall not be 
taken into account in computing the amount allow-
able to the taxpayer as a deduction under section 
162(l) or 213(a). Any amount taken into account in 
determining the credit allowed under section 35 shall 
not be taken into account for purposes of this sec-
tion. 
‘‘(2) DEDUCTION NOT ALLOWED FOR SELF-EM-
PLOYMENT
TAX
PURPOSES.—The deduction allow-
able by reason of this section shall not be taken into 
account in determining an individual’s net earnings 
from self-employment (within the meaning of section 
1402(a)) for purposes of chapter 2.’’. 
(b) DEDUCTION
ALLOWED
IN
COMPUTING
AD-
JUSTED GROSS INCOME.—Subsection (a) of section 62 of 
such Code is amended by inserting before the last sentence 
the following new paragraph: 
‘‘(22) PREMIUMS
PAID
FOR
FEHBP
COV-
ERAGE.—The deduction allowed by section 224.’’. 
(c) CLERICAL AMENDMENT.—The table of sections 
for part VII of subchapter B of chapter 1 of such Code 
is amended by redesignating the item relating to section 
224 as an item relating to section 225 and inserting before 
such item the following new item: 
‘‘Sec. 224. Premiums paid for FEHBP coverage.’’. 
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(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years ending after the 
date of the enactment of this Act. 
SEC. 4. PLAN FOR EXTENSION OF FEDERAL EMPLOYEE 
HEALTH BENEFITS PROGRAM. 
Not later than 6 months after the date of enactment 
of this Act and after consultation with appropriate ex-
perts, representatives of affected individuals, and Federal 
officers, the Director of the Office of Personnel Manage-
ment shall submit a comprehensive plan to Congress 
that— 
(1) provides for the orderly implementation of 
the amendments made by this Act; and 
(2) includes a schedule of actions to be taken 
to provide for that implementation. 
Æ 
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