I 
109TH CONGRESS 
2D SESSION 
H. R. 5171 
To amend the Public Health Service Act to provide for community projects 
that will reduce the number of individuals who are uninsured with respect 
to health care, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 25, 2006 
Mr. HOEKSTRA (for himself, Mr. GILLMOR, Mr. MCCOTTER, Mr. ROGERS of 
Michigan, Mr. EHLERS, Mr. BOOZMAN, Mr. SHADEGG, Mr. CAMP, and 
Mr. LATOURETTE) introduced the following bill; which was referred to 
the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to provide for 
community projects that will reduce the number of indi-
viduals who are uninsured with respect to health care, 
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 ‘‘Communities Building 
Access Act’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
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(1) Two models of community programs for the 
uninsured have emerged as effective in generating 
community support and funding in urban and rural 
areas; in providing effective care and coverage for 
the uninsured; in avoiding displacement of private 
coverage; and in avoiding duplication of other fed-
eral programs for the uninsured. 
(2) These community models have dem-
onstrated community-wide economic benefit. Em-
ployers in the community experience less health care 
cost-shifting, in addition to increased productivity 
and employee retention. With greater emphasis on 
preventive and chronic care, a community’s unin-
sured population becomes less of a financial burden 
on state and local budgets. 
(3) These community models have dem-
onstrated potential national solutions for certain un-
insured populations, including the working unin-
sured. Such lessons learned from these models in-
clude, for example, the level of subsidy necessary to 
get small employers to purchase coverage for their 
employees, how to effectively market access pro-
grams to the uninsured, and how to effectively man-
age chronic care among lower-income populations. 
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(4) These community models have succeeded in 
raising much of the funding necessary to function, 
but have lacked financial stability and would enjoy 
greater success with a stable partial funding stream 
from the Federal Government. 
(5) These community models, if involved in a 
Federal partnership, have the ability and willingness 
to be accountable for a return on investment for 
Federal funding, and to disseminate expertise to 
like-minded communities. 
SEC. 3. GRANTS FOR MULTI-SHARE HEALTH CARE COV-
ERAGE PROJECTS FOR UNINSURED WORKING 
INDIVIDUALS. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 
330M. 
MULTI-SHARE 
HEALTH 
CARE 
COVERAGE 
PROJECTS FOR UNINSURED WORKING INDI-
VIDUALS. 
‘‘(a) IN GENERAL.—The Secretary shall make grants 
to public or nonprofit private entities to carry out dem-
onstration projects for the purpose of— 
‘‘(1) making available, on a cost-sharing basis 
as described in subsection (c)(2)(C), health care cov-
erage to qualifying employees through employers 
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that have not contributed to health care benefits for 
employees during the 12-month period prior to par-
ticipating in such a project; and 
‘‘(2) making available, on such basis, health 
care coverage to qualifying self-employed individuals 
who have been without such coverage during the 12- 
month period prior to participating in such a 
project. 
‘‘(b) QUALIFYING EMPLOYEES AND SELF-EMPLOYED 
INDIVIDUALS.—For purposes of this section, the term 
‘qualifying’, with respect to an employee or self-employed 
individual, means that the employee or self-employed indi-
vidual is not eligible for health services under the program 
under title XVIII, XIX, or XXI of the Social Security Act 
(relating to the Medicare program, the Medicaid program, 
and the State children’s health insurance program, respec-
tively). 
‘‘(c) REQUIREMENTS FOR GRANT.— 
‘‘(1) IN
GENERAL.—A grant may be made 
under subsection (a) for a project only if the appli-
cant involved— 
‘‘(A) has defined a service area for the 
project; 
‘‘(B) has formed a consortium of entities 
in such service area, which consortium is com-
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posed of employers whose employees may or 
may not be served by the project, health care 
providers who will provide services through the 
project, and other appropriate entities; 
‘‘(C) has ensured that the consortium has 
established a set of unified goals for the project; 
‘‘(D) has conducted a basic level of demo-
graphic research to obtain data on the unin-
sured businesses, working uninsured, and pro-
vider community within the service area in 
order to determine the potential value and ef-
fectiveness of operating such a project, which 
data includes— 
‘‘(i) the rate of uncompensated care; 
‘‘(ii) the number of women lacking 
prenatal services; 
‘‘(iii) immunization rates; and 
‘‘(iv) the number of employers that do 
not provide health insurance to their em-
ployees; and 
‘‘(E) has conducted a basic evaluation of 
State health insurance and local laws that 
might impact the implementation of the project. 
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