I 
108TH CONGRESS 
2D SESSION 
H. R. 4964
To amend the Social Security Act and the Internal Revenue Code of 1986 
to assure comprehensive, affordable health insurance coverage for all 
Americans through an American Health Benefits Program. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 22, 2004
Mr. LANGEVIN introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend the Social Security Act and the Internal Revenue 
Code of 1986 to assure comprehensive, affordable health 
insurance coverage for all Americans through an Amer-
ican Health Benefits Program.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; FINDINGS; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘American Health Benefits Program Act of 2004’’. 
(b) FINDINGS.—Congress finds the following:
(1) UNINSURED AMERICANS AND LACK OF AC-
CESS TO CHOICES.—
(A) In 2002, 43.6 million Americans were 
uninsured, 80 percent of whom were employed 
(or dependents of individuals who were em-
ployed). 
(B) Health care providers provided to un-
insured Americans $35 billion in care for which 
they were not compensated by the individuals or 
through insurance. 
(C) Only 8 percent of employers providing 
health benefits are able to offer their employees 
a choice between two or more health plans. 
(2) DOUBLE-DIGIT
GROWTH
IN
EMPLOYER 
COSTS.—In 2003 the average per capita cost for em-
ployers to provide health benefits coverage increased 
by almost 14 percent. This was the third consecutive 
year of double-digit increases in such cost. 
(3) ADMINISTRATIVE
EFFICIENCY
OF
USING 
FEHBP MODEL FOR PROVIDING HEALTH INSURANCE 
COVERAGE.—
(A) The private insurance market presents 
increasing administrative challenges for employ-
ers in seeking out, contracting with, and admin-
istering health benefits.
(B) The Federal Employee Health Bene-
fits Program (FEHBP) currently manages ne-
gotiations with health insurers over premiums 
and benefits on behalf of 8.6 million Federal 
employees and retirees and their dependents. 
(C) Overhead costs for employers providing 
health benefits coverage can be over 30 percent 
for employers with fewer than 10 employees 
and about 12 percent for employers with more 
than 500 employees. 
(D) In comparison, the overhead cost of 
coverage provided under FEHBP is about 3 
percent. 
(4) EXPANSION OF FEHBP MODEL TO COVER 
UNINSURED
AND
OTHER
AMERICANS.—Requiring 
participation in an FEHBP-style program would ex-
pand consumer choice, ensure portability and con-
tinuity of coverage, improve incentives for cost con-
tainment, and stabilize the burden on businesses 
(5) PERSONAL RESPONSIBILITY.—A recent sur-
vey indicates that a clear majority of Americans see 
securing health insurance coverage as a personal re-
sponsibility for themselves and others. 
(c) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows:
Sec. 1. Short title; findings; table of contents.
Sec. 2. Establishment of American Health Benefits Program. 
‘‘TITLE XXII—AMERICAN HEALTH BENEFITS PROGRAM 
‘‘Sec. 2201. Establishment of program. 
‘‘Sec. 2202. Eligibility; requirement of coverage. 
‘‘Sec. 2203. Qualified health plans; benefits; premiums. 
‘‘Sec. 2204. Government contribution; American Health Benefits Program 
Trust Fund. 
‘‘Sec. 2205. Premium and cost-sharing subsidies for lower income individ-
uals. 
‘‘Sec. 2206. Administration. 
‘‘Sec. 2207. Definitions. 
Sec. 3. Collection of premiums, subsidies, and employer funding. 
Sec. 4. Amendments to the medicaid and SCHIP program. 
Sec. 5. Studies.
SEC. 2. ESTABLISHMENT OF AMERICAN HEALTH BENEFITS 
PROGRAM. 
(a) IN GENERAL.—The Social Security Act is amend-
ed by adding at the end the following new title: 
‘‘TITLE XXII—AMERICAN 
HEALTH BENEFITS PROGRAM 
‘‘SEC. 2201. ESTABLISHMENT OF PROGRAM. 
‘‘There is established under this title a program (to 
be known as the ‘American Health Benefits Program’) to 
provide comprehensive health insurance coverage to all 
Americans who are not covered under certain Federal 
health insurance programs. The coverage is provided in 
a manner similar to the manner in which coverage has 
been provided to Members of Congress and Federal gov-
ernment employees and retirees and their dependents 
under the Federal Employees Health Benefits Program 
(FEHBP).