State High Risk Pool Funding Extension Act of 2005

Bill: 109-hr-3204
Sponsor: Rep. Shadegg, John B. [R-AZ-3]
Introduced: 2005-07-12 in the House
Policy area: Health
Subjects: Appropriations
Authorization
Case management
Coinsurance
Congress
Congressional reporting requirements
Department of Health and Human Services
Economics and Public Finance
Finance and Financial Sector
Government Operations and Politics
Government insurance
Grants-in-aid
Health insurance
Insurance premiums
Losses
Medically uninsured
Standards
Subsidies

Summary:
action_date: 2005-07-12
text: 
State High Risk Pool Funding Extension Act of 2005 - Amends the Public Health Service Act to reauthorize funds for states to create and operate existing high risk health insurance pools. 
 
Increases the maximum allowable premium charged under a qualified high risk pool to 200% of the premium for applicable standard risk rates for those states that use 50% of the grant amount to reduce premiums for enrollees. Defines &quot;standard risk rate&quot; as a rate that: (1) is determined under the state high risk pool by considering the premiums charged by other health insurers in the same market; (2) is established using reasonable actuarial techniques; and (3) reflects anticipated claims experience and expenses.
 
 Revises the definition of &quot;qualified high risk pool&quot; to allow a state to elect to meet the requirement to provide all eligible individuals with health insurance coverage by utilizing an acceptable alternative mechanism that includes a high risk pool as a component.
 
Amends the formula for allocating funds to states to operate such pools to provide one-third of the funds to eligible states equally, one third based on the number of uninsured individuals in a state relative to all states, and one third based on the number of enrollees in a state's qualified high risk pool relative to all states. (Currently, all funds are allotted based solely on the number of uninsured individuals in the state.) 
 
Requires the Secretary of Health and Human Services to award grants to states with qualified high risk pools for the provision of supplemental consumer benefits. 

action_date: 2005-07-27
text: 
State High Risk Pool Funding Extension Act of 2005 - (Sec. 2) Amends the Public Health Service Act to reauthorize funds for states to create and operate existing high risk health insurance pools.
 
Increases the maximum allowable premium charged under a qualified high risk pool to 200% of the premium for applicable standard risk rates for states that use 50% of the grant amount to reduce premiums for enrollees. Defines &quot;standard risk rate&quot; as a rate that: (1) is determined under the state high risk pool by considering the premiums charged by other health insurers in the same market; (2) is established using reasonable actuarial techniques; and (3) reflects anticipated claims experience and expenses.
 
 Revises the definition of &quot;qualified high risk pool&quot; to allow a state to elect to meet the requirement to provide all eligible individuals with health insurance coverage by utilizing an acceptable alternative mechanism that includes a high risk pool as a component.
 
Amends the formula for allocating funds to states to operate such pools to provide one-third of the funds to eligible states equally, one-third based on the number of uninsured individuals in a state relative to all states, and one-third based on the number of enrollees in a state's qualified high risk pool relative to all states. (Currently, all funds are allotted based solely on the number of uninsured individuals in the state.) 
 
Sets forth reporting requirements.
 
Requires the Secretary of Health and Human Services to award grants to states with qualified high risk pools for the provision of supplemental consumer benefits, such as: (1) low-income premium subsidies; (2) a reduction in premium trends, actual premiums, or other cost-sharing requirements; and (3) an expansion of the pool of individuals eligible for coverage. 

action_date: 2005-10-19
text: 
State High Risk Pool Funding Extension Act of 2005 - (Sec. 2) Amends the Public Health Service Act to reauthorize funds for grants to each state that has not created a qualified high risk pool for the state's cost to create and initially operate such a pool.
 
Increases the maximum allowable premium charged under a qualified high risk pool to 200% of the premium for applicable standard risk rates. Defines &quot;standard risk rate&quot; as a rate that: (1) is determined under the state high risk pool by considering the premiums charged by other health insurers in the same market; (2) is established using reasonable actuarial techniques; and (3) reflects anticipated claims experience and expenses.
 
Permits grants awarded by the Secretary of Health and Human Services to states with existing qualified high risk pools to cover operating losses to be made to entities that operate such a pool under applicable state law. Changes the allocation of such grants to give 40% to eligible states equally, 30% based on the number of uninsured individuals in a state relative to all states, and 30% based on the number of enrollees in a state's qualified high risk pool relative to all states. (Currently, all funds are allotted based solely on the number of uninsured individuals in the state.)
 
 Requires a state which charges premiums that exceed 150% of the premium for applicable standard risk to use at least 50% of the grant amount to reduce premiums for enrollees. 
 
Limits the maximum grant amount allotted to territories.
 
Requires the Secretary to award grants to states with qualified high risk pools for the provision of supplemental consumer benefits, which must include one or more of the following: (1) low-income premium subsidies; (2) a reduction in premium trends, actual premiums, or other cost-sharing requirements; (3) an expansion or broadening of the pool of individuals eligible for coverage; (4) less stringent rules or additional waiver authority with respect to coverage of preexisting conditions; (5) increased benefits; or (6) establishment of disease management programs. Limits to 10% of appropriated funds the amount that any state may be allotted.
 
Authorizes appropriations for FY2006-FY2010 and appropriates funds for FY 2006.
 
Sets forth reporting requirements.
 
Revises the definition of &quot;qualified high risk pool&quot; to allow a state to elect to meet the requirement to provide all eligible individuals with health insurance coverage by utilizing an acceptable alternative mechanism that includes a high risk pool as a component.


Legislative actions:
action_date: 2005-10-20
text: Message on Senate action sent to the House.
action_date: 2005-10-19
text: Passed Senate with an amendment by Unanimous Consent.
action_date: 2005-10-19
text: Passed/agreed to in Senate: Passed Senate with an amendment by Unanimous Consent.
action_date: 2005-10-19
text: Measure laid before Senate by unanimous consent. (consideration: CR S11597-11598)
action_date: 2005-07-28
text: Received in the Senate. Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 181.
action_date: 2005-07-27
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2005-07-27
text: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. (text: CR H6668-6669)
action_date: 2005-07-27
text: Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote.(text: CR H6668-6669)
action_date: 2005-07-27
text: DEBATE - The House proceeded with forty minutes of debate on H.R. 3204.
action_date: 2005-07-27
text: Considered under suspension of the rules. (consideration: CR H6668-6671)
action_date: 2005-07-27
text: Mr. Deal (GA) moved to suspend the rules and pass the bill, as amended.
action_date: 2005-07-27
text: Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 109-192.
action_date: 2005-07-27
text: Placed on the Union Calendar, Calendar No. 116.
action_date: 2005-07-27
text: Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 109-192.
action_date: 2005-07-20
text: Ordered to be Reported (Amended) by Voice Vote.
action_date: 2005-07-20
text: Committee Consideration and Mark-up Session Held.
action_date: 2005-07-14
text: Forwarded by Subcommittee to Full Committee by Voice Vote.
action_date: 2005-07-14
text: Subcommittee Consideration and Mark-up Session Held.
action_date: 2005-07-14
text: Referred to the Subcommittee on Health.
action_date: 2005-07-12
text: Referred to the House Committee on Energy and Commerce.
action_date: 2005-07-12
text: Introduced in House
action_date: 2005-07-12
text: Introduced in House