Previous Efforts

History

Beginning in 1799, fishermen aboard U.S. registered fishing vessels were provided health care coverage, but that was stopped in 1981. Since that time fishermen in a highly seasonal and, at times, dangerous occupation have found it difficult, extremely expensive, and sometimes impossible to get coverage. Following on a successful Massachusetts’ program, fishermen are asking for legislation to provide for a national health care demonstration program for the nation’s fleet.

COMMERCIAL FISHING INDUSTRY HEALTH CARE COVERAGE ACT OF 2008

Establishment of Program.

Secretary of Health and Human Services to establish a grant program under the Health Resources and Services Administration for establishment of health care coverage programs for the commercial fishing industry.

  • Program planning grants (for commercial fishing states or organizations in such states).
  • Implementation and Administration grants for no more than 15 commercial fishing states.

Program Planning Grants.

  • Up to $200,000 annually for no more than two years to organizations or states
  • If awarded to an organization, the group must have knowledge of the industry
  • Recipients to conduct initial research and planning for development of a qualified health care coverage program within the state, including a demographic survey of the industry and its health needs; development of a strategic plan for implementation of a qualified program, and a detailed financial plan.
  • The Secretary must consult with states when awarding a planning grant to an organization to help determine if the group has the necessary knowledge and familiarity with the industry and doesn’t have a history of fraudulent or abusive practices.

Implementation and Program Administration Grants.

When a program planning grant is completed, a State may apply, as appropriate, for implementation and administration grants.

  • Grants for initial implementation of a program are not to exceed $2 million annually and are limited to no more than 2 years.
  • Grants for actual administration of a program are not to exceed $3 million annually and are limited to no more than 5 years.
  • Continued administration grants – after completion of 5 administration grants, up to $3 million annually if bad economic conditions or poor fish stock conditions jeopardize the ability of the program to continue providing affordable health care coverage.
  • Implementation, administration and continued administration grants can be awarded even if there was no planning grant under this Act (i.e. if a group did the planning work on its own), or if the program was developed or administered without funds from this Act and/or before enactment of this Act.

Eligibility Requirements (for implementation and administration grants): include enrollment of fishing industry members and their families if they were uninsured or underinsured; need for federal funding in order to operate; state assurances that, if a program already exists, new funds will not simply supplant existing state funding; state assurances that for new programs there will be appropriate financial and consumer protection policies, licensing and oversight, including insolvency protection, stop-loss protection, reinsurance requirements, receivership/liquidation protection, etc.

Matching Funds. (for implementation and administration grants): required ratio of 2:1 federal to non-federal funds. The latter can include in kind, services, equipment, etc.

Contracting Authority. States may contract with organizations or companies (which can in turn subcontract) for the purposes of carrying out implementation or administration grants. The Secretary shall issue regulations governing eligibility for contracts and subcontracts addressing concerns about a history of fraud or abuse, capability to administer a health coverage program, and familiarity with the fishing industry.

Definitions. The following terms are defined:

  • Commercial Fishing State (includes U.S. territories).
  • Commercial Fishing Industry Member (includes shore side fishing businesses)
  • Qualified Health Care Coverage Program (includes enrollment, eligibility, coverage and rate standards)
  • Qualified Health Care Coverage (must be actuarially equivalent to Federal Employees Health Benefits Program or State government health plan).

Authorization of Appropriations.

$5 million the first 2 years; $10 million the second 2 years; and $20 million in year 5

WE NEED YOUR HELP!

The Commercial Fishermen of America believes that all commercial fishermen should have access to high-quality, affordable health care. We need you help to make sure this happens!