text: SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
  
      (a) Short Title.--This Act may be cited as the ``Simple Universal 
  Healthcare Act of 2009''.
      (b) Table of Contents.--The table of contents of this Act is as 
  follows:
  
  Sec. 1. Short title; table of contents.
  Sec. 2. Establishment of Citizens Congressional Health Benefits Program 
                              (CCHBP).
  Sec. 3. Contracts with entities to offer qualified CCHBP health plans.
  Sec. 4. Scope of benefits and coverage.
  Sec. 5. Eligibility.
  Sec. 6. Enrollment.
  Sec. 7. Premiums.
  Sec. 8. High-risk reinsurance fund.
  Sec. 9. Definitions.
  Sec. 10. Effective date and treatment of collective bargaining 
                              agreements.
  
  SEC. 2. ESTABLISHMENT OF CITIZENS CONGRESSIONAL HEALTH BENEFITS PROGRAM 
                (CCHBP).
  
      (a) In General.--The Director of the Office of Personnel Management 
  shall establish a program (to be known as the ``Citizen's Congressional 
  Health Benefits Program'') to provide comprehensive health insurance 
  coverage to--
              (1) Federal elected officials (including the President, 
          Vice President, and Members of Congress); and
              (2) residents of the United States who are not covered 
          under the Federal Employees Health Benefits Program (FEHBP).
      (b) Similar to FEHBP.--The coverage shall be provided in a manner 
  similar to the manner in which coverage has been provided to Members of 
  Congress and Federal Government employees and retirees and their 
  dependents under the Federal Employees Health Benefits Program (FEHBP).
  
  SEC. 3. CONTRACTS WITH ENTITIES TO OFFER QUALIFIED CCHBP HEALTH PLANS.
  
      (a) In General.--The Director shall enter into contracts with 
  entities for the offering of qualified CCHBP health plans in accordance 
  with this Act. Such contracts shall be entered into in a manner similar 
  to the process by which the Director is authorized to enter into 
  contracts with entities offering health benefits plans under FEHBP.
      (b) Requirements for Entities Offering Plans.--The Director may 
  only enter into a contract under subsection (a) with an entity that 
  is--
              (1) licensed--
                      (A) as a health maintenance organization in the 
                  State in which the entity will offer the qualified 
                  CCHBP health plan; or
                      (B) to sell group health insurance coverage in such 
                  State;
              (2) meets such requirements, similar to requirements under 
          FEHBP, as the Director may establish, relating to solvency, 
          adequacy of plan benefits (subject to section 4), organization, 
          structure, governance, access, and quality; and
              (3) agrees to participate in the high-risk reinsurance fund 
          described in section 8.
      (c) FEHBP Plans.--Any health plan offered under FEHBP shall be 
  treated as a qualified CCHBP health plan for purposes of this Act.
      (d) Preemption of State Law.--The requirements of section 4, with 
  respect to the scope and type of benefits required to be provided by a 
  CCHBP health plan, shall supersede any and all State laws.
  
  SEC. 4. SCOPE OF BENEFITS AND COVERAGE.
  
      (a) Comprehensive Benefits.--
              (1) In general.--Subject to paragraph (2), qualified CCHBP 
          health plans shall provide for the same scope and type of 
          benefits that are provided under FEHBP, including--
                      (A) the types of benefits described in section 8904 
                  of title 5, United States Code; and
                      (B) benefits required by regulation or guidance 
                  under FEHBP.
              (2) Preventive benefits and mental health parity.--
          Qualified CCHBP health plans shall provide a minimum level of 
          preventive benefits determined by the Director, in consultation 
          with the U.S. Preventive Service Task Force, which shall 
          include vaccines for both children and adults, an annual 
          physical, cancer screening (including mammographies for women 
          of an appropriate age), and mental health parity.
      (b) No Exclusion for Pre-Existing Conditions.--Subject to section 
  6(b)(2), qualified CCHBP health plans shall not impose pre-existing 
  condition exclusions or otherwise discriminate against any individual 
  based on the health status of such individual (including genetic 
  information relating to such enrollee, or any disease or condition).
      (c) Annual and Lifetime Out-Of-Pocket Limit Information.--An entity 
  offering a qualified CCHBP health plan must provide notice to any 
  individual covered by such plan of any benefit or service that is not 
  included in the calculation of the annual or lifetime out-of-pocket 
  limit under such plan.
  
  SEC. 5. ELIGIBILITY.
  
      (a) In General.--An individual is eligible to enroll in a qualified 
  CCHBP health plan if--
              (1) the individual resides in the United States; and
              (2) the individual is--
                      (A) a citizen or national of the United States;
                      (B) an alien lawfully admitted to the United States 
                  for permanent residence;
                      (C) an alien admitted into the United States under 
                  section 207 of the Immigration and Nationality Act 
                  (relating to refugees);
                      (D) an alien otherwise permanently residing in the 
                  United States under color of law (as specified by the 
                  Director); or
                      (E) an alien with the status of a nonimmigrant who 
                  is within a class of long-term nonimmigrants under 
                  section 101(a)(15) of the Immigration and Nationality 
                  Act that the Director determines, in consultation with 
                  the Secretary of Homeland Security, to be appropriate.
      (b) Exceptions.--The following individuals are not eligible to 
  enroll in a qualified CCHBP health plan:
              (1) Individuals enrolled under public health insurance 
          programs.--An individual who is enrolled under the Federal 
          employees health benefits program under chapter 89 of title 5, 
          United States Code (except for a member of Congress, as defined 
          by section 2106 of title 5, United States Code; or the 
          President); the Medicare program under title XVIII of the 
          Social Security Act; the Medicaid program under title XIX of 
          such Act; the Children's Health Insurance Program under title 
          XXI of such Act; or Tricare under chapter 55 of title 10, 
          United States Code.
              (2) Incarcerated individuals.--An individual who is 
          incarcerated (as specified by the Director).
      (c) Treatment of Elected Officials.--A member of Congress (as 
  defined under section 2106 of title 5, United States Code) or the 
  President may enroll in either a qualified CCHBP health plan under this 
  Act or an FEHBP plan under title 5, United States Code, but may not be 
  enrolled in both types of plans at the same time.
      (d) Confirmation of Immigration Status.--The Director, in 
  consultation with each entity offering a qualified CCHBP plan, shall 
  promulgate regulations for the use of the automated system known as the 
  Systematic Alien Verification for Entitlements, as provided for by 
  section 404 of the Illegal Immigrations Reform and Immigrant 
  Responsibility Act of 1996 (110 Stat. 3009-664) to verify the legal 
  presence of the status of an individual, other than a United States 
  citizen, who seeks to enroll in a qualified CCHBP plan.
      (e) Employer Option.--
              (1) In general.--An employer may choose to participate in 
          CCHBP and offer qualified CCHBP health plans to employees of 
          such employer as employer-sponsored health insurance.
              (2) Notice.--The employer shall inform the Director that 
          the employer is taking such option in a form and manner 
          determined by the Director.
              (3) Maintenance of effort required.--An employer who 
          provides notice under paragraph (2) must pay the percentage of 
          the cost of the premium, as determined under section 7, for 
          each employee that enrolls in a qualified CCHBP health plan, 
          that is the same as the percentage of the cost of the premium 
          of the health insurance plan that such employer offered to its 
          employees before the employer provided notice under paragraph 
          (2).
              (4) Tax treatment.--For purposes of the Internal Revenue 
          Code of 1986, a qualified CCHBP health plan offered by an 
          employer under this subsection shall not fail to be treated as 
          employer-provided coverage solely because such employer 
          provides such plan through the CCHBP.
  
  SEC. 6. ENROLLMENT.
  
      (a) Enrollment Process.--The Director shall establish a process to 
  enroll eligible individuals and their families in qualified CCHBP 
  health plans. Such process shall be conducted in a manner that is 
  similar to the manner enrollment is conducted under FEHBP. To the 
  extent consistent with eligibility under section 3, the Director shall 
  provide rules similar to the rules under FEHBP for the enrollment of 
  family members who are CCHBP-eligible individuals in the same plan.
      (b) Enrollment Period.--
              (1) Enrollment upon initial eligibility.--
                      (A) In general.--An eligible individual may enroll 
                  in a qualified CCHBP health plan--
                              (i) at any time during the 1-year period 
                          beginning on the date that the Citizen's 
                          Congressional Health Benefits Program begins to 
                          operate; or, if later,
                              (ii) at any time during the 3-month period 
                          beginning on the date that such individual 
                          becomes eligible to enroll in any qualified 
                          CCHBP health plan.
                      (B) Treatment of preexisting conditions.--An 
                  individual who enrolls during the periods under 
                  paragraph (1) shall not be subject to exclusions or 
                  additional costs due to any preexisting conditions that 
                  such individual developed before the date such 
                  individual enrolled in a qualified CCHBP plan.
              (2) Annual enrollment.--
                      (A) In general.--An eligible individual who does 
                  not enroll in a qualified CCHBP health plan under 
                  paragraph (1) may enroll in such a plan during an 
                  annual enrollment period of not more than 1 month, as 
                  determined by the Director.
                      (B) Treatment of preexisting conditions.--Subject 
                  to rules developed by the Director, the entity offering 
                  the qualified CCHBP health plan may exclude such 
                  individual from enrolling in such a plan under this 
                  paragraph due to any preexisting condition which such 
                  individual develops before the date of such annual 
                  enrollment period. Upon excluding such individual, the 
                  entity offering the qualified CCHBP health plan shall 
                  provide such individual with notice of such exclusion 
                  and information about enrolling in a high risk pool.
      (c) Changes in Enrollment.--The Director shall establish enrollment 
  procedures that include an annual open season of at least 1 month and 
  permit changes in enrollment with qualified health plans at other times 
  (such as by reason of changes in marital or dependent status or 
  eligibility). Such procedures shall be based on the enrollment 
  procedures established under FEHBP. The Director shall provide for 
  termination of such enrollment for an individual at the time the 
  individual is no longer an eligible individual.
      (d) Enrollment of Employees.--Notwithstanding subsection (b)(2), 
  the employees of an employer that provides notice to the Director under 
  section 5(e)(2) may enroll in a qualified CCHBP health plan during 
  either the 3-month period beginning on the date that such employer 
  provides such notice or the 3-month period beginning on the date that 
  such employee begins working for such employer, whichever is later. 
  Such employee shall not be subject to any costs related to such 
  employee's pre-existing conditions if so enrolled during such period.
      (e) Enrollment Guides.--The Director shall provide for the broad 
  dissemination of information on qualified CCHBP health plans offered 
  under this title. Such information shall be provided in a comparative 
  manner, similar to that used under FEHBP, and shall include 
  information, collected through surveys of enrollees, on measures of 
  enrollee satisfaction with the different plans.
  
  SEC. 7. PREMIUMS.
  
      The premiums established for a qualified CCHBP health plan under 
  this Act for individual or family coverage--
              (1) based on the rating system used under FEHBP; and
              (2) shall not vary based on age, gender, health status 
          (including genetic information), or other factors.
  
  SEC. 8. HIGH-RISK REINSURANCE FUND.
  
      The Director shall establish an arrangement among the entities 
  offering qualified health plans under which such entities contribute in 
  an equitable manner (as determined by the Director) into a fund that 
  provides payment to plans for a percentage (specified by the Director 
  and not to exceed 90 percent) of the costs that they incur for 
  enrollees beyond a predetermined threshold specified by the Director. 
  Such fund shall be funded exclusively by such entities.
  
  SEC. 9. DEFINITIONS.
  
      For purposes of this Act:
              (1) The term ``CCHBP-eligible individual'' means an 
          individual described in section 5.
              (2) The term ``Director'' means the Director of the Office 
          of Personnel Management.
              (3) The term ``FEHBP'' means the program under chapter 89 
          of title 5, United States Code.
              (4) The term ``qualified CCHBP health plan'' means a fee-
          for-service plan, health maintenance organization plan, high 
          deductible health insurance plan, or other health insurance 
          plan that meets the requirements for a health insurance plan 
          under FEHBP and is offered through the CCHBP under this Act by 
          an entity that is qualified to offer such plans.
  
  SEC. 10. EFFECTIVE DATE AND TREATMENT OF COLLECTIVE BARGAINING 
                AGREEMENTS.
  
      (a) Effective Date.--Benefits shall first be made available under 
  this title for items and services furnished on or after the last day of 
  the 9-month period beginning on the date of the enactment of this Act.
      (b) Non-Preemption of Existing Collective Bargaining Agreements.--
  Nothing in this Act shall be construed as preempting any collective 
  bargaining agreement that is in effect as of the date of the enactment 
  of this Act, during the period in which such agreement is in effect 
  (without regard to any extension of such agreement effected as of such 
  date of enactment).
target: Simple Universal Healthcare Act of 2009 - Requires the Director of the Office of Personnel Management (OPM) to establish a Citizen's Congressional Health Benefits Program (CCHBP) to provide comprehensive health insurance coverage similar to coverage that has been provided to Members of Congress and federal employees, retirees, and their dependents under the Federal Employees Health Benefits Program (FEHBP) to: (1) federal elected officials; and (2) U.S. residents who are not covered under FEHBP. Authorizes the Director to enter into contracts with entities for the offering of qualified CCHBP health plans in a manner similar to the process by which the Director is authorized to enter into contracts with entities under FEHBP.
  
  Requires any FEHBP health plan to be treated as a qualified CCHBP health plan. Requires CCHBP health plans to: (1) provide for the same scope and type of benefits that are provided under FEHBP; (2) provide a minimum level of preventive benefits determined by the Director, including vaccines for children and adults, an annual physical, cancer screening, and mental health parity; and (3) provide notice to any covered individual of any benefit or service that is not included in the calculation of the annual or lifetime out-of-pocket limit. Prohibits CCHBP health plans from imposing preexisting condition exclusions or otherwise discriminating based on health status with respect to individuals who enroll upon initial eligibility. Allows a plan to exclude an individual from enrolling based on a preexisting condition during an annual enrollment period after such individual's initial eligibility period.
  
  Lists eligibility requirements. Excludes individuals enrolled under FEHBP or other specified public health insurance programs and incarcerated individuals. Requires the Director to promulgate regulations for the use of the Systematic Alien Verification for Entitlements system to verify the legal presence and status of an individual, other than a U.S. citizen, who seeks to enroll in a qualified CCHBP plan.
  
  Permits an employer to choose to participate in CCHBP and offer employees qualified CCHBP health plans as employer-sponsored health insurance.
feat_title: To establish a health benefits program, based on the Federal employees health benefits program, to provide health insurance coverage for the President, Vice President, and Members of Congress, and citizens not eligible for coverage under the Federal employees health benefits program.