United States · Bill · HR
H.R. 4281 (108th)
Small Business Health Fairness Act of 2004
Introduced
5 May 2004
Last action
13 May 2004 · Floor
Status
Pursuant to the provisions of H. Res. 638, H.R. 4281 is laid on the table.
Sponsors
Rep. Johnson, Sam [R-TX-3], Rep. Dooley, Calvin M. [D-CA-20], Rep. Velázquez, Nydia M. [D-NY-7], Rep. Boehner, John A. [R-OH-8], Rep. Burns, Max [R-GA-12], Rep. Emerson, Jo Ann [R-MO-8], Rep. Shays, Christopher [R-CT-4], Rep. Kolbe, Jim [R-AZ-8], Rep. Miller, Candice S. [R-MI-10], Rep. Crane, Philip M. [R-IL-8], Rep. Ballenger, Cass [R-NC-10], Rep. Greenwood, James C. [R-PA-8], Sen. Capito, Shelley Moore [R-WV], Sen. Blackburn, Marsha [R-TN], Rep. Pearce, Stevan [R-NM-2], Rep. McInnis, Scott [R-CO-3], Rep. Burgess, Michael C. [R-TX-26], Rep. Keller, Ric [R-FL-8]
Subjects
Healthcare, Taxation
Source updated
21 July 2025
Summary
Small Business Health Fairness Act of 2004 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide for establishment and governance of association health plans (AHPs), which are group health plans whose sponsors are trade, industry, professional, chamber of commerce, or similar business associations, and which meet certain ERISA certification requirements. (Thus, through ERISA preemption of State laws, certified AHPs are exempted from State regulation of health insurance providers, including State consumer protection laws and State requirements for health care benefits to be offered by such entities, with certain exceptions.) Establishes rules governing AHPs, including requirements relating to certification, sponsors and boards of trustees, participation and coverage, nondiscrimination, plan documents, contribution rates, benefit options, applications for certification, notice of voluntary termination, corrective actions, and mandatory termination. Requires AHPs which provide health benefits in addition to health insurance coverage to maintain certain reserves and comply with other solvency requirements. Directs the Secretary of Labor to apply for appointment, and carry out specified duties, as trustee of any insolvent AHPs which provide health benefits in addition to health insurance coverage. Allows a State to impose a contribution tax on any AHP commencing operations in such State after the enactment of this Act. Sets forth limits on such tax, including reduction by the amount of any tax or assessment otherwise imposed by the State on specified other insurance related items maintained by the AHP. Requires AHPs to include in their summary plan descriptions, in connection with each benefit option, a description of the form of any solvency or guarantee fund protection secured under ERISA or applicable State law. Allows a certified AHP to exist in a State regardless of any State law that would preclude it. Preempts State requirements for benefits to be offered by AHPs; but allows a State in which an AHP is domiciled to require the domiciled AHP to cover particular types of diseases and conditions. Allows health insurance issuers to offer coverage of the same policy type offered in connection with a particular AHP to eligible employers, regardless of whether such employers are members of the particular association and regardless of State law. Deems health insurance coverage policy forms filed and approved in a particular State in connection with an insurer's offering under an AHP as approved in any other State in which such coverage is offered when the insurer provides a complete filing in the same form and manner to the authority in the other State. Makes inapplicable to certified AHPs certain current ERISA provisions which allow State regulation of multiple employer welfare arrangements (MEWAs). Revises ERISA preemption rules to permit State regulation of self-insured MEWAs providing medical care which do not elect to meet the certification requirements for AHPs. Directs the Secretary to report to specified congressional committees by January 1, 2009, on the effect, if any, AHPs have had on the number of uninsured individuals. Revises requirements for treatment of single employer arrangements. Allows two or more trades or businesses to be deemed a single employer if they are in the same control group offering medical care benefits, under specified conditions. Provides for enforcement of AHP requirements, including criminal penalties for certain willful misrepresentations, issuance of cease and desist orders, and the responsibility of AHP boards of trustees for certain claims procedures. Directs the Secretary, regarding the exercise of authority, to consult only with the recognized primary domicile State for an AHP. Provides for transitional and other rules relating to treatment of certain existing health benefit programs.
This text is taken from the official record. PoliticalRepo does not editorialize.
Timeline
5 May 2004
Introduced
Referred to the House Committee on Education and the Workforce.
Source: IntroReferral
5 May 2004
Introduced
Sponsor introductory remarks on measure. (CR E761)
Source: IntroReferral
5 May 2004
Introduced
Introduced in House
Source: IntroReferral
5 May 2004
Introduced
Introduced in House
Source: IntroReferral
11 May 2004
Reported
Rules Committee Resolution H. Res. 638 Reported to House. Rule provides for consideration of H.R. 4279, H.R. 4280 and H.R. 4281. Previous question shall be considered as ordered without intervening motions except motion to recommit with or without instructions. Measure will be considered read. Bill is closed to amendments.
Source: Floor
12 May 2004
Passed
Rule H. Res. 638 passed House.
Source: Floor
13 May 2004
Floor
Pursuant to the provisions of H. Res. 638, H.R. 4281 is laid on the table.
Source: Floor
13 May 2004
Passed
Motion to reconsider laid on the table Agreed to without objection.
Source: Floor
13 May 2004
Vote
On passage Passed by the Yeas and Nays: 252 - 162, 1 Present (Roll no. 174). (text: CR H2951-2957)
Source: Floor
13 May 2004
Vote
Passed/agreed to in House: On passage Passed by the Yeas and Nays: 252 - 162, 1 Present (Roll no. 174).(text: CR H2951-2957)
Source: Floor
13 May 2004
Vote
On motion to recommit with instructions Failed by recorded vote: 196 - 218 (Roll no. 173).
Source: Floor
13 May 2004
Floor
The previous question on the motion to recommit with instructions was ordered without objection. (consideration: CR 5/14/2004 H2983)
Source: Floor
13 May 2004
Floor
Rule provides for consideration of H.R. 4279, H.R. 4280 and H.R. 4281. Previous question shall be considered as ordered without intervening motions except motion to recommit with or without instructions. Measure will be considered read. A specified amendment is in order.
Source: Floor
13 May 2004
Floor
Mrs. McCarthy (NY) moved to recommit with instructions to Education and the Workforce. (consideration: CR 5/14/2004 H2984-2986; text: CR 5/14/2004 H2984)
Source: Floor
13 May 2004
Floor
Considered under the provisions of rule H. Res. 638. (consideration: CR H2951-2960, CR 5/14/2004 H2967-2986)
Source: Floor
Votes
No vote records are attached yet.
Versions
- Introduced in House · 5 May 2004 · Download file
Documents
4 official files
Introduced in House (text)
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Passed House without amendment
summary · EN · 13 May 2004
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Introduced in House (text)
Introduced in House · EN · 5 May 2004
Introduced in House (PDF)
Introduced in House · EN · 5 May 2004
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Introduced in House
summary · EN · 5 May 2004
Leesvertaling
Vertaal dit document naar jouw taal. PoliticalRepo bewaart geen aparte kopie per EU-taal.
Documentvertaling op verzoek met downloadbare PDF (logo + link naar de officiële bron). Het bronbestand blijft leidend.
Sponsors
- Rep. Johnson, Sam [R-TX-3] · R · Sponsor
- Rep. Dooley, Calvin M. [D-CA-20] · D · Sponsor
- Rep. Velázquez, Nydia M. [D-NY-7] · D · Sponsor
- Rep. Boehner, John A. [R-OH-8] · R · Sponsor
- Rep. Burns, Max [R-GA-12] · R · Sponsor
- Rep. Emerson, Jo Ann [R-MO-8] · R · Cosponsor
- Rep. Shays, Christopher [R-CT-4] · R · Cosponsor
- Rep. Kolbe, Jim [R-AZ-8] · R · Cosponsor
- Rep. Miller, Candice S. [R-MI-10] · R · Cosponsor
- Rep. Crane, Philip M. [R-IL-8] · R · Cosponsor
- Rep. Ballenger, Cass [R-NC-10] · R · Cosponsor
- Rep. Greenwood, James C. [R-PA-8] · R · Cosponsor
- Sen. Capito, Shelley Moore [R-WV] · R · Cosponsor
- Sen. Blackburn, Marsha [R-TN] · R · Cosponsor
- Rep. Pearce, Stevan [R-NM-2] · R · Cosponsor
- Rep. McInnis, Scott [R-CO-3] · R · Cosponsor
- Rep. Burgess, Michael C. [R-TX-26] · R · Cosponsor
- Rep. Keller, Ric [R-FL-8] · R · Cosponsor
- · hsed00 · Standing
Related records
- related to → Small Business Health Fairness Act of 2003
- related to → Providing for consideration of the bill (H.R. 4279) to amend the Internal Revenue Code of 1986 to provide for the disposition of unused health benefits in cafeteria plans and flexible spending arrangements; for consideration of the bill (H.R. 4280) to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system; and for consideration of the bill (H.R. 4281) to amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.
- related to → To amend the Internal Revenue Code of 1986 to permanently extend the 10-percent individual income tax rate bracket.
- related to ← To amend the Internal Revenue Code of 1986 to provide for the disposition of unused health benefits in cafeteria plans and flexible spending arrangements, to improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system, and to amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.
- related to ← Small Business Health Fairness Act of 2003
- amends ← An amendment in the nature of a substitute printed in Part B of House Report 108-484.
Sources
PoliticalRepo is an index and interpretation layer, not the authoritative legal source.
- Official source: https://www.congress.gov/bill/108th-congress/house-bill/4281
- Open data entity: https://api.congress.gov/v3/bill/108/hr/4281
- us · 108-hr-4281 · source updated 21 July 2025