Health Care Access for Small Businesses Act of 2004 - Amends the Social Security Act to create a new title XXII to address health insurance coverage for small businesses.
Requires the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, to award grants for the startup and operation of 50 eligible three-share (three-way health insurance premium sharing between employer, employee, and the community) pilot programs for a five-year period.
Authorizes the use of grants to establish three-share programs, provide for contributions to premiums assessed for coverage under such programs, and establish risk pools.
Requires grant applicants to: (1) be either nonprofits or local governmental entities; (2) define the program's service region; (3) have the capacity to carry out administrative functions associated with managing health plans; and (4) have demonstrated community involvement.
Requires programs to pay for the costs of services through monthly premiums, divided according to specified percentages.
Sets forth minimal coverage requirements for three-share program eligibility.
Requires the Administrator to develop a formula to determine which businesses qualify as distressed businesses for purposes of this Act.
Directs the General Accounting Office to submit a report to the Secretary and appropriate congressional committees after the grant period has ended.