No Discrimination in Health Insurance Act of 2009 - Amends the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code, and the Public Health Service Act to prohibit a group health plan from imposing any preexisting conditions exclusion.
Requires each health insurance issuer that offers health insurance coverage in the group market in a state to: (1) accept every employer in the state that applies for such coverage; (2) accept enrollment for every eligible individual who applies during the enrollment period; (3) charge the same premium price for the same coverage; and (4) openly disclose such premium price.
Eliminates provisions allowing nonfederal governmental plans to opt out of certain group health plan requirements.
Prohibits health insurance issuers that offer coverage in the individual market to individuals residing in an area from: (1) declining to offer such coverage to, or denying enrollment of, eligible individuals in the area who desire to enroll; or (2) imposing any preexisting conditions exclusion. Defines "eligible individual" to mean: (1) a U.S. citizen or national; (2) an alien lawfully admitted to the United States for permanent residence; or (3) an alien who is otherwise lawfully residing in the United States. Requires such issuers to: (1) charge the same premium price for the same coverage, including coverage offered in the group market; and (2) openly disclose such premium price.
Authorizes the Secretary of Health and Human Services to establish rules to deter individuals from: (1) enrolling in individual health insurance coverage only after they develop an illness or injury; or (2) disenrolling for periods in which they are unlikely to require such coverage.
[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1092 Introduced in House (IH)]
111th CONGRESS
1st Session
H. R. 1092
To amend the Employee Retirement Income Security Act of 1974, Public
Health Service Act, and the Internal Revenue Code of 1986 to prohibit
discrimination in group health coverage and individual health insurance
coverage.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2009
Mr. Kagen introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committees on
Education and Labor and Ways and Means, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend the Employee Retirement Income Security Act of 1974, Public
Health Service Act, and the Internal Revenue Code of 1986 to prohibit
discrimination in group health coverage and individual health insurance
coverage.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; PURPOSE.
(a) Short Title.--This Act may be cited as the ``No Discrimination
in Health Insurance Act of 2009''.
(b) Purpose.--It is the purpose of this Act to--
(1) eliminate the application of pre-existing condition
exclusions in all group health coverage policies and all
individual health insurance policies; and
(2) provide that all health insurance issuers determine and
openly disclose the premium price for each and every group
health insurance policy and each and every individual health
insurance policy, such that within a specific metropolitan
statistical area, or other geographic area, all such premiums
and prices established by a given issuer shall be uniform.
SEC. 2. NONDISCRIMINATION IN GROUP HEALTH COVERAGE.
(a) Application Under the Employee Retirement Income Security Act
of 1974.--
(1) Elimination of preexisting condition exclusions.--
Section 701 of the Employee Retirement Income Security Act of
1974 (29 U.S.C. 1181) is amended--
(A) by amending the heading to read as follows:
``elimination of preexisting condition exclusions'';
(B) by amending subsection (a) to read as follows:
``(a) In General.--A group health plan, and a health insurance
issuer offering group health insurance coverage, with respect to a
participant or beneficiary--
``(1) may not impose any pre-existing condition exclusion;
and
``(2) in the case of a group health plan that offers
medical care through health insurance coverage offered by a
health maintenance organization, may not provide for an
affiliation period with respect to coverage through the
organization.'';
(C) in subsection (b), by striking paragraph (3)
and inserting the following:
``(3) Affiliation period.--The term `affiliation period'
means a period which, under the terms of the health insurance
coverage offered by the health maintenance organization, must
expire before the health insurance coverage becomes
effective.'';
(D) by striking subsections (c), (d), (e), and (g);
and
(E) by redesignating subsection (f) (relating to
special enrollment periods) as subsection (c).
(2) Clerical amendment.--The item in the table of contents
of such Act relating to section 701 is amended to read as
follows:
``Sec. 701. Elimination of pre-existing condition exclusions.''.
(b) Application Under the Internal Revenue Code of 1986.--
(1) Elimination of preexisting condition exclusions.--
Section 9801 of the Internal Revenue Code of 1986 is amended--
(A) by amending the heading to read as follows:
``elimination of preexisting condition exclusions'';
(B) by amending subsection (a) to read as follows:
``(a) In General.--A group health plan with respect to a
participant or beneficiary may not impose any pre-existing condition
exclusion.'';
(C) by striking paragraph (3) of subsection (b);
(D) by striking subsections (c), (d), and (e); and
(E) by redesignating subsection (f) (relating to
special enrollment periods) as subsection (c).
(2) Clerical amendment.--The item in the table of sections
of chapter 100 of such Code relating to section 9801 is amended
to read as follows:
``Sec. 9801. Elimination of preexisting condition exclusions.''.
(c) Application Under Public Health Service Act.--
(1) Elimination of preexisting condition exclusions.--
Section 2701 of the Public Health Service Act (42 U.S.C. 300gg)
is amended--
(A) by amending the heading to read as follows:
``elimination of preexisting condition exclusions'';
(B) by amending subsection (a) to read as follows:
``(a) In General.--A group health plan, and a health insurance
issuer offering group health insurance coverage, with respect to a
participant or beneficiary--
``(1) may not impose any pre-existing condition exclusion;
and
``(2) in the case of a group health plan that offers
medical care through health insurance coverage offered by a
health maintenance organization, may not provide for an
affiliation period with respect to coverage through the
organization.'';
(C) in subsection (b), by striking paragraph (3)
and inserting the following:
``(3) Affiliation period.--The term `affiliation period'
means a period which, under the terms of the health insurance
coverage offered by the health maintenance organization, must
expire before the health insurance coverage becomes
effective.'';
(D) by striking subsections (c), (d), (e), and (g);
and
(E) by redesignating subsection (f) (relating to
special enrollment periods) as subsection (c).
(2) Guaranteed availability of group health insurance
coverage to employers of all sizes in the group market.--
Section 2711 of such Act (42 U.S.C. 300gg-11) is amended--
(A) in subsection (a)--
(i) in the heading, by striking ``Small'';
(ii) in paragraph (1), by striking ``(c)
through (f)'' and inserting ``(b) through
(d)'';
(iii) in paragraph (1), in the matter
before subparagraph (A), by striking ``small'';
(iv) in paragraph (1)(A), by striking
``small employer (as defined in section
2791(e)(4))'' and inserting ``employer'';
(v) in paragraph (2), by striking ``small''
each place it appears; and
(vi) in paragraph (2), by striking
``coverage to a'' and inserting ``coverage to
an'';
(B) by striking subsection (b);
(C) in subsections (c), (d), and (e), by striking
``small'' each place it appears; and
(D) by striking subsection (f).
(3) Application of uniform premiums.--Section 2711 of such
Act, as so amended, is amended by inserting after subsection
(a) the following new subsection:
``(b) Application of Uniform Premium.--
``(1) In general.--Each and every health insurance issuer
that offers health insurance coverage in the group market in a
State shall--
``(A) shall charge the same premium price for the
same coverage; and
``(B) shall openly disclose, in a manner specified
by the Secretary and including disclosure through the
Internet, the amount of the premium price that is being
charged for the coverage involved.
``(2) Uniform application to family coverage and to
different geographic areas.--Paragraph (1) shall be applied
uniformly--
``(A) for coverage on the basis of such different
family categories as the Secretary approves; and
``(B) for coverage within each metropolitan
statistical area and for coverage within the portions
of a State that are not within a metropolitan
statistical area.
``(3) Application.--Paragraph (1) shall not be construed as
preventing variations in premiums that result from the
application of a uniform monthly premium over different policy
years.''.
(4) Application of nondiscrimination rules to nonfederal
governmental plans.--Section 2721(b)(2)(A) of such Act (42
U.S.C. 300gg-21(b)(2)(A)) is amended by striking ``subparts 1
through 3'' and ``such subparts'' and inserting ``subpart 2''
and ``such subpart'', respectively.
(d) Effective Date.--
(1) In general.--The amendments made by this section shall
apply to plan years beginning on or after January 1, 2010,
regardless of whether an individual is provided coverage under
a group health plan before such date.
(2) Special rule for collective bargaining agreements.--In
the case of a group health plan maintained pursuant to one or
more collective bargaining agreements between employee
representatives and one or more employers ratified before the
date of the enactment of this Act, the amendments made by this
section shall not apply to plan years beginning before the
later of--
(A) the date on which the last of the collective
bargaining agreements relating to the plan terminates
(determined without regard to any extension thereof
agreed to after the date of the enactment of this Act),
or
(B) January 1, 2011.
For purposes of subparagraph (A), any plan amendment made
pursuant to a collective bargaining agreement relating to the
plan which amends the plan solely to conform to any requirement
under the amendments made by this section shall not be treated
as a termination of such collective bargaining agreement.
SEC. 3. NONDISCRIMINATION IN INDIVIDUAL HEALTH INSURANCE.
(a) In General.--Section 2741 of the Public Health Service Act (42
U.S.C. 300gg-41) is amended--
(1) by amending the heading to read as follows:
``guaranteed issue of individual health insurance coverage;
uniform premiums'';
(2) by amending subsections (a) and (b) to read as follows:
``(a) In General.--
``(1) Guaranteed issue.--Subject to the succeeding
subsections of this section, each and every health insurance
issuer that offers health insurance coverage (as defined in
section 2791(b)(1)) in the individual market to individuals
residing in an area may not, with respect to an eligible
individual (as defined in subsection (b)) residing in the area
who desires to enroll in individual health insurance coverage--
``(A) decline to offer such coverage to, or deny
enrollment of, such individual; or
``(B) impose any preexisting condition exclusion
(as defined in section 2701(b)(1)(A)) with respect to
such coverage.
``(2) Application of uniform premium.--
``(A) In general.--Each and every health insurance
issuer that offers health insurance coverage in the
individual market in a State--
``(i) shall charge the same premium price
for the same coverage;
``(ii) if the issuer offers such coverage
in the group market in the State, shall charge
the same premium for the same coverage offered
in the group market; and
``(iii) shall openly disclose, in a manner
specified by the Secretary and including
disclosure through the Internet, the amount of
the premium price that is being charged for the
coverage involved.
``(B) Uniform application to family coverage and to
different geographic areas.--Subparagraph (A) shall be
applied uniformly--
``(i) for coverage on the basis of such
different family categories as the Secretary
approves; and
``(ii) for coverage within each
metropolitan statistical area and for coverage
within the portions of a State that are not
within a metropolitan statistical area.
``(C) Application.--Subparagraph (A) shall not be
construed as preventing variations in premiums that
result from the application of a uniform monthly
premium over different policy years.
``(b) Eligible Individual Defined.--In this part, the term
`eligible individual' means, with respect to an area, an individual who
resides in such area, without regard to the period of such residency,
and who is--
``(1) a citizen or national of the United States;
``(2) an alien lawfully admitted to the United States for
permanent residence; or
``(3) an alien who is otherwise lawfully residing in the
United States.'';
(3) by striking subsection (c);
(4) by redesignating subsection (d) and the first
subsection (e) (relating to application of financial capacity
limits) as subsections (c) and (d), respectively;
(5) in paragraph (1) of the subsection (e) relating to
market requirements, by striking ``or through one or more bona
fide associations, or both''; and
(6) by striking subsection (f) and inserting the following:
``(f) Uniform Rules To Respond to Adverse Selection.--
``(1) In general.--The Secretary may establish rules for
uniform application that are designed to deter individuals--
``(A) from enrolling in individual health insurance
coverage only after they develop an illness or injury
for which such coverage applies; and
``(B) from disenrolling from health insurance
coverage for periods in which they are unlikely (or
less likely) to require such coverage.
``(2) Considerations.--Such rules may take into account the
financial and other circumstances of individuals for not being
so enrolled or for so disenrolling.''.
(b) Conforming Amendment.--Section 2742(b) of such Act (42 U.S.C.
300gg-42(b)) is amended by striking paragraph (5).
(c) Effective Date.--The amendments made by this section shall
apply with respect to health insurance coverage offered, sold, issued,
renewed, in effect, or operated in the individual market after December
31, 2009.
<all>
Introduced in House
Introduced in House
Referred to House Energy and Commerce
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Labor, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to House Education and Labor
Referred to House Ways and Means
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health, Employment, Labor, and Pensions.
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