Guaranteed Health Coverage for Pre-Existing Conditions Act of 2014 - Amends the Public Health Service Act to maintain, upon repeal of the Patient Protection and Affordable Care Act and the health care provisions of the Health Care and Education Reconciliation Act of 2010, the requirements that: (1) health insurance includes coverage for preexisting conditions; and (2) health insurers accept every employer and every individual in a group that applies for coverage in the group market and every individual that applies for coverage in the individual market.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5328 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 5328
To amend the Public Health Service Act to prohibit application of
preexisting condition exclusions and to guarantee availability of
health insurance coverage in the individual and group market,
contingent on the enactment of legislation repealing the Patient
Protection and Affordable Care Act, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 31, 2014
Mr. Coffman (for himself, Mr. Pearce, and Mr. Valadao) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to prohibit application of
preexisting condition exclusions and to guarantee availability of
health insurance coverage in the individual and group market,
contingent on the enactment of legislation repealing the Patient
Protection and Affordable Care Act, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Guaranteed Health Coverage for Pre-
Existing Conditions Act of 2014''.
SEC. 2. PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS.
(a) Group Market.--Subpart 1 of part A of title XXVII of the Public
Health Service Act (42 U.S.C. 300gg et seq.) is amended by striking
section 2701 and inserting the following:
``SEC. 2701. PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS.
``(a) In General.--A group health plan or a health insurance issuer
offering group health insurance coverage may not impose any preexisting
condition exclusion with respect to such plan or coverage.
``(b) Definitions.--For purposes of this section:
``(1) Preexisting condition exclusion.--
``(A) In general.--The term `preexisting condition
exclusion' means, with respect to a group health plan
or health insurance coverage, a limitation or exclusion
of benefits relating to a condition based on the fact
that the condition was present before the date of
enrollment in such plan or for such coverage, whether
or not any medical advice, diagnosis, care, or
treatment was recommended or received before such date.
``(B) Treatment of genetic information.--Genetic
information shall not be treated as a preexisting
condition in the absence of a diagnosis of the
condition related to such information.
``(2) Date of enrollment.--The term `date of enrollment'
means, with respect to an individual covered under a group
health plan or health insurance coverage, the date of
enrollment of the individual in the plan or coverage or, if
earlier, the first day of the waiting period for such
enrollment.
``(3) Waiting period.--The term `waiting period' means,
with respect to a group health plan and an individual who is a
potential participant or beneficiary in the plan, the period
that must pass with respect to the individual before the
individual is eligible to be covered for benefits under the
terms of the plan.''.
(b) Individual Market.--Subpart 1 of part B of title XXVII of the
Public Health Service Act (42 U.S.C. 300gg-41 et seq.) is amended by
adding at the end the following:
``SEC. 2746. PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS OR OTHER
DISCRIMINATION BASED ON HEALTH STATUS.
``The provisions of section 2701 shall apply to health insurance
coverage offered to individuals by a health insurance issuer in the
individual market in the same manner as it applies to health insurance
coverage offered by a health insurance issuer in the group market.''.
SEC. 3. GUARANTEED AVAILABILITY OF COVERAGE.
(a) Group Market.--Subpart 3 of part A of title XXVII of the Public
Health Service Act is amended by striking section 2711 (42 U.S.C.
300gg-11) and inserting the following:
``SEC. 2711. GUARANTEED AVAILABILITY OF COVERAGE.
``(a) Guaranteed Issuance of Coverage in the Group Market.--Subject
to subsection (b), each health insurance issuer that offers health
insurance coverage in the group market in a State shall accept every
employer and every individual in a group in the State that applies for
such coverage.
``(b) Enrollment.--
``(1) Restriction.--A health insurance issuer described in
subsection (a) may restrict enrollment in coverage described in
such subsection to open or special enrollment periods.
``(2) Establishment.--A health insurance issuer described
in subsection (a) shall establish special enrollment periods
for qualifying events (as such term is defined in section 603
of the Employee Retirement Income Security Act of 1974).''.
(b) Individual Market.--Subpart 1 of part B of title XXVII of the
Public Health Service Act is amended by striking section 2741 of such
Act (42 U.S.C. 300gg-41) and inserting the following:
``SEC. 2741. GUARANTEED AVAILABILITY OF COVERAGE.
``The provisions of section 2711 shall apply to health insurance
coverage offered to individuals by a health insurance issuer in the
individual market in the same manner as such provisions apply to health
insurance coverage offered to employers by a health insurance issuer in
connection with health insurance coverage in the group market. For
purposes of this section, the Secretary shall treat any reference of
the word `employer' in such section as a reference to the term
`individual'.''.
SEC. 4. EFFECTIVE DATE CONTINGENT ON REPEAL OF PPACA.
(a) In General.--Sections 2 and 3 and the amendments made by such
section shall take effect upon the enactment of PPACA repeal
legislation described in subsection (b) and such sections and
amendments shall have no force or effect if such PPACA repeal
legislation is not enacted.
(b) PPACA Repeal Legislation Described.--For purposes of subsection
(a), PPACA repeal legislation described in this subsection is
legislation that--
(1) repeals Public Law 111-148, and restores or revives the
provisions of law amended or repealed, respectively, by such
Act as if such Act had not been enacted and without further
amendment to such provisions of law; and
(2) repeals title I and subtitle B of title II of the
Health Care and Education Reconciliation Act of 2010 (Public
Law 111-152), and restores or revives the provisions of law
amended or repealed, respectively, by such title or subtitle,
respectively, as if such title and subtitle had not been
enacted and without further amendment to such provisions of
law.
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Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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