H.R. 2833 – Reading Mode

110th CONGRESS

1st Session

H. R. 2833

IN THE HOUSE OF REPRESENTATIVES

June 22, 2007

Mr. Courtney (for himself and Mr. George Miller of California) 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 title I of the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to provide additional limitations on preexisting condition exclusions in group health plans and health insurance coverage in the group and individual markets.

Short title

This Act may be cited as the Preexisting Condition Exclusion Patient Protection Act of 2007.

Amendments relating to preexisting condition exclusions under group health plans

(a)

Amendments to the Employee Retirement Income Security Act of 1974

(1)

Reduction in look-back period

Section 701(a)(1) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1181(a)(1)) is amended by striking 6-month period and inserting 30-day period.

(2)

Reduction in permitted preexisting condition limitation period

Section 701(a)(2) of such Act (29 U.S.C. 1181(a)(2)) is amended by striking 12 months and inserting 3 months, and by striking 18 months and inserting 9 months.

(b)

Amendments to the Public Health Service Act

(1)

Reduction in look-back period

Section 2701(a)(1) of the Public Health Service Act (42 U.S.C. 300gg(a)(1)) is amended by striking 6-month period and inserting 30-day period.

(2)

Reduction in permitted preexisting condition limitation period

Section 2701(a)(2) of such Act (42 U.S.C. 300gg(a)(2)) is amended by striking 12 months and inserting 3 months, and by striking 18 months and inserting 9 months.

(c)

Amendments to the Internal Revenue Code of 1986

(1)

Reduction in look-back period

Paragraph (1) of section 9801(a) of the Internal Revenue Code of 1986 (relating to limitation on preexisting condition exclusion period and crediting for periods of previous coverage) is amended by striking 6-month period and inserting 30-day period.

(2)

Reduction in permitted preexisting condition limitation period

Paragraph (2) of section 9801(a) of such Code is amended by striking 12 months and inserting 3 months, and by striking 18 months and inserting 9 months.

(d)

Effective date

(1)

In general

Except as provided in paragraph (2), the amendments made by this section shall apply with respect to group health plans for plan years beginning after the end of the 12th calendar month following the date of the enactment of this Act.

(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 earlier 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)

3 years after the date of the enactment of this Act.

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 added by the amendments made by this section shall not be treated as a termination of such collective bargaining agreement.

Amendments relating to preexisting condition exclusions in health insurance coverage in the individual market

(a)

Applicability of group health insurance limitations on imposition of preexisting condition exclusions

(1)

In general

Section 2741 of the Public Health Service Act (42 U.S.C. 300gg–41) is amended—

(A)

by redesignating the second subsection (e) (relating to market requirements) and subsection (f) as subsections (f) and (g), respectively; and

(B)

by adding at the end the following new subsection:

(h)

Application of group health insurance limitations on imposition of preexisting condition exclusions

(1)

In general

Subject to paragraph (2), a health insurance issuer that provides individual health insurance coverage may not impose a preexisting condition exclusion (as defined in subsection (b)(1)(A) of section 2701) with respect to such coverage except to the extent that such exclusion could be imposed consistent with such section if such coverage were group health insurance coverage.

(2)

Limitation

In the case of an individual who—

(A)

is enrolled in individual health insurance coverage;

(B)

during the period of such enrollment has a condition for which no medical advice, diagnosis, care, or treatment had been recommended or received as of the enrollment date; and

(C)

seeks to enroll under other individual health insurance coverage which provides benefits different from those provided under the coverage referred to in subparagraph (A) with respect to such condition,

the issuer of the individual health insurance coverage described in subparagraph (C) may impose a preexisting condition exclusion with respect to such condition and any benefits in addition to those provided under the coverage referred to in subparagraph (A), but such exclusion may not extend for a period of more than 3 months.

(2)

Elimination of COBRA requirement

Subsection (b) of such section is amended—

(A)

by adding and at the end of paragraph (2);

(B)

by striking the semicolon at the end of paragraph (3) and inserting a period; and

(C)

by striking paragraphs (4) and (5).

(3)

Conforming amendment

Section 2744(a)(1) of such Act (42 U.S.C. 300gg–44(a)(1)) is amended by inserting (other than subsection (h)) after section 2741 .

(b)

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 the end of the 12th calendar month following the date of the enactment of this Act.