[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2532 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 2532

 To amend the Internal Revenue Code of 1986, the Public Health Service 
Act, and the Employee Retirement Income Security Act of 1974 to expand 
  access to health insurance coverage without pre-existing condition 
    exclusions in the group and individual health insurance markets.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 23, 1997

  Mr. Stark introduced the following bill; which was referred to the 
 Committee on Commerce, and in addition to the Committees on Ways and 
Means, and Education and the Workforce, 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 Internal Revenue Code of 1986, the Public Health Service 
Act, and the Employee Retirement Income Security Act of 1974 to expand 
  access to health insurance coverage without pre-existing condition 
    exclusions in the group and individual health insurance markets.

    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 ``Health Insurance Access Amendments 
of 1997''.

SEC. 2. PHASE-DOWN OF APPLICATION OF PREEXISTING CONDITION EXCLUSIONS 
              IN GROUP MARKET.

    Section 9801 of the Internal Revenue Code of 1986, section 701 of 
the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1181), 
and section 2701 of the Public Health Service Act (42 U.S.C. 300g) are 
each amended as follows:
            (1) Effective with respect to group health plans for plan 
        years beginning on or after January 1, 2000, in subsection (a), 
        strike ``not more than 12 months (or 18 months in the case of a 
        late enrollee) after the enrollment date'' and insert ``not 
        more than 6 months after the enrollment date''.
            (2) Effective with respect to group health plans for plan 
        years beginning on or after January 1, 2001, in subsection (a) 
        (as amended by paragraph (1)), strike ``not more than 6 months 
        after the enrollment date'' and insert ``not more than 3 months 
        after the enrollment date''.
            (3) Effective with respect to group health plans for plan 
        years beginning on or after January 1, 2002, in subsection (a) 
        (as amended by paragraph (1)), strike ``3 months'' and insert 
        ``one month''.

SEC. 3. EXTENDING AVAILABILITY OF COVERAGE IN INDIVIDUAL MARKET WITHOUT 
              APPLICATION OF PREEXISTING CONDITION EXCLUSIONS.

    (a) Phase-Down in Eligibility Restrictions.--Section 2741(b)(1)(A) 
of the Public Health Service Act (42 U.S.C. 300g-41(b)(1)(A)) is 
amended as follows:
            (1) Effective with respect to health insurance coverage 
        offered, sold, issued, renewed, in effect, or operated in the 
        individual market on or after January 1, 2000, strike ``18 or 
        more months'' and insert ``12 or more months''.
            (2) Effective with respect to health insurance coverage 
        offered, sold, issued, renewed, in effect, or operated in the 
        individual market on or after January 1, 2001, strike ``12 or 
        more months'' (as inserted by paragraph (1)) and insert ``6 or 
        more months''.
            (3) Effective with respect to health insurance coverage 
        offered, sold, issued, renewed, in effect, or operated in the 
        individual market on or after January 1, 2002, strike ``6 or 
        more months'' (as inserted by paragraph (2)) and insert ``one 
        month''.

SEC. 4. EXPANSION OF GUARANTEED ISSUE PROTECTIONS TO LARGE GROUP 
              MARKET.

    (a) In General.--Section 2711 of the Public Health Service Act (42 
U.S.C. 300g-11) is amended--
            (1) by striking ``Small Group'', ``small group'', and 
        ``small group'' each place it appears and inserting ``Relevant 
        Group'', ``relevant group'', and ``relevant group'', 
        respectively;
            (2) in paragraph (1)(A), by striking ``small employer (as 
        defined in section 2791(e)(4)'' and inserting ``relevant 
        employer (as defined in subsection (b)(2))'';
            (3) by striking ``small employer'' and ``small employers'' 
        each other place it appears and inserting ``relevant employer'' 
        and ``relevant employers'', respectively; and
            (4) by striking subsection (b) and inserting the following:
    ``(b) Relevant Employer and Group Defined.--For purposes of this 
subpart:
            ``(1) Relevant employer.--The term `relevant employer' 
        means--
                    ``(A) for periods before January 1, 2000, a small 
                employer (as defined in section 2791(e)(4)),
                    ``(B) for the period beginning on January 1, 2000, 
                and ending December 31, 2001, an employer that would be 
                a small employer if `100' were substituted for `50' in 
                section 2791(e)(4), and
                    ``(C) for the period beginning on January 1, 2002, 
                any employer.
            ``(2) Relevant group market.--The term `relevant group 
        market' means--
                    ``(A) for periods before January 1, 2000, the small 
                group market,
                    ``(B) for the period beginning on January 1, 2000, 
                and ending December 31, 2001, the small group market 
                and the market that would be included in the small 
                group market if `100' were substituted for `50' in 
                section 2791(e)(4), and
                    ``(C) for the period beginning on January 1, 2002, 
                the small and large group market.''.
    (b) Application of Information Disclosure to Relevant Group 
Market.--Section 2713 of such Act (42 U.S.C. 300gg-13) is amended--
            (1) in subsection (a), by striking ``small employer'' the 
        first place it appears and inserting ``relevant employer (as 
        defined in section 2711(b)(1))'', and
            (2) by striking ``small employer'' and ``small employers'' 
        each succeeding place it appears and inserting ``relevant 
        employer'' and ``relevant employers'', respectively.
    (c) Conforming Changes in Guaranteed Renewability Requirements.--
Section 2712 of such Act (42 U.S.C. 300gg-12) is amended--
            (1) effective January 1, 2000, by adding at the end the 
        following new subsection:
    ``(f) Transition.--For purposes of applying this section during the 
period beginning January 1, 2000, and ending December 31, 2001, any 
reference in paragraphs (2) and (4) of section 2791(e) to `51 
employees' and to `50 employees', respectively, is deemed a reference 
to `101 employees' and to `100 employees', respectively.''; and
            (2) effective January 1, 2002--
                    (A) in subsection (b), in the matter before 
                paragraph (1), by striking ``small or large'',
                    (B) in subsection (b)(5), by striking ``, in the 
                case of the small group market,'',
                    (C) in subsection (b)(6), by striking ``in the 
                small or large group market (as the case may be)'' and 
                inserting ``in the group market'',
                    (D) in subsection (c)(1), by striking ``small or 
                large'',
                    (E) in subsection (c)(1)(B), by striking ``(or, in 
                the case of the large group market, any)'',
                    (F) in subsection (c)(2)(A), by striking ``in the 
                small group market or the large group market, or both 
                markets,'' and inserting ``in the group market'',
                    (G) in subsection (c)(2)(A)(ii), by striking ``(or 
                markets)'' each place it appears,
                    (H) in subsection (d), by striking ``offered to a 
                group health plan'' and all that follows through ``in 
                such market'' and inserting ``offered to a group health 
                plan in the group market'', and
                    (J) in subsection (e), by striking ``small or 
                large''.
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