[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2851 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 2851

   To amend the Employee Retirement Income Security Act of 1974, the 
  Public Health Service Act, and the Internal Revenue Code of 1986 to 
ensure that dependent students who take a medically necessary leave of 
 absence do not lose health insurance coverage, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 25, 2007

 Mr. Hodes (for himself, Mr. Castle, Ms. Shea-Porter, Mr. Nadler, Mrs. 
McCarthy of New York, Mr. Davis of Illinois, Ms. Sutton, Mrs. Boyda of 
Kansas, Mr. McGovern, Mr. Stark, Ms. Castor, Ms. Clarke, Mr. Cohen, Mr. 
 Johnson of Georgia, Mrs. Lowey, Mr. Edwards, Mr. Emanuel, Ms. Solis, 
  Ms. Zoe Lofgren of California, Mr. Lantos, Mr. Sherman, Mr. Wu, Mr. 
 Lincoln Davis of Tennessee, Mr. Kagen, Mr. Larson of Connecticut, Mr. 
  Berry, Mr. McDermott, Mrs. Tauscher, Ms. Harman, Mr. Gutierrez, Mr. 
  Scott of Virginia, Ms. Schakowsky, Mr. Mitchell, Mr. Sarbanes, Ms. 
 Kaptur, Mr. Gilchrest, Mr. Barrow, Mr. McNulty, Mr. Welch of Vermont, 
  Ms. Schwartz, Mr. Braley of Iowa, Mr. Ellison, Mr. Regula, and Mr. 
 Bishop of New York) 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, the 
  Public Health Service Act, and the Internal Revenue Code of 1986 to 
ensure that dependent students who take a medically necessary leave of 
 absence do not lose health insurance coverage, 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 ``Michelle's Law''.

SEC. 2. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY LEAVE OF 
              ABSENCE.

    (a) Amendments of ERISA.--
            (1) In general.--Subpart B of part 7 of title I of the 
        Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 
        et seq.) is amended by adding at the end the following:

``SEC. 714. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY LEAVE 
              OF ABSENCE.

    ``(a) Medically Necessary Leave of Absence.--In this section, the 
term `medically necessary leave of absence' means, with respect to a 
dependent child described in subsection (b)(2), a leave of absence of 
such child from a postsecondary educational institution (including an 
institution of higher education as defined in section 102 of the Higher 
Education Act of 1965), or any other change in enrollment of such child 
at such an institution, that--
            ``(1) commences while such child is suffering from a severe 
        illness or injury;
            ``(2) is medically necessary; and
            ``(3) causes such child to lose full-time student status 
        under the terms of the plan.
    ``(b) Requirement To Continue Coverage.--
            ``(1) In general.--In the case of a dependent child 
        described in paragraph (2), a group health plan (or health 
        insurance coverage offered in connection with such a plan) 
        shall not terminate coverage of such child due to a medically 
        necessary leave of absence before the date that is the earlier 
        of--
                    ``(A) the date that is 1 year after the first day 
                of the medically necessary leave of absence; or
                    ``(B) the date on which such coverage would 
                otherwise terminate under the terms of the plan.
            ``(2) Dependent child described.--A dependent child 
        described in this paragraph is a beneficiary under the plan 
        who--
                    ``(A) is a dependent child, under the terms of the 
                plan, of a participant or beneficiary of the plan;
                    ``(B) was enrolled in the plan or coverage as of 
                the first day of the medically necessary leave of 
                absence involved; and
                    ``(C) was enrolled as a full-time student at a 
                postsecondary educational institution (as described in 
                subsection (a)) until the first day of the medically 
                necessary leave of absence involved.
            ``(3) Certification by physician.--Paragraph (1) shall not 
        apply to a group health plan (or health insurance coverage 
        offered in connection with such a plan) unless certification by 
        the child's attending physician is submitted to the plan or 
        issuer stating that the dependent child is suffering from a 
        severe illness or injury and that the leave of absence is 
        medically necessary.
    ``(c) No Loss of Full-Time Status Due to Break in Semester.--Any 
breaks in the school semester shall not disqualify a dependent child 
described under subsection (b) from coverage under this section.
    ``(d) No Change in Benefits.--A dependent child whose benefits are 
continued under this section shall be entitled to the same benefits as 
if (during the medically necessary leave of absence) the child 
continued to be a full-time student at the institution of higher 
education and was not on a medically necessary leave of absence.
    ``(e) Coverage Under Successor Plan.--If a plan sponsor changes 
group health plans after the first day of a medically necessary leave 
of absence of dependent child described in subsection (b) but before 
the date described under subsection (b)(1), and such new group health 
plan offers coverage of beneficiaries as dependent children, such new 
group health plan shall be subject to this section in the same manner 
as the predecessor group health plan.
    ``(f) Presumption.--For purposes of administrative or judicial 
proceedings, upon certification under subsection (b)(3), there shall be 
a rebuttable presumption that the requirements of paragraphs (1) and 
(2) of subsection (a) have been met.''.
            (2) Conforming amendment.--The table of contents in section 
        1 of such Act is amended by inserting after the item relating 
        to section 713 the following new item:

``Sec. 714. Coverage of dependent students on medically necessary leave 
                            of absence.''.
    (b) Amendments to the Public Health Service Act.--
            (1) Group markets.--Subpart 2 of part A of title XXVII of 
        the Public Health Service Act (42 U.S.C. 300gg-4 et seq.) is 
        amended by adding at the end the following new section:

``SEC. 2707. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY 
              LEAVE OF ABSENCE.

    ``(a) Medically Necessary Leave of Absence.--In this section, the 
term `medically necessary leave of absence' means, with respect to a 
dependent child, a leave of absence of such child from a postsecondary 
educational institution (including an institution of higher education 
as defined in section 102 of the Higher Education Act of 1965), or any 
other change in enrollment of such child at such an institution, that--
            ``(1) commences while such child is suffering from a severe 
        illness or injury;
            ``(2) is medically necessary; and
            ``(3) causes such child to lose full-time student status 
        under the terms of the plan.
    ``(b) Requirement To Continue Coverage.--
            ``(1) In general.--In the case of a dependent child 
        described in paragraph (2), a group health plan (or health 
        insurance coverage offered in connection with such a plan) 
        shall not terminate coverage of such child due to a medically 
        necessary leave of absence before the date that is the earlier 
        of--
                    ``(A) the date that is 1 year after the first day 
                of the medically necessary leave of absence; or
                    ``(B) the date on which such coverage would 
                otherwise terminate under the terms of the plan.
            ``(2) Child described.--A dependent child described in this 
        paragraph is a beneficiary under the plan who--
                    ``(A) is a dependent child, under the terms of the 
                plan, of a participant or beneficiary of the plan;
                    ``(B) was enrolled in the plan or coverage as of 
                the first day of the medically necessary leave of 
                absence involved; and
                    ``(C) was enrolled as a full-time student at a 
                postsecondary educational institution (as described in 
                subsection (a)) until the first day of the medically 
                necessary leave of absence involved.
            ``(3) Certification by physician.--Paragraph (1) shall not 
        apply to a group health plan (or health insurance coverage 
        offered in connection with such a plan) unless certification by 
        the child's attending physician is submitted to the plan or 
        issuer stating that the dependent child is suffering from a 
        severe illness or injury and that the leave of absence is 
        medically necessary.
    ``(c) No Loss of Full-Time Status Due to Break in Semester.--Any 
breaks in the school semester shall not disqualify a dependent child 
described under subsection (b) from coverage under this section.
    ``(d) No Change in Benefits.--A dependent child whose benefits are 
continued under this section shall be entitled to the same benefits as 
if (during the medically necessary leave of absence) the child 
continued to be a full-time student at the institution of higher 
education and was not on a medically necessary leave of absence.
    ``(e) Coverage Under Successor Plan.--If a plan sponsor changes 
group health plans after the first day of a medically necessary leave 
of absence of dependent child described in subsection (b) but before 
the date described under subsection (b)(1), and such new group health 
plan offers coverage of beneficiaries as dependent children, such new 
group health plan shall be subject to this section in the same manner 
as the predecessor group health plan.
    ``(f) Presumption.--For purposes of administrative or judicial 
proceedings, upon certification under subsection (b)(3), there shall be 
a rebuttable presumption that the requirements of paragraphs (1) and 
(2) of subsection (a) have been met.''.
            (2) Individual market.--Subpart 3 of part B of title XXVII 
        of such Act (42 U.S.C. 300gg-51 et seq.) is amended by adding 
        at the end the following new section:

``SEC. 2753. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY 
              LEAVE OF ABSENCE.

    ``The provisions of section 2707 shall apply to health insurance 
coverage offered by a health insurance issuer in the individual market 
in the same manner as they apply to health insurance coverage offered 
by a health insurance issuer in connection with a group health plan in 
the small or large group market.''.
    (c) Amendments to the Internal Revenue Code.--
            (1) In general.--Subchapter B of chapter 100 of the 
        Internal Revenue Code of 1986 (relating to other group health 
        plan requirements) is amended by inserting after section 9812 
        the following new section:

``SEC. 9813. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY 
              LEAVE OF ABSENCE.

    ``(a) Medically Necessary Leave of Absence.--In this section, the 
term `medically necessary leave of absence' means, with respect to a 
dependent child, a leave of absence of such child from a postsecondary 
educational institution (including an institution of higher education 
as defined in section 102 of the Higher Education Act of 1965), or any 
other change in enrollment of such child at such an institution, that--
            ``(1) commences while such child is suffering from a severe 
        illness or injury;
            ``(2) is medically necessary; and
            ``(3) causes such child to lose full-time student status 
        under the terms of the plan.
    ``(b) Requirement To Continue Coverage.--
            ``(1) In general.--In the case of a dependent child 
        described in paragraph (2), a group health plan shall not 
        terminate coverage of such child due to a medically necessary 
        leave of absence before the date that is the earlier of--
                    ``(A) the date that is 1 year after the first day 
                of the medically necessary leave of absence; or
                    ``(B) the date on which such coverage would 
                otherwise terminate under the terms of the plan.
            ``(2) Child described.--A dependent child described in this 
        paragraph is a beneficiary under the plan who--
                    ``(A) is a dependent child, under the terms of the 
                plan, of a participant or beneficiary of the plan;
                    ``(B) was enrolled in the plan or coverage as of 
                the first day of the medically necessary leave of 
                absence involved; and
                    ``(C) was enrolled as a full-time student at a 
                postsecondary educational institution (as described in 
                subsection (a)) until the first day of the medically 
                necessary leave of absence involved.
            ``(3) Certification by physician.--Paragraph (1) shall not 
        apply to a group health plan (or health insurance coverage 
        offered in connection with such a plan) unless certification by 
        the child's attending physician is submitted to the plan (or 
        the issuer health insurance coverage in connection with the 
        plan) stating that the dependent child is suffering from a 
        severe illness or injury and that the leave of absence is 
        medically necessary.
    ``(c) No Loss of Full-Time Status Due to Break in Semester.--Any 
breaks in the school semester shall not disqualify a dependent child 
described under subsection (b) from coverage under this section.
    ``(d) No Change in Benefits.--A dependent child whose benefits are 
continued under this section shall be entitled to the same benefits as 
if (during the medically necessary leave of absence) the child 
continued to be a full-time student at the institution of higher 
education and was not on a medically necessary leave of absence.
    ``(e) Coverage Under Successor Plan.--If a plan sponsor changes 
group health plans after the first day of a medically necessary leave 
of absence of a dependent child described in subsection (b) but before 
the date described under subsection (b)(1), and such new group health 
plan offers coverage of beneficiaries as dependent children, such new 
group health plan shall be subject to this section in the same manner 
as the predecessor group health plan.
    ``(f) Presumption.--For purposes of administrative or judicial 
proceedings, upon certification under subsection (b)(3), there shall be 
a rebuttable presumption that the requirements of paragraphs (1) and 
(2) of subsection (a) have been met.''.
            (2) Conforming amendment.--The table of sections for 
        subchapter B of chapter 100 of such Code is amended by 
        inserting after the item relating to section 9812 the following 
        new item:

``Sec. 9813. Coverage of dependent students on medically necessary 
                            leave of absence.''.
    (d) Effective Date.--The amendments made by this Act shall apply 
with respect to plan years beginning on or after the date of the 
enactment of this Act and to medically necessary leaves of absence 
beginning during such plan years.
                                 <all>