[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2236 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                S. 2236

  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.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 25, 2007

Mr. Rockefeller introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 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.

    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 ``Preexisting Condition Exclusion 
Patient Protection Act of 2007''.

SEC. 2. 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.

SEC. 3. 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.
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