[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2292 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 2292

   To amend the Employee Retirement Income Security Act of 1974, the 
  Public Health Service Act, and the Internal Revenue Code of 1986 to 
           require coverage of preventive care for children.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 6, 2009

Mr. Thompson of California (for himself and Mr. Blumenauer) introduced 
  the following bill; which was referred to the Committee on Ways and 
  Means, and in addition to the Committees on Education and Labor and 
Energy and Commerce, 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 
           require coverage of preventive care for children.

    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 ``Healthy Kids for Healthy Futures Act of 
2009''.

SEC. 2. COVERAGE OF PREVENTIVE CARE FOR CHILDREN.

    (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 PREVENTIVE CARE FOR CHILDREN.

    ``(a) In General.--A group health plan, and a health insurance 
issuer providing health insurance coverage in connection with a group 
health plan, shall provide coverage for appropriate preventive care for 
each qualified dependent child of the participant.
    ``(b) Appropriate Preventive Care.--For purposes of this section, 
the term `appropriate preventive care' means medical care which, under 
regulations prescribed by the Secretary of Health and Human Services, 
in consultation with the Secretary and the Secretary of the Treasury, 
meets the most recent Bright Futures Guidelines for Health Supervision 
of Infants, Children, and Adolescents.
    ``(c) Qualified Dependent Child.--For purposes of this section, the 
term `qualified dependent child' means a child of the participant who--
            ``(1) is not more than 18 years of age, and
            ``(2) is a dependent child, under the terms of the plan or 
        coverage, of the participant.
    ``(d) Cost-Sharing Prohibited.--A group health plan and health 
insurance coverage provided in connection with a group health plan may 
not impose deductibles, copayments, coinsurance, or other cost-sharing 
in relation to services provided pursuant to the requirements of 
subsection (a).
    ``(e) Certain Coverage Restrictions Prohibited.--A group health 
plan, and a health insurance issuer providing coverage in connection 
with a group health plan, may not--
            ``(1) deny to a participant or beneficiary eligibility, or 
        continued eligibility, to enroll or to renew coverage under the 
        terms of the plan solely for the purpose of avoiding the 
        requirements of this section, or
            ``(2) penalize, or otherwise reduce or limit the 
        reimbursement of, an attending provider, or provide incentives 
        (monetary or otherwise) to an attending provider, so as to 
        induce the provider to provide care to a beneficiary in a 
        manner inconsistent with this section.
    ``(f) Allowance for Level or Type of Provider Reimbursement.--
Nothing in this section shall be construed to prevent a group health 
plan or a health insurance issuer providing health insurance coverage 
in connection with a group health plan from negotiating the level and 
type of reimbursement with a provider for care provided in accordance 
with this section.
    ``(g) Notice.--A group health plan, and a health insurance issuer 
providing health insurance coverage in connection with a group health 
plan, shall provide notice to each participant and beneficiary under 
such plan regarding the coverage required by this section in accordance 
with regulations which shall be promulgated by the Secretary, in 
consultation with the Secretary of Health and Human Services and the 
Secretary of the Treasury. Such notice shall be in writing and 
prominently positioned in any literature or correspondence made 
available or distributed to participants and beneficiaries by the plan 
or issuer on an annual or other more frequent periodic basis.
    ``(h) Relation to State Laws.--Nothing in this section shall be 
construed to preempt or otherwise limit any State law with respect to 
health insurance coverage that requires more extensive coverage than is 
otherwise required under this section.''.
            (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 preventive care for children.''.
    (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 PREVENTIVE CARE FOR CHILDREN.

    ``(a) In General.--A group health plan, and a health insurance 
issuer providing health insurance coverage in connection with a group 
health plan, shall provide coverage for appropriate preventive care for 
each qualified dependent child of the participant.
    ``(b) Appropriate Preventive Care.--For purposes of this section, 
the term `appropriate preventive care' means medical care which, under 
regulations prescribed by the Secretary, in consultation with the 
Secretary of Labor and the Secretary of the Treasury, meets the most 
recent Bright Futures Guidelines for Health Supervision of Infants, 
Children, and Adolescents.
    ``(c) Qualified Dependent Child.--For purposes of this section, the 
term `qualified dependent child' means a child of the participant who--
            ``(1) is not more than 18 years of age, and
            ``(2) is a dependent child, under the terms of the plan or 
        coverage, of the participant.
    ``(d) Cost-Sharing Prohibited.--A group health plan and health 
insurance coverage provided in connection with a group health plan may 
not impose deductibles, copayments, coinsurance, or other cost-sharing 
in relation to services provided pursuant to the requirements of 
subsection (a).
    ``(e) Certain Coverage Restrictions Prohibited.--A group health 
plan, and a health insurance issuer providing coverage in connection 
with a group health plan, may not--
            ``(1) deny to a participant or beneficiary eligibility, or 
        continued eligibility, to enroll or to renew coverage under the 
        terms of the plan solely for the purpose of avoiding the 
        requirements of this section, or
            ``(2) penalize, or otherwise reduce or limit the 
        reimbursement of, an attending provider, or provide incentives 
        (monetary or otherwise) to an attending provider, so as to 
        induce the provider to provide care to a beneficiary in a 
        manner inconsistent with this section.
    ``(f) Allowance for Level or Type of Provider Reimbursement.--
Nothing in this section shall be construed to prevent a group health 
plan or a health insurance issuer providing health insurance coverage 
in connection with a group health plan from negotiating the level and 
type of reimbursement with a provider for care provided in accordance 
with this section.
    ``(g) Notice.--A group health plan, and a health insurance issuer 
providing health insurance coverage in connection with a group health 
plan, shall provide notice to each participant and beneficiary under 
such plan regarding the coverage required by this section in accordance 
with regulations which shall be promulgated by the Secretary of Labor, 
in consultation with the Secretary and the Secretary of the Treasury. 
Such notice shall be in writing and prominently positioned in any 
literature or correspondence made available or distributed to 
participants and beneficiaries by the plan or issuer on an annual or 
other more frequent periodic basis.
    ``(h) Relation to State Laws.--Nothing in this section shall be 
construed to preempt or otherwise limit any State law with respect to 
health insurance coverage that requires more extensive coverage than is 
otherwise required under this section.''.
            (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 PREVENTIVE CARE FOR CHILDREN.

    ``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 PREVENTIVE CARE FOR CHILDREN.

    ``(a) In General.--A group health plan shall provide coverage for 
appropriate preventive care for each qualified dependent child of the 
participant.
    ``(b) Appropriate Preventive Care.--For purposes of this section, 
the term `appropriate preventive care' means medical care which, under 
regulations prescribed by the Secretary of Health and Human Services in 
consultation with the Secretary and the Secretary of Labor, meets the 
most recent Bright Futures Guidelines for Health Supervision of 
Infants, Children, and Adolescents.
    ``(c) Qualified Dependent Child.--For purposes of this section, the 
term `qualified dependent child' means a child of the participant who--
            ``(1) is not more than 18 years of age, and
            ``(2) is a dependent child, under the terms of the plan or 
        coverage, of the participant.
    ``(d) Cost-Sharing Prohibited.--A group health plan may not impose 
deductibles, copayments, coinsurance, or other cost-sharing in relation 
to services provided pursuant to the requirements of subsection (a).
    ``(e) Certain Coverage Restrictions Prohibited.--A group health 
plan may not--
            ``(1) deny to a participant or beneficiary eligibility, or 
        continued eligibility, to enroll or to renew coverage under the 
        terms of the plan solely for the purpose of avoiding the 
        requirements of this section, or
            ``(2) penalize, or otherwise reduce or limit the 
        reimbursement of, an attending provider, or provide incentives 
        (monetary or otherwise) to an attending provider, so as to 
        induce the provider to provide care to a beneficiary in a 
        manner inconsistent with this section.
    ``(f) Allowance for Level or Type of Provider Reimbursement.--
Nothing in this section shall be construed to prevent a group health 
plan or a health insurance issuer providing health insurance coverage 
in connection with a group health plan from negotiating the level and 
type of reimbursement with a provider for care provided in accordance 
with this section.
    ``(g) Notice.--A group health plan shall provide notice to each 
participant and beneficiary under such plan regarding the coverage 
required by this section in accordance with regulations which shall be 
promulgated by the Secretary of Labor, in consultation with the 
Secretary and the Secretary of Health and Human Services. Such notice 
shall be in writing and prominently positioned in any literature or 
correspondence made available or distributed to participants and 
beneficiaries by the plan or issuer on an annual or other more frequent 
periodic basis.
    ``(h) Relation to State Laws.--Nothing in this section shall be 
construed to preempt or otherwise limit any State law with respect to 
health insurance coverage that requires more extensive coverage than is 
otherwise required under this section.''.
            (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 preventive care for children.''.
    (d) Effective Date.--The amendments made by this Act shall apply 
with respect to plan years beginning on or after January 1, 2010.
    (e) Initial Notice.--Each group health plan and health insurance 
issuer to which the notice requirements of section 714(g) of the 
Employee Retirement Income Security Act of 1974, section 2707(g) of the 
Public Health Service Act, or section 9813(g) of the Internal Revenue 
Code of 1986 apply shall be deemed not in compliance with such 
requirements with respect to the first plan year beginning on or after 
January 1, 2010, unless, not later than January 1, 2010, the plan or 
issuer includes the information described in such section in a notice 
which is provided to each participant and beneficiary in writing.

SEC. 3. COVERAGE OF PREVENTATIVE CARE FOR CHILDREN UNDER HEALTH SAVINGS 
              ACCOUNTS.

    (a) In General.--Paragraph (2) of section 223(c) of the Internal 
Revenue Code of 1986 (defining high deductible health plan) is amended 
by adding at the end the following new subparagraph:
                    ``(E) Special rule for preventative care for 
                children.--
                            ``(i) In general.--A plan shall not be 
                        treated as a high deductible health plan unless 
                        such plan meets the requirements of section 
                        9813 (relating to coverage of preventative care 
                        for children).
                            ``(ii) Plan treated as group health plan.--
                        For purposes of clause (i), the plan shall be 
                        treated as a group health plan.''.
    (b) Effective Date.--The amendment made by this section shall apply 
to taxable years beginning after December 31, 2009.
                                 <all>