I 111th CONGRESS 1st Session H. R. 3824 IN THE HOUSE OF REPRESENTATIVES October 15, 2009 Mr. Deal of Georgia (for himself, Mr. Burgess, Mr. Pitts, Mr. Blunt, Mr. Barton of Texas, and Mr. Buyer) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To allow States to establish interstate compacts for the purpose of expanding health insurance options.

1.

Short title

This Act may be cited as the Expanded Health Insurance Options Act of 2009.

2.

Expanding health insurance options

(a)

More affordable health coverage through State compacts

(1)

Authorizing compacts

States may enter into arrangements with other States for the purposes of forming one or more interstate compacts— (A)that meet the requirements of this subsection; and (B)under which health insurance issuers would offer health insurance coverage meeting the requirements of this subsection under a unified regulatory structure to residents of the States that are parties to the compact. (2)

Regulatory structure

The regulatory structure under such a compact may include regulations relating to the issuance, renewal, rating, mandated benefits, and similar items with respect to health insurance coverage. (3)

Regulation; grievances

Health insurance coverage offered in a State that is a party to such a compact shall be regulated by the State involved in the manner specified in the compact and any grievances with respect to such coverage shall be handled in the State in which the covered individual resides. (4)

Continuation of anti-fraud activities

Nothing in this section shall be construed to prohibit a State from engaging in anti-fraud activities for the purposes of enforcing regulations or other provisions within such a compact. (5)

Independent external appeals

Each interstate compact shall ensure that individuals who are insured in a State that participates in an interstate compact are able to access an independent external appeals process to review decisions made by health insurance issuers relating to the health insurance coverage of such individual. (b)

Responsibility of primary state

In the case of an activity described in paragraph (1)(A) that occurs in a State that is participating in an interstate compact, the primary State, or the State in which the insurance issuer is licensed, is responsible for the enforcement of applicable laws, regulations, agreements, and orders governing the health insurance issuers and health insurance coverage involved, including laws relating to the following: (1)The offer, sale, rating, renewal, and issuance of individual health insurance coverage. (2)The coverage of health care and insurance related services. (3)Management, operations, and investment activities of a health insurance issuer. (4)Liability loss control and claims administration. (c)

Responsibility of secondary state

The secondary State that is participating in an interstate compact, or the State in which the individual resides, may require a health insurance issuer— (1)to pay premiums and taxes; (2)to submit to examination of financial condition; (3)to comply with State laws regarding fraud and abuse; and (4)to comply with laws regarding unfair claims practices. (d)

Disclosure

The health insurance issuer must provide a clear disclosure to the individual that the issuer is in a secondary State and all laws and regulations of the secondary State are applicable. (e)

Effective date

This subsection shall apply beginning 1 year after the date of the enactment of this Act. (f)

Definitions

In this section: (1)The terms health insurance coverage and health insurance issuer have the meanings given such terms in section 2791 of the Public Health Service Act. (2)The term State means each of the 50 States and the District of Columbia.