[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 643 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 643

  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 prohibit pre-existing condition exclusions for 
  children in group health plans and health insurance coverage in the 
                     group and individual markets.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 19, 2009

 Mr. Lautenberg (for himself, Mr. Brown, and Ms. Klobuchar) 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 prohibit pre-existing condition exclusions for 
  children 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 ``Children's Health Protection Act of 
2009''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) According to the Bureau of the Census, 8,100,000 
        children and young adults are uninsured at some point during 
        the year. Young adults between the ages of 18 and 25 years old 
        make up 21 percent of the total uninsured population.
            (2) According to a recent study, approximately 20 percent 
        of school-aged children suffer from a chronic illness.
            (3) Thirteen States have passed legislation that increased 
        the age of dependency for young adults for purposes of private 
        insurance coverage to age 25.
            (4) When a child or young adult has a 63 day gap in 
        insurance coverage, pre-existing condition exclusions, such as 
        coverage limits or waiting periods, can be applied when the 
        child or young adult becomes insured under a new health 
        insurance policy.
            (5) Eliminating pre-existing condition exclusions for 
        children is a vital safeguard to ensure all children have 
        access to health care when in need.
            (6) High-risk pools were created to help individuals with 
        pre-existing conditions purchase insurance with the assistance 
        of government subsidies. However, State high-risk pools are 
        often underfunded, unaffordable for patients, have long waiting 
        lists and impose pre-existing condition waiting periods once 
        enrolled.
            (7) Pre-existing condition limitation periods for children 
        in the private market discourage families from moving off 
        Medicaid or the Children's Health Insurance Program.

SEC. 3. PROHIBITION OF PRE-EXISTING CONDITION EXCLUSIONS FOR CHILDREN 
              UNDER GROUP HEALTH PLANS.

    (a) Amendments to the Employee Retirement Income Security Act of 
1974.--Section 701(d) of the Employee Retirement Income Security Act of 
1974 (29 U.S.C. 1181(d)) is amended--
            (1) by striking paragraph (1) and inserting the following:
            ``(1) Exclusion not applicable to children.--A group health 
        plan, and a health insurance issuer offering group health 
        insurance coverage, may not impose any pre-existing condition 
        exclusion in the case of an individual who has not attained 25 
        years of age.'';
            (2) by striking paragraphs (2) and (4); and
            (3) by redesignating paragraph (3) as paragraph (2).
    (b) Amendments to the Public Health Service Act.--Section 2701(d) 
of the Public Health Service Act (42 U.S.C. 300gg(d)) is amended--
            (1) by striking paragraph (1) and inserting the following:
            ``(1) Exclusion not applicable to children.--A group health 
        plan, and a health insurance issuer offering group health 
        insurance coverage, may not impose any pre-existing condition 
        exclusion in the case of an individual who has not attained 25 
        years of age.'';
            (2) by striking paragraphs (2) and (4); and
            (3) by redesignating paragraph (3) as paragraph (2).
    (c) Amendments to the Internal Revenue Code of 1986.--Subsection 
(d) of section 9801 of the Internal Revenue Code of 1986 (relating to 
exceptions) is amended--
            (1) by striking paragraph (1) and inserting the following:
            ``(1) Exclusion not applicable to children.--A group health 
        plan may not impose any pre-existing condition exclusion in the 
        case of an individual who has not attained 25 years of age.'';
            (2) by striking paragraphs (2) and (4); and
            (3) by redesignating paragraph (3) as paragraph (2).
    (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 
        later 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) the date that is after the end of the 12th 
                calendar month following the date of 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. 4. PROHIBITION OF PRE-EXISTING CONDITION EXCLUSIONS FOR CHILDREN 
              IN HEALTH INSURANCE COVERAGE IN THE INDIVIDUAL MARKET.

    (a) In General.--Section 2741 of the Public Health Service Act (42 
U.S.C. 300gg-41) is amended--
            (1) by redesignating the second subsection (e) (relating to 
        market requirements) and subsection (f) as subsections (f) and 
        (g), respectively; and
            (2) by adding at the end the following new subsection:
    ``(h) Prohibition of Pre-Existing Condition Exclusions for 
Children.--Each health insurance issuer that offers health insurance 
coverage in the individual market may not impose any pre-existing 
condition exclusion (as defined in section 2701(b)(1)(A)) in the case 
of an individual who has not attained 25 years of age.''.
    (b) 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''.
    (c) 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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