[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 969 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 969

   To amend the Public Health Service Act to ensure fairness in the 
      coverage of women in the individual health insurance market.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 5, 2009

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

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to ensure fairness in the 
      coverage of women in the individual health insurance market.

    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 ``Women's Health Insurance Fairness 
Act of 2009''.

SEC. 2. ELIMINATION OF GENDER RATING IN THE INDIVIDUAL INSURANCE 
              MARKET.

    (a) In General.--Subpart 2 of part B of title XXVII of the Public 
Health Service Act (42 U.S.C. 300gg-51 et seq.) is amended by adding at 
the end the following:

``SEC. 2754. ELIMINATION OF GENDER RATING.

    ``A health insurance issuer offering health insurance coverage in 
the individual market may not consider the gender of an enrollee when 
determining the amount of premiums to assess such enrollee for such 
coverage.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to health insurance coverage in the individual 
market for plan years beginning on or after the date that is 6 months 
after the date of enactment of this Act.

SEC. 3. PREVENTING INSURERS FROM DENYING OR LIMITING COVERAGE BASED ON 
              PREGNANCY AND COVERAGE OF MATERNITY CARE.

    (a) In General.--Subpart 2 of part B of title XXVII of the Public 
Health Service Act (42 U.S.C. 300gg-51 et seq.), as amended by section 
2, is further amended by adding at the end the following:

``SEC. 2755. STANDARDS RELATING TO PREGNANCY AND MATERNITY CARE.

    ``(a) Pregnancy, Method of Delivery, and Outcome.--A health 
insurance issuer offering health insurance coverage in the individual 
market may not impose any preexisting condition exclusion (as such term 
is defined in section 2701(b)(1)(A)) relating to pregnancy as a pre-
existing condition, impose any waiting period, deny, refuse to issue, 
renew, or reissue, substandard rate, re-underwrite, cancel or otherwise 
terminate a policy, add any surcharge or rating factor to the premium, 
exclude, limit, or cap benefits relating to a condition, or otherwise 
discriminate in the provision of coverage, or in assessing premiums for 
such coverage, against women on the basis of a current or past 
pregnancy, or past or future method of delivery, and past pregnancy 
outcome.
    ``(b) Maternity Care.--
            ``(1) In general.--The Secretary shall--
                    ``(A) propose a rule to develop a minimum benefit 
                standard for the provision of comprehensive maternity 
                coverage under an individual health plan, which 
                standard shall require coverage for the full scope of 
                maternity services from preconception through 
                postpartum, as determined by the Secretary; and
                    ``(B) periodically review the minimum benefit 
                standard for the provision of comprehensive maternity 
                coverage under an individual health plan to ensure the 
                minimum benefit standard reflects current standards of 
                care.
            ``(2) Requirement.--A health insurance issuer offering 
        health insurance coverage in the individual market shall ensure 
        that the minimum benefit standard developed under paragraph (1) 
        is included in any such coverage.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to health insurance coverage in the individual 
market for plan years beginning on or after the date that is 6 months 
after the date of enactment of this Act.

SEC. 4. ENFORCEMENT AND COMPLIANCE.

    (a) Provision of Data.--The Secretary of Health and Human Services 
shall promulgate regulations to require health insurance issuers that 
offer health insurance coverage in the individual market provide data 
to the Secretary to enable the Secretary to monitor the compliance of 
such issuers with the requirements of the amendment made by this Act.
    (b) Failure To Comply.--Any health insurance issuer that fails to 
submit the data required under the regulations promulgated under 
subsection (a) shall be subject to a civil monetary penalty in an 
amount that is not less than $10,000 (as determined by the Secretary).
    (c) Definitions.--The definitions contained in section 2791 of the 
Public Health Service Act (42 U.S.C. 300gg-91) shall apply for purposes 
of this section.

SEC. 5. STUDY OF THE INDIVIDUAL MARKET.

    Not later than December 31, 2010, the Comptroller General of the 
United States shall submit to the appropriate committees of Congress, a 
report concerning health insurance coverage offered on the individual 
insurance market in all 50 States and the District of Columbia, on 
problems remaining for women after the enactment of this Act.
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