[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 416 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 416

   To amend the Public Health Service Act to provide protections for 
 consumers against excessive, unjustified, or unfairly discriminatory 
                      increases in premium rates.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 25, 2011

Ms. Schakowsky (for herself, Mr. Andrews, Mrs. Capps, Ms. DeLauro, Mr. 
    Doggett, Mr. Ellison, Mr. Farr, Mr. Frank of Massachusetts, Mr. 
   Garamendi, Mr. Gene Green of Texas, Mr. Grijalva, Ms. Harman, Ms. 
 Hirono, Mr. Kildee, Ms. Lee of California, Mr. Levin, Mr. Markey, Mr. 
  George Miller of California, Ms. Moore, Mr. Rangel, Ms. Speier, Mr. 
Stark, Ms. Sutton, Mr. Tonko, Mr. Waxman, Ms. Woolsey, and Mr. Pallone) 
 introduced the following bill; which was referred to the Committee on 
                          Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to provide protections for 
 consumers against excessive, unjustified, or unfairly discriminatory 
                      increases in premium rates.

    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 ``Health Insurance Rate Review Act''.

SEC. 2. PROTECTION OF CONSUMERS FROM EXCESSIVE, UNJUSTIFIED, OR 
              UNFAIRLY DISCRIMINATORY RATES.

    (a) Protection From Excessive, Unjustified, or Unfairly 
Discriminatory Rates.--The first section 2794 of the Public Health 
Service Act (42 U.S.C. 300gg-94), as added by section 1003 of the 
Patient Protection and Affordable Care Act (Public Law 111-148), is 
amended by adding at the end the following new subsection:
    ``(e) Protection From Excessive, Unjustified, or Unfairly 
Discriminatory Rates.--
            ``(1) Authority of states.--Nothing in this section shall 
        be construed to prohibit a State from imposing requirements 
        (including requirements relating to rate review standards and 
        procedures and information reporting) on health insurance 
        issuers with respect to rates that are in addition to the 
        requirements of this section and are more protective of 
        consumers than such requirements.
            ``(2) Consultation in rate review process.--In carrying out 
        this section, the Secretary shall consult with the National 
        Association of Insurance Commissioners and consumer groups.
            ``(3) Determination of who conducts reviews for each 
        state.--The Secretary shall determine, after the date of 
        enactment of this section and periodically thereafter, the 
        following:
                    ``(A) In which States the State insurance 
                commissioner or relevant State regulator shall 
                undertake the corrective actions under paragraph (4), 
                as a condition of the State receiving the grant in 
                subsection (c), based on the Secretary's determination 
                that the State is adequately prepared to undertake and 
                is adequately undertaking such actions.
                    ``(B) In which States the Secretary shall undertake 
                the corrective actions under paragraph (4), in 
                cooperation with the relevant State insurance 
                commissioner or State regulator, based on the 
                Secretary's determination that the State is not 
                adequately prepared to undertake or is not adequately 
                undertaking such actions.
            ``(4) Corrective action for excessive, unjustified, or 
        unfairly discriminatory rates.--In accordance with the process 
        established under this section, the Secretary or the relevant 
        State insurance commissioner or State regulator shall take 
        corrective actions to ensure that any excessive, unjustified, 
        or unfairly discriminatory rates are corrected prior to 
        implementation, or as soon as possible thereafter, including 
        through mechanisms such as--
                    ``(A) denying rates;
                    ``(B) modifying rates; or
                    ``(C) requiring rebates to consumers.''.
    (b) Clarification of Regulatory Authority.--Such section is further 
amended--
            (1) in subsection (a)--
                    (A) in the heading, by striking ``Premium'' and 
                inserting ``Rate'';
                    (B) in paragraph (1), by striking ``unreasonable 
                increases in premiums'' and inserting ``potentially 
                excessive, unjustified, or unfairly discriminatory 
                rates, including premiums,''; and
                    (C) in paragraph (2)--
                            (i) by striking ``an unreasonable premium 
                        increase'' and inserting ``a potentially 
                        excessive, unjustified, or unfairly 
                        discriminatory rate'';
                            (ii) by striking ``the increase'' and 
                        inserting ``the rate''; and
                            (iii) by striking ``such increases'' and 
                        inserting ``such rates'';
            (2) in subsection (b)--
                    (A) by striking ``premium increases'' each place it 
                appears and inserting ``rates''; and
                    (B) in paragraph (2)(B), by striking ``premium'' 
                and inserting ``rate''; and
            (3) in subsection (c)(1)--
                    (A) in the heading, by striking ``Premium'' and 
                inserting ``Rate'';
                    (B) by inserting ``that satisfy the condition under 
                subsection (e)(3)(A)'' after ``award grants to 
                States''; and
                    (C) in subparagraph (A), by striking ``premium 
                increases'' and inserting ``rates''.
    (c) Conforming Amendment.--Title XXVII of the Public Health Service 
Act (42 U.S.C. 300gg et seq.) is amended--
            (1) in section 2723 (42 U.S.C. 300gg-22), as redesignated 
        by the Patient Protection and Affordable Care Act--
                    (A) in subsection (a)--
                            (i) in paragraph (1), by inserting ``and 
                        section 2794'' after ``this part''; and
                            (ii) in paragraph (2), by inserting ``or 
                        section 2794'' after ``this part''; and
                    (B) in subsection (b)--
                            (i) in paragraph (1), by inserting ``and 
                        section 2794'' after ``this part''; and
                            (ii) in paragraph (2)--
                                    (I) in subparagraph (A), by 
                                inserting ``or section 2794 that is'' 
                                after ``this part''; and
                                    (II) in subparagraph (C)(ii), by 
                                inserting ``or section 2794'' after 
                                ``this part''; and
            (2) in section 2761 (42 U.S.C. 300gg-61)--
                    (A) in subsection (a)--
                            (i) in paragraph (1), by inserting ``and 
                        section 2794'' after ``this part''; and
                            (ii) in paragraph (2)--
                                    (I) by inserting ``or section 
                                2794'' after ``set forth in this 
                                part''; and
                                    (II) by inserting ``and section 
                                2794'' after ``the requirements of this 
                                part''; and
                    (B) in subsection (b)--
                            (i) by inserting ``and section 2794'' after 
                        ``this part''; and
                            (ii) by inserting ``and section 2794'' 
                        after ``part A''.
    (d) Applicability to Grandfathered Plans.--Section 1251(a)(4)(A) of 
the Patient Protection and Affordable Care Act (Public Law 111-148), as 
added by section 2301 of the Health Care and Education Reconciliation 
Act of 2010 (Public Law 111-152), is amended by adding at the end the 
following:
                            ``(v) Section 2794 (relating to 
                        reasonableness of rates with respect to health 
                        insurance coverage).''.
    (e) Effective Date.--The amendments made by this section shall take 
effect on the date of enactment of this Act.
                                 <all>