[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5328 Introduced in House (IH)]

113th CONGRESS
  2d Session
                                H. R. 5328

   To amend the Public Health Service Act to prohibit application of 
   preexisting condition exclusions and to guarantee availability of 
     health insurance coverage in the individual and group market, 
   contingent on the enactment of legislation repealing the Patient 
      Protection and Affordable Care Act, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 31, 2014

 Mr. Coffman (for himself, Mr. Pearce, and Mr. Valadao) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to prohibit application of 
   preexisting condition exclusions and to guarantee availability of 
     health insurance coverage in the individual and group market, 
   contingent on the enactment of legislation repealing the Patient 
      Protection and Affordable Care Act, and for other purposes.

    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 ``Guaranteed Health Coverage for Pre-
Existing Conditions Act of 2014''.

SEC. 2. PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS.

    (a) Group Market.--Subpart 1 of part A of title XXVII of the Public 
Health Service Act (42 U.S.C. 300gg et seq.) is amended by striking 
section 2701 and inserting the following:

``SEC. 2701. PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS.

    ``(a) In General.--A group health plan or a health insurance issuer 
offering group health insurance coverage may not impose any preexisting 
condition exclusion with respect to such plan or coverage.
    ``(b) Definitions.--For purposes of this section:
            ``(1) Preexisting condition exclusion.--
                    ``(A) In general.--The term `preexisting condition 
                exclusion' means, with respect to a group health plan 
                or health insurance coverage, a limitation or exclusion 
                of benefits relating to a condition based on the fact 
                that the condition was present before the date of 
                enrollment in such plan or for such coverage, whether 
                or not any medical advice, diagnosis, care, or 
                treatment was recommended or received before such date.
                    ``(B) Treatment of genetic information.--Genetic 
                information shall not be treated as a preexisting 
                condition in the absence of a diagnosis of the 
                condition related to such information.
            ``(2) Date of enrollment.--The term `date of enrollment' 
        means, with respect to an individual covered under a group 
        health plan or health insurance coverage, the date of 
        enrollment of the individual in the plan or coverage or, if 
        earlier, the first day of the waiting period for such 
        enrollment.
            ``(3) Waiting period.--The term `waiting period' means, 
        with respect to a group health plan and an individual who is a 
        potential participant or beneficiary in the plan, the period 
        that must pass with respect to the individual before the 
        individual is eligible to be covered for benefits under the 
        terms of the plan.''.
    (b) Individual Market.--Subpart 1 of part B of title XXVII of the 
Public Health Service Act (42 U.S.C. 300gg-41 et seq.) is amended by 
adding at the end the following:

``SEC. 2746. PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS OR OTHER 
              DISCRIMINATION BASED ON HEALTH STATUS.

    ``The provisions of section 2701 shall apply to health insurance 
coverage offered to individuals by a health insurance issuer in the 
individual market in the same manner as it applies to health insurance 
coverage offered by a health insurance issuer in the group market.''.

SEC. 3. GUARANTEED AVAILABILITY OF COVERAGE.

    (a) Group Market.--Subpart 3 of part A of title XXVII of the Public 
Health Service Act is amended by striking section 2711 (42 U.S.C. 
300gg-11) and inserting the following:

``SEC. 2711. GUARANTEED AVAILABILITY OF COVERAGE.

    ``(a) Guaranteed Issuance of Coverage in the Group Market.--Subject 
to subsection (b), each health insurance issuer that offers health 
insurance coverage in the group market in a State shall accept every 
employer and every individual in a group in the State that applies for 
such coverage.
    ``(b) Enrollment.--
            ``(1) Restriction.--A health insurance issuer described in 
        subsection (a) may restrict enrollment in coverage described in 
        such subsection to open or special enrollment periods.
            ``(2) Establishment.--A health insurance issuer described 
        in subsection (a) shall establish special enrollment periods 
        for qualifying events (as such term is defined in section 603 
        of the Employee Retirement Income Security Act of 1974).''.
    (b) Individual Market.--Subpart 1 of part B of title XXVII of the 
Public Health Service Act is amended by striking section 2741 of such 
Act (42 U.S.C. 300gg-41) and inserting the following:

``SEC. 2741. GUARANTEED AVAILABILITY OF COVERAGE.

    ``The provisions of section 2711 shall apply to health insurance 
coverage offered to individuals by a health insurance issuer in the 
individual market in the same manner as such provisions apply to health 
insurance coverage offered to employers by a health insurance issuer in 
connection with health insurance coverage in the group market. For 
purposes of this section, the Secretary shall treat any reference of 
the word `employer' in such section as a reference to the term 
`individual'.''.

SEC. 4. EFFECTIVE DATE CONTINGENT ON REPEAL OF PPACA.

    (a) In General.--Sections 2 and 3 and the amendments made by such 
section shall take effect upon the enactment of PPACA repeal 
legislation described in subsection (b) and such sections and 
amendments shall have no force or effect if such PPACA repeal 
legislation is not enacted.
    (b) PPACA Repeal Legislation Described.--For purposes of subsection 
(a), PPACA repeal legislation described in this subsection is 
legislation that--
            (1) repeals Public Law 111-148, and restores or revives the 
        provisions of law amended or repealed, respectively, by such 
        Act as if such Act had not been enacted and without further 
        amendment to such provisions of law; and
            (2) repeals title I and subtitle B of title II of the 
        Health Care and Education Reconciliation Act of 2010 (Public 
        Law 111-152), and restores or revives the provisions of law 
        amended or repealed, respectively, by such title or subtitle, 
        respectively, as if such title and subtitle had not been 
        enacted and without further amendment to such provisions of 
        law.
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