[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 986 Engrossed in House (EH)]

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116th CONGRESS
  1st Session
                                H. R. 986

_______________________________________________________________________

                                 AN ACT


 
     To provide that certain guidance related to waivers for State 
 innovation under the Patient Protection and Affordable Care Act shall 
                        have no force or effect.

    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 ``Protecting Americans with 
Preexisting Conditions Act of 2019''.

SEC. 2. FINDINGS.

     Congress finds the following:
            (1) On October 24, 2018, the administration published new 
        guidance to carry out section 1332 of the Patient Protection 
        and Affordable Care Act (42 U.S.C. 18052) entitled ``State 
        Relief and Empowerment Waivers'' (83 Fed. Reg. 53575).
            (2) The new guidance encourages States to provide health 
        insurance coverage through insurance plans that may 
        discriminate against individuals with preexisting health 
        conditions, including the one in four Americans living with a 
        disability.
            (3) The implementation and enforcement of the new guidance 
        weakens protections for the millions of Americans living with 
        preexisting health conditions and jeopardizes Americans' access 
        to quality, affordable health insurance coverage.

SEC. 3. PROVIDING THAT CERTAIN GUIDANCE RELATED TO WAIVERS FOR STATE 
              INNOVATION UNDER THE PATIENT PROTECTION AND AFFORDABLE 
              CARE ACT SHALL HAVE NO FORCE OR EFFECT.

    Beginning April 1, 2019, the Secretary of Health and Human Services 
and the Secretary of the Treasury may not take any action to implement, 
enforce, or otherwise give effect to the guidance entitled ``State 
Relief and Empowerment Waivers'' (83 Fed. Reg. 53575 (October 24, 
2018)), including any such action that would result in individuals 
losing health insurance coverage that includes the essential health 
benefits package (as defined in subsection (a) of section 1302 of the 
Patient Protection and Affordable Care Act (42 U.S.C. 18022(a)) without 
regard to any waiver of any provision of such package under a waiver 
under such section 1332), including the maternity and newborn care 
essential health benefit described in subsection (b)(1)(D) of such 
section, including any such action that would result in a decrease in 
the number of such individuals enrolled in coverage that is at least as 
comprehensive as the coverage defined in section 1302(a) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18022(a)) compared to the 
number of such individuals who would have been so enrolled in such 
coverage had such action not been taken, including any such action that 
would, with respect to individuals with substance use disorders, 
including opioid use disorders, reduce the availability or 
affordability of coverage that is at least as comprehensive as the 
coverage defined in section 1302(a) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18022(a)) compared to the availability 
or affordability, respectively, of such coverage had such action not 
been taken, including any such action that would result, with respect 
to vulnerable populations (including low-income individuals, elderly 
individuals, and individuals with serious health issues or who have a 
greater risk of developing serious health issues), in a decrease in the 
availability of coverage that is at least as comprehensive as the 
coverage defined in section 1302(a) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18022(a)) with coverage and cost sharing 
protections required under section 1332(b)(1)(B) of such Act (42 U.S.C. 
18052(b)(1)(B)), including any such action that would, with respect to 
individuals with preexisting conditions, reduce the affordability of 
coverage that is at least as comprehensive as the coverage defined in 
section 1302(a) of the Patient Protection and Affordable Care Act (42 
U.S.C. 18022(a)) compared to the affordability of such coverage had 
such action not been taken, including any such action that would result 
in higher health insurance premiums for individuals enrolled in health 
insurance coverage that is at least as comprehensive as the coverage 
defined in section 1302(b) of such Act (42 U.S.C. 18022(b)), and the 
Secretaries may not promulgate any substantially similar guidance or 
rule. Nothing in the previous sentence shall be construed to affect the 
approval of waivers under section 1332 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18052) that establish reinsurance 
programs that are consistent with the requirements under subsection 
(b)(1) of such section (42 U.S.C. 18052(b)(1)), lower health insurance 
premiums, and protect health insurance coverage for people with 
preexisting conditions.

SEC. 4. GAO REPORT ON AFFECT OF STATE INNOVATION WAIVERS ON COVERAGE OF 
              INDIVIDUALS AND ON MENTAL HEALTH HEALTH CARE TREATMENT.

    Not later than 1 year after the date of the enactment of this Act, 
the Comptroller General of the United States shall submit to Congress a 
report on the number of individuals expected to lose access to health 
insurance coverage (as defined in section 2791 of the Public Health 
Service Act (42 U.S.C. 300gg-91)) if section 2 were not enacted and 
waivers under section 1332 of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18052) were approved under the guidance described 
in such section 2. Such report shall include an analysis of the 
expected effect such waivers approved under such guidance would have on 
mental health care treatment.

            Passed the House of Representatives May 9, 2019.

            Attest:

                                                                 Clerk.
116th CONGRESS

  1st Session

                               H. R. 986

_______________________________________________________________________

                                 AN ACT

     To provide that certain guidance related to waivers for State 
 innovation under the Patient Protection and Affordable Care Act shall 
                        have no force or effect.