[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. Res. 273 Introduced in Senate (IS)]
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116th CONGRESS
1st Session
S. RES. 273
Expressing the sense of the Senate with respect to health care rights.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 9, 2019
Mr. Merkley (for himself, Mr. Menendez, Mr. Schatz, Ms. Baldwin, Mrs.
Shaheen, Mr. Murphy, Mr. Sanders, Ms. Hassan, Mr. Cardin, Mr. Durbin,
Mr. Blumenthal, Mrs. Gillibrand, Ms. Duckworth, Mr. Brown, Ms.
Klobuchar, Ms. Warren, Mr. Markey, and Mrs. Feinstein) submitted the
following resolution; which was referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
RESOLUTION
Expressing the sense of the Senate with respect to health care rights.
Resolved, That it is the sense of the Senate that all people of the
United States have the right--
(1) to affordable health insurance coverage, including--
(A) the right of individuals with pre-existing
conditions to secure health insurance with the same
terms, benefits, and price as individuals who do not
have pre-existing conditions;
(B) the right to a comprehensive set of essential
health benefits in the individual and small group
markets;
(C) the right to stay on a parent's policy until
age 26 for young adults who meet certain requirements;
(D) the right to keep health coverage after getting
sick, even if the individual made an honest mistake on
his or her insurance application;
(E) the right to use an individual's own resources
to purchase and pay for treatment or services; and
(F) the right to a cap on the yearly deductibles
and other out-of-pocket costs an individual is required
to pay for covered services under a health insurance
plan;
(2) to coverage and access to health care services,
including--
(A) the right to health insurance coverage
regardless of an individual's pre-existing medical
conditions or health status;
(B) the right to certain preventive screenings
without paying out-of-pocket fees or copayments;
(C) the right to health insurance that provides
value relative to the premium cost;
(D) the right to be held harmless from surprise
medical bills;
(E) the right to coverage of mental health and
substance abuse services with no annual or lifetime
limits (including behavioral health treatment, mental
and behavioral health inpatient services, substance use
disorder treatment);
(F) the right to mental health and substance abuse
benefits without financial, treatment, or care
management limitations that only apply to such
benefits;
(G) the right to access all smoking cessation
medications that are approved by the Food and Drug
Administration;
(H) the right to choose a provider, and to receive
an accurate list of all participating providers;
(I) the right to access doctors, specialists, and
hospitals;
(J) the right to emergency medical services
without--
(i) preauthorization for emergency
services;
(ii) extra administrative hurdles for out-
of-network emergency services; or
(iii) higher cost-sharing for out-of-
network emergency services than in-network
emergency services;
(K) the right to affordable medications;
(L) the right to physical, mental, and oral care;
(M) the right to a treatment plan from provider for
a complex or serious medical condition;
(N) the right to go directly to a women's health
care specialist (including obstetricians and
gynecologists) without a referral for routine and
preventive health care services;
(O) the right to a full scope of reproductive
health services, including contraceptive care,
pregnancy-related care, prenatal care, miscarriage
management, family planning services, abortion care,
labor and delivery services, and postnatal care;
(P) the right to breastfeeding support, counseling,
and equipment (including manual and electric pumping
equipment);
(Q) the right to prescription medications and
medical and surgical services related to gender
transition;
(R) the right to try investigational drugs;
(S) the right to a second medical opinion;
(T) the right to home care services;
(U) the right to a full scope of hospice and
palliative care, and end-of-life options; and
(V) the right of pediatric patients to a full scope
of services offered to adult patients;
(3) to health information and records privacy;
(4) to explanations of coverage decisions, including--
(A) the right to an explanation and appeal if a
plan denies payment for a medical treatment or service;
(B) the right to an internal appeal of payment
decisions of private health plans if the health plan
refuses to make a payment;
(C) the right to a review by an outside review, by
an independent organization; and
(D) the right to complain, through grievances
processes;
(5) to transparency, including--
(A) the right to an easy-to-understand summary of
benefits and coverage;
(B) the right to at least 30 days' notice if an
insurer cancels coverage;
(C) the right to clear justification and
explanation for premium increases that are
unreasonable;
(D) the right to know how an enrollee's plan pays
its providers;
(E) the right to give informed consent and
understanding about medical conditions, risks and
benefits of treatment, and appropriate alternatives;
(F) the right to know how drug companies set drug
prices; and
(G) the right to know the amount of money pharmacy
benefit managers keep and the amount of savings from
pharmacy benefits managers that reach patients and
consumers;
(6) to protection from discrimination, including on the
basis of race, color, national origin, sex (including sexual
orientation and gender identity), age, disability, or
documentation status; and
(7) to culturally appropriate care, including health care
services in a language that the patient understands and that is
culturally sensitive.
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