[Congressional Record Volume 149, Number 28 (Friday, February 14, 2003)]
[Senate]
[Pages S2539-S2540]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Mr. Feingold):
  S. 423. A bill to promote health care coverage parity for individuals 
participating in legal recreational activities or legal transportation 
activities; to the Committee on Health, Education, Labor, and Pensions.
  Ms. COLLINS. Mr. President, I am pleased to join with my colleague 
from Wisconsin, Senator Feingold, in introducing legislation to 
prohibit health insurers from denying benefits to plan participants if 
they are injured while engaging in legal recreational activities like 
skiing or horseback riding.
  Among the many rules that were issued at the end of the Clinton 
Administration was one that was intended to ensure non-discrimination 
in health coverage in the group market. This rule was issued jointly on 
January 8, 2001, by the Department of Labor, the Internal Revenue 
Service and the Health Care Financing Administration--now the Centers 
for Medicare and Medicaid Services--in accordance with the Health 
Insurance Portability and Accountability Act, HIPAA, of 1996.
  While I was pleased that the rule prohibits health plans and issuers 
from denying coverage to individuals who engage in certain types of 
recreational activities, such as skiing, horseback riding, snowmobiling 
or motorcycling, I am extremely concerned that it would allow insurers 
to deny health benefits for an otherwise covered injury that results 
from participation in these activities.
  The rule states that: ``While a person cannot be excluded from a plan 
for engaging in certain recreational activities, benefits for a 
particular injury can, in some cases, be excluded based on the source 
of the injury.'' A plan could, for example, include a general exclusion 
for injuries sustained while doing a specified list of recreational 
activities, even though treatment for those injuries, a broken arm for 
instance, would have been covered under the plan if the individual had 
tripped and fallen.
  Because of this loophole, an individual who was injured while skiing 
or running could be denied health care coverage, while someone who is 
injured while drinking and driving a car would be protected.
  This clearly is contrary to Congressional intent. One of the purposes 
of HIPAA was to prohibit plans and issuers from establishing 
eligibility rules for health coverage based on certain health-related 
factors, including evidence of insurability. To underscore that point, 
the conference report language stated that ``the inclusion of evidence 
of insurability in the definition of health status is intended to 
ensure, among other things, that individuals are not excluded from 
health care coverage due to their participation in activities such as 
motorcycling, snowmobiling, all-terrain vehicle riding, horseback 
riding, skiing and other similar activities.'' The conference report 
also states that ``this provision is meant to prohibit insurers or 
employers from excluding employees in a group from coverage or charging 
them higher premiums based on their health status and other related 
factors that could lead to higher health costs.''
  Millions of Americans participate in these legal and common 
recreational activities which, if practiced with appropriate 
precautions, do not significantly increase the likelihood of serious 
injury. Moreover, in enacting HIPAA, Congress simply did not intend 
that people would be allowed to purchase health insurance only to find 
out, after the fact, that they have no coverage for an injury resulting 
from a common recreational activity. If this rule is allowed to stand, 
millions of Americans will be forced to forgo recreational activities 
that they currently enjoy lest they have an accident and find out that 
they are not covered for needed care resulting from that accident.
  The legislation that we are introducing today will clarify that 
individuals participating in activities routinely enjoyed by millions 
of Americans cannot be denied access to health care coverage or health 
benefits as a result of their activities, and I urge all of our 
colleagues to join us as cosponsors.
  Mr. FEINGOLD. Mr. President, I rise today with my colleague from 
Maine to introduce legislation to promote health care parity for 
individuals participating in legal transportation and recreational 
activities. This legislation addresses concerns that I have been 
hearing from a wide range of Wisconsinites about a loophole caused by 
the Department of Health and Human Services' ruling that makes it 
possible for health care coverage to be denied to those who are injured 
while participating in these kinds of legal activities.
  In January of 2001, the Health Care Finance administration released 
regulations governing the Health Care Insurance Accountability Act of 
1996, also known as HIPAA. As part of this act, Congress intended to 
ban health insurance discrimination against those participating in 
legal transportation or recreational activities. Ironically, it appears 
that the rules written in response to this legislation may have had 
precisely the opposite effect.
  These new regulations at first state that an employer cannot refuse 
health care coverage to an employee on the basis of participation in 
recreational activities. But they then go on to say that health care 
benefits can be denied for injuries sustained in connection with those 
recreational activities.
  Not only does this ruling make little sense, it flies in the face of 
what Congress intended. In a colloquy between Senators Moseley-Braun 
and Kassebaum, Senator Mosely-Braun stated, ``As I understand it, this 
formulation is intended to ensure that, among other things, 
participants and beneficiaries are not excluded from health care 
coverage because they participate in activities such as motorcycling, 
skiing, horseback riding, snowmobiling, or other similar activities.''
  And Senator Kassebaum simply said ``The Senator from Illinois is 
correct.''
  But the bureaucrats turned around and permitted the denial of 
benefits for any injury sustained while participating in these legal 
activities. This ruling makes no sense. Because of this loophole, 
someone who participates in motorcycling, snowmobiling, running or 
walking could be denied health care coverage, while someone who is 
injured while drinking and driving a car would be protected.
  Congress voted 98-0 in favor of the HIPAA legislation that included 
this language. We must close the loophole that the interpretation of 
this provision has created.

[[Page S2540]]

  From riding Harley Davidson motorcycles to the visiting the 
Snowmobile Hall of Fame in St. Germain, these activities are part of 
Wisconsin's heritage and economy. It makes no sense that they would be 
singled out for this unfair treatment.
  Millions of Americans rely on motorcycles for their transportation to 
work. Individuals should not singled out just because they choose a 
different mode of transportation to go to work.
  I urge my colleagues to cosponsor this legislation and provide health 
care parity for individuals participating in legal transportation and 
recreational activities.
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