[Congressional Record Volume 153, Number 29 (Thursday, February 15, 2007)]
[Senate]
[Pages S2042-S2044]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Mr. Feingold):
  S. 616. 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, snowmobiling, or horseback riding.
  Among the many rules that were issued at the end of the Clinton 
administration was one that was intended to

[[Page S2044]]

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 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.''
  Mr. PRESIDENT, 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. The bill should not be 
controversial. In fact, it passed the Senate by unanimous consent at 
the end of the 108th Congress.
  I am therefore hopeful that we will be able to move quickly on this 
legislation this year, and I urge all of my colleagues to join us as 
cosponsors.
                                 ______