[House Report 113-580]
[From the U.S. Government Publishing Office]


113th Congress  }                                     {   Rept. 113-580
  2d Session    }        HOUSE OF REPRESENTATIVES     {          Part 1

=======================================================================
 
              EMPLOYEE HEALTH CARE PROTECTION ACT OF 2013 

                                _______
                                

 September 8, 2014.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

  Mr. Upton, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                             together with

                            DISSENTING VIEWS

                        [To accompany H.R. 3522]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 3522) to authorize health insurance issuers to 
continue to offer for sale current group health insurance 
coverage in satisfaction of the minimum essential health 
insurance coverage requirement, and for other purposes, having 
considered the same, report favorably thereon without amendment 
and recommend that the bill do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     1
Background and Need for Legislation..............................     1
Hearings.........................................................     1
Committee Consideration..........................................     1
Committee Votes..................................................     1
Committee Oversight Findings.....................................     4
Statement of General Performance Goals and Objectives............     4
New Budget Authority, Entitlement Authority, and Tax Expenditures     4
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     4
Committee Cost Estimate..........................................     4
Congressional Budget Office Estimate.............................     4
Federal Mandates Statement.......................................     4
Duplication of Federal Programs..................................     4
Disclosure of Directed Rule Makings..............................     4
Advisory Committee Statement.....................................     5
Applicability to Legislative Branch..............................     5
Section-by-Section Analysis of the Legislation...................     5
Dissenting Views.................................................     6

                          Purpose and Summary

    H.R. 3522 permits a health insurance issuer that has in 
effect health insurance coverage in the group market on any 
date during 2013 to continue offering such coverage for sale 
during 2014 outside of a health care exchange established under 
the Patient Protection and Affordable Care Act (PPACA). Such 
plans may be offered notwithstanding the provisions of the 
Patient Protection and Affordable Care Act and the Health Care 
and Education Reconciliation Act.

                  Background and Need for Legislation

    During the debate over PPACA, President Obama stated, 
``[w]e will keep this promise to the American people: If you 
like your doctor, you will be able to keep your doctor, period. 
If you like your health care plan, you'll be able to keep your 
health care plan, period. No one will take it away, no matter 
what.'' However, health coverage not in compliance with 
requirements of PPACA generally cannot be offered after 2014. 
PPACA's requirements affect the ability of many individuals to 
keep plans that they relied upon in both the nongroup and group 
markets.
    While the Department of Health and Human Services has 
delayed administratively some of PPACA's requirements and some 
plan cancellations in certain instances, the remaining non-
compliant ACA plans in effect will ultimately be ended under 
current law.

                                Hearings

    The Subcommittee on Health held a hearing on H.R. 3522 on 
July 28, 2014. The Subcommittee received testimony from:
           Edmund Haislmaier, Senior Research Fellow, 
        Heritage Foundation;
           Stan Veuger, Resident Scholar, American 
        Enterprise Institute; and,
           John Hoadley, Research Professor, Georgetown 
        University.

                        Committee Consideration

    On July 29, 2014, the full Committee met in open markup 
session and approved H.R. 3522 by a vote of 27 yeas and 20 
nays.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. A 
motion by Mr. Upton to order H.R. 3522 reported to the House, 
was agreed to by a record vote of 27 yeas and 20 nays. The 
following reflects the record votes taken during the Committee 
consideration:

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

                      Committee Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee held a hearing and made 
findings that are reflected in this report.

         Statement of General Performance Goals and Objectives

    The purpose of this act is to protect Americans from losing 
their preferred health coverage and provide more affordable 
choices to America's workers.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
3522 would result in no new or increased budget authority, 
entitlement authority, or tax expenditures or revenues.

       Earmark, Limited Tax Benefits, and Limited Tariff Benefits

    In compliance with clause 9(e), 9(f), and 9(g) of rule XXI 
of the Rules of the House of Representatives, the Committee 
finds that H.R. 3522 contains no earmarks, limited tax 
benefits, or limited tariff benefits.

                        Committee Cost Estimate

    Pursuant to section 402 of the Congressional Budget Act of 
1974, the Committee estimates that enacting this legislation 
would have no significant impact on the Federal budget.

                  Congressional Budget Office Estimate

    With respect to clause 3(c)(3) of rule XIII of the Rules of 
the House of Representatives, an estimate and comparison 
prepared by the Director of the Congressional Budget Office 
under section 402 of the Congressional Budget Act of 1974 was 
not submitted to the Committee before the of filing of the 
report.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                    Duplication of Federal Programs

    No provision of H.R. 3522 establishes or reauthorizes a 
program of the Federal Government known to be duplicative of 
another Federal program, a program that was included in any 
report from the Government Accountability Office to Congress 
pursuant to section 21 of Public Law 111-139, or a program 
related to a program identified in the most recent Catalog of 
Federal Domestic Assistance.

                  Disclosure of Directed Rule Makings

    The Committee estimates that enacting H.R. 3522 does not 
direct any specific rule making within the meaning of 5 U.S.C. 
551.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 provides the short title of ``Employee Health 
Care Protection Act.''

Section 2. If you Like Your Group Health Insurance Plan, You Can Keep 
        It

    Section 2 permits health insurance issuers to continue to 
offer coverage effective in 2013, notwithstanding requirements 
of PPACA. Such coverage shall be treated as a grandfathered 
health plan for purposes of an individual meeting the 
requirement to maintain minimum essential health coverage.

                            DISSENTING VIEWS

    H.R. 3522 would permit any health insurance issuer offering 
coverage in the group market in 2013 to continue to offer that 
coverage in 2014 and beyond, regardless of whether those 
policies include the critical consumer protections provided by 
the Affordable Care Act (ACA).
    While critics of the ACA have inaccurately claimed that 
enhanced consumer protections for American families would kill 
jobs, lead to employers dropping coverage and cause increases 
in the rate of health spending growth, the facts show 
otherwise.
    As key reforms went into effect, health care cost growth 
was at record lows and the United States has added 10 million 
private sector jobs. The non-partisan Congressional Budget 
Office (CBO) and the Centers for Medicare and Medicaid 
Services' (CMS) Actuary have both found that in recent years 
Medicare and private health care spending have grown at some of 
the slowest levels in decades.
    And, contrary to fictitious charges that the ACA will lead 
some employers to terminate employer health insurance coverage 
because the law's new beneficiary protections will be too 
costly for businesses, the overall number of Americans 
receiving employer-based coverage is expected to grow from 156 
million in 2014 to 166 million in 2023, and the number of 
uninsured is expected to fall by 26 million people, according 
to the latest estimates from CBO.
    This outcome is supported by the Massachusetts experience 
as well. Massachusetts enacted health care reforms that were 
almost identical to those in the ACA. In that instance, the 
percentage of employers offering coverage has increased from 72 
percent in 2007 to 77 percent in 2010.
    The legislation, while masquerading as ``choice'' for 
consumers, simply eviscerates the critical consumer protections 
that ensure women, older workers, people with disabilities, and 
individuals with pre-existing conditions rely on to make 
coverage available. The bill would allow insurance companies to 
discriminate against small businesses if they have an older 
workforce, more women in their workforce, or if any of their 
employees or their children have pre-existing health 
conditions.
    Under the legislation, these small businesses would face 
higher premiums and would continue to see their premiums spike 
year to year if an employee had an accident, developed a 
chronic health condition, or had a complicated pregnancy.
    Group health insurance plans could continue to impose 
annual limits on coverage, meaning that insurers could cease to 
provide any coverage after an individual's care reached a 
certain overall cost. These plans could also continue to impose 
extensive waiting periods before individuals could enroll in 
coverage and they could discriminate against workers with lower 
compensation by offering them lesser health coverage than 
highly compensated workers.
    In March 2014, the Administration announced a transition 
policy that would allow small groups who purchased coverage in 
2013 to remain in that same coverage into 2016. That coverage 
would not have to comply with ACA consumer protections going 
into effect in 2014 but it could not be sold to groups 
purchasing coverage for the first time or switching coverage.
    Many of the ACA's key reforms impacting the group market 
had already gone into effect for plans sold in 2013. Since 
2011, all insurers are required to spend over 80 percent of 
premiums on patient care rather than excessive profits and 
administrative costs. Insurers in the large group market are 
required to spend at least 85 percent of premiums on patient 
care. All told, these reforms saved consumers more than $4 
billion in 2013 and have resulted in early $2 billion in 
rebates directly to consumers.
    In short, the legislation is unnecessary, and harms 
consumers.

                                   Henry A. Waxman.
                                   Frank Pallone, Jr.