[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6136 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 6136
To amend the Public Health Service Act to provide protections for
consumers against excessive, unjustified, or unfairly discriminatory
increases in premium rates.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 9, 2020
Ms. Schakowsky introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to provide protections for
consumers against excessive, unjustified, or unfairly discriminatory
increases in premium rates.
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 Consumers from
Unreasonable Rates Act of 2020''.
SEC. 2. PROTECTION OF CONSUMERS FROM EXCESSIVE, UNJUSTIFIED, OR
UNFAIRLY DISCRIMINATORY RATES.
(a) Protection From Excessive, Unjustified, or Unfairly
Discriminatory Rates.--The first section 2794 of the Public Health
Service Act (42 U.S.C. 300gg-94), as added by section 1003 of the
Patient Protection and Affordable Care Act (Public Law 111-148), is
amended by adding at the end the following new subsection:
``(e) Protection From Excessive, Unjustified, or Unfairly
Discriminatory Rates.--
``(1) Authority of states.--Nothing in this section shall
be construed to prohibit a State from imposing requirements
(including requirements relating to rate review standards and
procedures and information reporting) on health insurance
issuers with respect to rates that are in addition to the
requirements of this section and are more protective of
consumers than such requirements.
``(2) Consultation in rate review process.--In carrying out
this section, the Secretary shall consult with the National
Association of Insurance Commissioners and consumer groups.
``(3) Determination of who conducts reviews for each
state.--The Secretary shall determine, after the date of
enactment of this section and periodically thereafter, the
following:
``(A) In which markets in each State the State
insurance commissioner or relevant State regulator
shall undertake the corrective actions under paragraph
(4), based on the Secretary's determination that the
State regulator is adequately undertaking and utilizing
such actions in that market.
``(B) In which markets in each State the Secretary
shall undertake the corrective actions under paragraph
(4), in cooperation with the relevant State insurance
commissioner or State regulator, based on the
Secretary's determination that the State is not
adequately undertaking and utilizing such actions in
that market.
``(4) Corrective action for excessive, unjustified, or
unfairly discriminatory rates.--In accordance with the process
established under this section, the Secretary or the relevant
State insurance commissioner or State regulator shall take
corrective actions to ensure that any excessive, unjustified,
or unfairly discriminatory rates are corrected prior to
implementation, or as soon as possible thereafter, through
mechanisms such as--
``(A) denying rates;
``(B) modifying rates; or
``(C) requiring rebates to consumers.
``(5) Noncompliance.--Failure to comply with any corrective
action taken by the Secretary under this subsection may result
in the application of civil monetary penalties under section
2723 and, if the Secretary determines appropriate, make the
plan involved ineligible for classification as a qualified
health plan.''.
(b) Clarification of Regulatory Authority.--Such section is further
amended--
(1) in subsection (a)--
(A) in the heading, by striking ``Premium'' and
inserting ``Rate'';
(B) in paragraph (1), by striking ``unreasonable
increases in premiums'' and inserting ``potentially
excessive, unjustified, or unfairly discriminatory
rates, including premiums,''; and
(C) in paragraph (2)--
(i) by striking ``an unreasonable premium
increase'' and inserting ``a potentially
excessive, unjustified, or unfairly
discriminatory rate'';
(ii) by striking ``the increase'' and
inserting ``the rate''; and
(iii) by striking ``such increases'' and
inserting ``such rates''; and
(2) in subsection (b)--
(A) by striking ``premium increases'' each place it
appears and inserting ``rates''; and
(B) in paragraph (2)(B), by striking ``premium''
and inserting ``rate''.
(c) Conforming Amendments.--Title XXVII of the Public Health
Service Act (42 U.S.C. 300gg et seq.) is amended--
(1) in section 2723 (42 U.S.C. 300gg-22), as redesignated
by the Patient Protection and Affordable Care Act--
(A) in subsection (a)--
(i) in paragraph (1), by inserting ``and
section 2794'' after ``this part''; and
(ii) in paragraph (2), by inserting ``or
section 2794'' after ``this part''; and
(B) in subsection (b)--
(i) in paragraph (1), by inserting ``and
section 2794'' after ``this part''; and
(ii) in paragraph (2)--
(I) in subparagraph (A), by
inserting ``or section 2794 that is''
after ``this part''; and
(II) in subparagraph (C)(ii), by
inserting ``or section 2794'' after
``this part''; and
(2) in section 2761 (42 U.S.C. 300gg-61)--
(A) in subsection (a)--
(i) in paragraph (1), by inserting ``and
section 2794'' after ``this part''; and
(ii) in paragraph (2)--
(I) by inserting ``or section
2794'' after ``set forth in this
part''; and
(II) by inserting ``and section
2794'' after ``the requirements of this
part''; and
(B) in subsection (b)--
(i) by inserting ``and section 2794'' after
``this part''; and
(ii) by inserting ``and section 2794''
after ``part A''.
(d) Applicability to Grandfathered Plans.--Section 1251(a)(4)(A) of
the Patient Protection and Affordable Care Act (Public Law 111-148), as
added by section 2301 of the Health Care and Education Reconciliation
Act of 2010 (Public Law 111-152), is amended by adding at the end the
following:
``(v) Section 2794 (relating to
reasonableness of rates with respect to health
insurance coverage).''.
(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this Act, such sums as may be necessary.
(f) Effective Date.--The amendments made by this section shall take
effect on the date of enactment of this Act and shall be implemented
with respect to health plans beginning not later than January 1, 2021.
<all>