[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7512 Introduced in House (IH)]
<DOC>
117th CONGRESS
2d Session
H. R. 7512
To amend title XXVII of the Public Health Service Act, title I of the
Employee Retirement Income Security Act of 1974, and the Internal
Revenue Code of 1986 to limit enrollment in coverage for excepted
benefits to individuals enrolled in a health plan providing minimum
essential coverage.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 14, 2022
Mrs. Hayes (for herself and Ms. Schakowsky) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and
in addition to the Committees on Education and Labor, and Ways and
Means, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XXVII of the Public Health Service Act, title I of the
Employee Retirement Income Security Act of 1974, and the Internal
Revenue Code of 1986 to limit enrollment in coverage for excepted
benefits to individuals enrolled in a health plan providing minimum
essential coverage.
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 Patients from Deceptive
Health Plans Act''.
SEC. 2. MODIFYING EXCEPTED BENEFITS WITH RESPECT TO CERTAIN PLANS.
(a) Public Health Service Act.--
(1) Additional requirements for excepted benefit.--Section
2722(c)(2) of the Public Health Service Act (42 U.S.C. 300gg-
21(c)(2)) is amended--
(A) in subparagraph (B), by striking ``sponsor.''
and inserting ``sponsor, or with respect to individual
coverage, under any health insurance coverage
maintained by the same health insurance issuer.''; and
(B) by adding at the end the following:
``(D) Such benefits are paid without regard to, and
do not vary based on, the severity of the illness,
injury, diagnosis, or other characteristics related to
treatment for which such benefits are paid.
``(E) With respect to such benefits, the separate
policy, certificate, or contract of insurance is
provided only to an individual enrolled in minimum
essential coverage (as defined in section 5000A(f) of
the Internal Revenue Code of 1986), and such minimum
essential coverage's share of the total allowed costs
(as determined for purposes of section 36B(c)(2)(C)(ii)
of such Code) of benefits provided under such minimum
essential coverage is greater than or equal to 60
percent of such costs.''.
(2) Modification of certain excepted benefits.--Section
2791(c) of the Public Health Service Act (42 U.S.C. 300gg-
91(c)) is amended--
(A) in paragraph (1)(A), by striking ``accident''
and all that follows through ``combination thereof'',
and inserting ``disability income insurance''; and
(B) in paragraph (3), by adding at the end the
following:
``(C) Coverage only for accident.''.
(b) Employee Retirement Income Security Act.--
(1) Additional requirements for excepted benefits.--Section
732(c)(2) of the Employee Retirement Income Security Act of
1974 (29 U.S.C. 1191a(c)(2)) is amended by adding at the end
the following:
``(D) Such benefits are paid without regard to, and
do not vary based on, the severity of the illness,
injury, diagnosis, or other characteristics related to
treatment for which such benefits are paid.
``(E) With respect to such benefits, the separate
policy, certificate, or contract of insurance is
provided only to a participant or beneficiary enrolled
in minimum essential coverage (as defined in section
5000A(f) of the Internal Revenue Code of 1986), and
such minimum essential coverage's share of the total
allowed costs (as determined for purposes of section
36B(c)(2)(C)(ii) of such Code) of benefits provided
under such minimum essential coverage is greater than
or equal to 60 percent of such costs.''.
(2) Modification of certain excepted benefits.--Section
733(c) of the Employee Retirement Income Security Act of 1974
(29 U.S.C. 1191b(c)) is amended--
(A) in paragraph (1)(A), by striking ``accident''
and all that follows through ``combination thereof'',
and inserting ``disability income insurance''; and
(B) in paragraph (3), by adding at the end the
following:
``(C) Coverage only for accident.''.
(c) Internal Revenue Code.--
(1) Additional requirements for excepted benefits.--Section
9831(c)(2) of the Internal Revenue Code of 1986 is amended by
adding at the end the following:
``(D) Such benefits are paid without regard to, and
do not vary based on, the severity of the illness,
injury, diagnosis, or other characteristics related to
treatment for which such benefits are paid.
``(E) With respect to such benefits, the separate
policy, certificate, or contract of insurance is
provided only to a participant or beneficiary enrolled
in minimum essential coverage (as defined in section
5000A(f)), and such minimum essential coverage's share
of the total allowed costs (as determined for purposes
of section 36B(c)(2)(C)(ii)) of benefits provided under
such minimum essential coverage is greater than or
equal to 60 percent of such costs.''.
(2) Modification of certain excepted benefits.--Section
9832(c) of the Internal Revenue Code of 1986 is amended--
(A) in paragraph (1)(A), by striking ``accident''
and all that follows through ``combination thereof'',
and inserting ``disability income insurance''; and
(B) in paragraph (3), by adding at the end the
following:
``(C) Coverage only for accident.''.
(d) Effective Date.--The amendments made by this section shall take
effect beginning January 1, 2023, and shall apply with respect to
policies issued, sold, or renewed on or after such date.
<all>