Text: H.R.1890 — 117th Congress (2021-2022)All Information (Except Text)

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Introduced in House (03/12/2021)


117th CONGRESS
1st Session
H. R. 1890


To amend the Patient Protection and Affordable Care Act to require Exchanges to establish network adequacy standards for qualified health plans and 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 12, 2021

Ms. Schakowsky introduced the following bill; which was referred to the Committee on Energy and Commerce


A BILL

To amend the Patient Protection and Affordable Care Act to require Exchanges to establish network adequacy standards for qualified health plans and 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 “Health Insurance Consumer Protection Act”.

TITLE INo More Narrow Networks

SEC. 101. Short title.

This title may be cited as the “No More Narrow Networks Act of 2021”.

SEC. 102. Requiring Exchanges to establish network adequacy standards for qualified health plans.

(a) In general.—Section 1311(d) of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(d)) is amended by adding at the end the following new paragraph:

“(8) NETWORK ADEQUACY STANDARDS.—

“(A) CERTAIN EXCHANGES.—In the case of an Exchange operated by the Secretary pursuant section 1321(c)(1) or an Exchange described in section 155.200(f) of title 42, Code of Federal Regulations (or a successor regulation), the Exchange shall require each qualified health plan offered through such Exchange to meet such quantitative network adequacy standards as the Secretary may prescribe for purposes of this subparagraph.

“(B) STATE EXCHANGES.—In the case of an Exchange not described in subparagraph (A), the Exchange shall establish quantitative network adequacy standards with respect to qualified health plans offered through such Exchange and require such plans to meet such standards.”.

(b) Effective date.—The amendment made by this section shall apply with respect to plan years beginning on or after January 1, 2023.

TITLE IIProtecting Consumers from Unreasonable Rates

SEC. 201. Short title.

This title may be cited as the “Protecting Consumers from Unreasonable Rates Act”.

SEC. 202. 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)—

(A) in subsection (a)—

(i) in paragraph (1), by inserting “, section 2794,” after “this part”; and

(ii) in paragraph (2), by inserting “, section 2794,” after “this part”; and

(B) in subsection (b)—

(i) in paragraph (1), by inserting “, section 2794,” after “this part”; and

(ii) in paragraph (2)—

(I) in subparagraph (A), by inserting “, section 2794,” after “this part”; and

(II) in subparagraph (C)(ii), by inserting “, 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, 2023.


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