I 

114TH CONGRESS 

1ST SESSION H. R. 3727 

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 

OCTOBER 8, 2015 

Ms. SCHAKOWSKY (for herself, Mr. DEUTCH, Mr. GRIJALVA, Mr. RANGEL, 

Ms. NORTON, Ms. DELAURO, Mr. MCDERMOTT, Mr. TAKANO, Mrs. 

CAPPS, Mr. GUTIE ́RREZ, and Ms. MICHELLE LUJAN GRISHAM of New 

Mexico) 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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Health Insurance Rate 

5 Review Act’’. 


asabaliauskas on DSK5VPTVN1PROD with BILLS
2 

•HR 3727 IH

1 SEC. 2. PROTECTION OF CONSUMERS FROM EXCESSIVE, 

2 UNJUSTIFIED, OR UNFAIRLY DISCRIMINA3 TORY RATES. 

4 (a) PROTECTION FROM EXCESSIVE, UNJUSTIFIED, 

5 OR UNFAIRLY DISCRIMINATORY RATES.—The first sec6 tion 2794 of the Public Health Service Act (42 U.S.C. 

7 300gg–94), as added by section 1003 of the Patient Pro8 tection and Affordable Care Act (Public Law 111–148), 

9 is amended by adding at the end the following new sub10 section: 

11 ‘‘(e) PROTECTION FROM EXCESSIVE, UNJUSTIFIED, 

12 OR UNFAIRLY DISCRIMINATORY RATES.— 

13 ‘‘(1) AUTHORITY OF STATES.—Nothing in this 

14 section shall be construed to prohibit a State from 

15 imposing requirements (including requirements re16 lating to rate review standards and procedures and 

17 information reporting) on health insurance issuers 

18 with respect to rates that are in addition to the re19 quirements of this section and are more protective of 

20 consumers than such requirements. 

21 ‘‘(2) CONSULTATION IN RATE REVIEW PROC22 ESS.—In carrying out this section, the Secretary 

23 shall consult with the National Association of Insur24 ance Commissioners and consumer groups. 

25 ‘‘(3) DETERMINATION OF WHO CONDUCTS RE26 VIEWS FOR EACH STATE.—The Secretary shall deVerDate Sep 11 2014 22:42 Oct 14, 2015 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3727.IH H3727

asabaliauskas on DSK5VPTVN1PROD with BILLS
3 

•HR 3727 IH

1 termine, after the date of enactment of this section 

2 and periodically thereafter, the following: 

3 ‘‘(A) In which markets in each State the 

4 State insurance commissioner or relevant State 

5 regulator shall undertake the corrective actions 

6 under paragraph (4), based on the Secretary’s 

7 determination that the State regulator is ade8 quately undertaking and utilizing such actions 

9 in that market. 

10 ‘‘(B) In which markets in each State the 

11 Secretary shall undertake the corrective actions 

12 under paragraph (4), in cooperation with the 

13 relevant State insurance commissioner or State 

14 regulator, based on the Secretary’s determina15 tion that the State is not adequately under16 taking and utilizing such actions in that mar17 ket. 

18 ‘‘(4) CORRECTIVE ACTION FOR EXCESSIVE, UN19 JUSTIFIED, OR UNFAIRLY DISCRIMINATORY

20 RATES.—In accordance with the process established 

21 under this section, the Secretary or the relevant 

22 State insurance commissioner or State regulator 

23 shall take corrective actions to ensure that any ex24 cessive, unjustified, or unfairly discriminatory rates 


asabaliauskas on DSK5VPTVN1PROD with BILLS
4 

•HR 3727 IH

1 are corrected prior to implementation, or as soon as 

2 possible thereafter, through mechanisms such as— 

3 ‘‘(A) denying rates; 

4 ‘‘(B) modifying rates; or 

5 ‘‘(C) requiring rebates to consumers. 

6 ‘‘(5) NONCOMPLIANCE.—Failure to comply with 

7 any corrective action taken by the Secretary under 

8 this subsection may result in the application of civil 

9 monetary penalties under section 2723 and, if the 

10 Secretary determines appropriate, make the plan in11 volved ineligible for classification as a qualified 

12 health plan.’’. 

13 (b) CLARIFICATION OF REGULATORY AUTHORITY.— 

14 Such section is further amended— 

15 (1) in subsection (a)— 

16 (A) in the heading, by striking ‘‘PRE17 MIUM’’ and inserting ‘‘RATE’’; 

18 (B) in paragraph (1), by striking ‘‘unrea19 sonable increases in premiums’’ and inserting 

20 ‘‘potentially excessive, unjustified, or unfairly 

21 discriminatory rates, including premiums,’’; and 

22 (C) in paragraph (2)— 

23 (i) by striking ‘‘an unreasonable pre24 mium increase’’ and inserting ‘‘a potenVerDate Sep 11 2014 22:42 Oct 14, 2015 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3727.IH H3727

asabaliauskas on DSK5VPTVN1PROD with BILLS
5 

•HR 3727 IH

1 tially excessive, unjustified, or unfairly dis2 criminatory rate’’; 

3 (ii) by striking ‘‘the increase’’ and in4 serting ‘‘the rate’’; and 

5 (iii) by striking ‘‘such increases’’ and 

6 inserting ‘‘such rates’’; and 

7 (2) in subsection (b)— 

8 (A) by striking ‘‘premium increases’’ each 

9 place it appears and inserting ‘‘rates’’; and 

10 (B) in paragraph (2)(B), by striking ‘‘pre11 mium’’ and inserting ‘‘rate’’. 

12 (c) CONFORMING AMENDMENTS.—Title XXVII of 

13 the Public Health Service Act (42 U.S.C. 300gg et seq.) 

14 is amended— 

15 (1) in section 2723 (42 U.S.C. 300gg–22), as 

16 redesignated by the Patient Protection and Afford17 able Care Act— 

18 (A) in subsection (a)— 

19 (i) in paragraph (1), by inserting 

20 ‘‘and section 2794’’ after ‘‘this part’’; and 

21 (ii) in paragraph (2), by inserting ‘‘or 

22 section 2794’’ after ‘‘this part’’; and 

23 (B) in subsection (b)— 

24 (i) in paragraph (1), by inserting 

25 ‘‘and section 2794’’ after ‘‘this part’’; and 


asabaliauskas on DSK5VPTVN1PROD with BILLS
6 

•HR 3727 IH

1 (ii) in paragraph (2)— 

2 (I) in subparagraph (A), by in3 serting ‘‘or section 2794 that is’’ after 

4 ‘‘this part’’; and 

5 (II) in subparagraph (C)(ii), by 

6 inserting ‘‘or section 2794’’ after 

7 ‘‘this part’’; and 

8 (2) in section 2761 (42 U.S.C. 300gg–61)— 

9 (A) in subsection (a)— 

10 (i) in paragraph (1), by inserting 

11 ‘‘and section 2794’’ after ‘‘this part’’; and 

12 (ii) in paragraph (2)— 

13 (I) by inserting ‘‘or section 

14 2794’’ after ‘‘set forth in this part’’; 

15 and 

16 (II) by inserting ‘‘and section 

17 2794’’ after ‘‘the requirements of this 

18 part’’; and 

19 (B) in subsection (b)— 

20 (i) by inserting ‘‘and section 2794’’ 

21 after ‘‘this part’’; and 

22 (ii) by inserting ‘‘and section 2794’’ 

23 after ‘‘part A’’. 

24 (d) APPLICABILITY TO GRANDFATHERED PLANS.— 

25 Section 1251(a)(4)(A) of the Patient Protection and AfVerDate Sep 11 2014 22:42 Oct 14, 2015 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3727.IH H3727

asabaliauskas on DSK5VPTVN1PROD with BILLS
7 

•HR 3727 IH

1 fordable Care Act (Public Law 111–148), as added by sec2 tion 2301 of the Health Care and Education Reconcili3 ation Act of 2010 (Public Law 111–152), is amended by 

4 adding at the end the following: 

5 ‘‘(v) Section 2794 (relating to reason6 ableness of rates with respect to health in7 surance coverage).’’. 

8 (e) AUTHORIZATION OF APPROPRIATIONS.—There 

9 are authorized to be appropriated to carry out this Act, 

10 such sums as may be necessary. 

11 (f) EFFECTIVE DATE.—The amendments made by 

12 this section shall take effect on the date of enactment of 

13 this Act and shall be implemented with respect to health 

14 plans beginning not later than January 1, 2017. 

Æ 


asabaliauskas on DSK5VPTVN1PROD with BILLS