I 

111TH CONGRESS 

1ST SESSION H. R. 2292 

To amend the Employee Retirement Income Security Act of 1974, the Public 

Health Service Act, and the Internal Revenue Code of 1986 to require 

coverage of preventive care for children. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 6, 2009 

Mr. THOMPSON of California (for himself and Mr. BLUMENAUER) introduced 

the following bill; which was referred to the Committee on Ways and 

Means, and in addition to the Committees on Education and Labor and 

Energy and Commerce, 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 the Employee Retirement Income Security Act 

of 1974, the Public Health Service Act, and the Internal 

Revenue Code of 1986 to require coverage of preventive 

care for children. 

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 ‘‘Healthy Kids for Healthy 

5 Futures Act of 2009’’. 


jbell on PROD1PC69 with BILLS
2 

•HR 2292 IH

1 SEC. 2. COVERAGE OF PREVENTIVE CARE FOR CHILDREN. 

2 (a) AMENDMENTS OF ERISA.— 

3 (1) IN GENERAL.—Subpart B of part 7 of title 

4 I of the Employee Retirement Income Security Act 

5 of 1974 (29 U.S.C. 1185 et seq.) is amended by 

6 adding at the end the following: 

7 ‘‘SEC. 714. COVERAGE OF PREVENTIVE CARE FOR CHIL8 DREN. 

9 ‘‘(a) IN GENERAL.—A group health plan, and a 

10 health insurance issuer providing health insurance cov11 erage in connection with a group health plan, shall provide 

12 coverage for appropriate preventive care for each qualified 

13 dependent child of the participant. 

14 ‘‘(b) APPROPRIATE PREVENTIVE CARE.—For pur15 poses of this section, the term ‘appropriate preventive 

16 care’ means medical care which, under regulations pre17 scribed by the Secretary of Health and Human Services, 

18 in consultation with the Secretary and the Secretary of 

19 the Treasury, meets the most recent Bright Futures 

20 Guidelines for Health Supervision of Infants, Children, 

21 and Adolescents. 

22 ‘‘(c) QUALIFIED DEPENDENT CHILD.—For purposes 

23 of this section, the term ‘qualified dependent child’ means 

24 a child of the participant who— 

25 ‘‘(1) is not more than 18 years of age, and 


jbell on PROD1PC69 with BILLS
3 

•HR 2292 IH

1 ‘‘(2) is a dependent child, under the terms of 

2 the plan or coverage, of the participant. 

3 ‘‘(d) COST-SHARING PROHIBITED.—A group health 

4 plan and health insurance coverage provided in connection 

5 with a group health plan may not impose deductibles, co6 payments, coinsurance, or other cost-sharing in relation 

7 to services provided pursuant to the requirements of sub8 section (a). 

9 ‘‘(e) CERTAIN COVERAGE RESTRICTIONS PROHIB10 ITED.—A group health plan, and a health insurance issuer 

11 providing coverage in connection with a group health plan, 

12 may not— 

13 ‘‘(1) deny to a participant or beneficiary eligi14 bility, or continued eligibility, to enroll or to renew 

15 coverage under the terms of the plan solely for the 

16 purpose of avoiding the requirements of this section, 

17 or 

18 ‘‘(2) penalize, or otherwise reduce or limit the 

19 reimbursement of, an attending provider, or provide 

20 incentives (monetary or otherwise) to an attending 

21 provider, so as to induce the provider to provide care 

22 to a beneficiary in a manner inconsistent with this 

23 section. 

24 ‘‘(f) ALLOWANCE FOR LEVEL OR TYPE OF PROVIDER

25 REIMBURSEMENT.—Nothing in this section shall be conVerDate Nov 24 2008 04:31 May 08, 2009 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2292.IH H2292

jbell on PROD1PC69 with BILLS
4 

•HR 2292 IH

1 strued to prevent a group health plan or a health insur2 ance issuer providing health insurance coverage in connec3 tion with a group health plan from negotiating the level 

4 and type of reimbursement with a provider for care pro5 vided in accordance with this section. 

6 ‘‘(g) NOTICE.—A group health plan, and a health in7 surance issuer providing health insurance coverage in con8 nection with a group health plan, shall provide notice to 

9 each participant and beneficiary under such plan regard10 ing the coverage required by this section in accordance 

11 with regulations which shall be promulgated by the Sec12 retary, in consultation with the Secretary of Health and 

13 Human Services and the Secretary of the Treasury. Such 

14 notice shall be in writing and prominently positioned in 

15 any literature or correspondence made available or distrib16 uted to participants and beneficiaries by the plan or issuer 

17 on an annual or other more frequent periodic basis. 

18 ‘‘(h) RELATION TO STATE LAWS.—Nothing in this 

19 section shall be construed to preempt or otherwise limit 

20 any State law with respect to health insurance coverage 

21 that requires more extensive coverage than is otherwise 

22 required under this section.’’. 

23 (2) CONFORMING AMENDMENT.—The table of 

24 contents in section 1 of such Act is amended by inVerDate Nov 24 2008 04:31 May 08, 2009 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2292.IH H2292

jbell on PROD1PC69 with BILLS
5 

•HR 2292 IH

1 serting after the item relating to section 713 the fol2 lowing new item: 

‘‘Sec. 714. Coverage of preventive care for children.’’. 

3 (b) AMENDMENTS TO THE PUBLIC HEALTH SERVICE

4 ACT.— 

5 (1) GROUP MARKETS.—Subpart 2 of part A of 

6 title XXVII of the Public Health Service Act (42 

7 U.S.C. 300gg–4 et seq.) is amended by adding at 

8 the end the following new section: 

9 ‘‘SEC. 2707. COVERAGE OF PREVENTIVE CARE FOR CHIL10 DREN. 

11 ‘‘(a) IN GENERAL.—A group health plan, and a 

12 health insurance issuer providing health insurance cov13 erage in connection with a group health plan, shall provide 

14 coverage for appropriate preventive care for each qualified 

15 dependent child of the participant. 

16 ‘‘(b) APPROPRIATE PREVENTIVE CARE.—For pur17 poses of this section, the term ‘appropriate preventive 

18 care’ means medical care which, under regulations pre19 scribed by the Secretary, in consultation with the Sec20 retary of Labor and the Secretary of the Treasury, meets 

21 the most recent Bright Futures Guidelines for Health Su22 pervision of Infants, Children, and Adolescents. 

23 ‘‘(c) QUALIFIED DEPENDENT CHILD.—For purposes 

24 of this section, the term ‘qualified dependent child’ means 

25 a child of the participant who— 


jbell on PROD1PC69 with BILLS
6 

•HR 2292 IH

1 ‘‘(1) is not more than 18 years of age, and 

2 ‘‘(2) is a dependent child, under the terms of 

3 the plan or coverage, of the participant. 

4 ‘‘(d) COST-SHARING PROHIBITED.—A group health 

5 plan and health insurance coverage provided in connection 

6 with a group health plan may not impose deductibles, co7 payments, coinsurance, or other cost-sharing in relation 

8 to services provided pursuant to the requirements of sub9 section (a). 

10 ‘‘(e) CERTAIN COVERAGE RESTRICTIONS PROHIB11 ITED.—A group health plan, and a health insurance issuer 

12 providing coverage in connection with a group health plan, 

13 may not— 

14 ‘‘(1) deny to a participant or beneficiary eligi15 bility, or continued eligibility, to enroll or to renew 

16 coverage under the terms of the plan solely for the 

17 purpose of avoiding the requirements of this section, 

18 or 

19 ‘‘(2) penalize, or otherwise reduce or limit the 

20 reimbursement of, an attending provider, or provide 

21 incentives (monetary or otherwise) to an attending 

22 provider, so as to induce the provider to provide care 

23 to a beneficiary in a manner inconsistent with this 

24 section. 


jbell on PROD1PC69 with BILLS
7 

•HR 2292 IH

1 ‘‘(f) ALLOWANCE FOR LEVEL OR TYPE OF PROVIDER

2 REIMBURSEMENT.—Nothing in this section shall be con3 strued to prevent a group health plan or a health insur4 ance issuer providing health insurance coverage in connec5 tion with a group health plan from negotiating the level 

6 and type of reimbursement with a provider for care pro7 vided in accordance with this section. 

8 ‘‘(g) NOTICE.—A group health plan, and a health in9 surance issuer providing health insurance coverage in con10 nection with a group health plan, shall provide notice to 

11 each participant and beneficiary under such plan regard12 ing the coverage required by this section in accordance 

13 with regulations which shall be promulgated by the Sec14 retary of Labor, in consultation with the Secretary and 

15 the Secretary of the Treasury. Such notice shall be in writ16 ing and prominently positioned in any literature or cor17 respondence made available or distributed to participants 

18 and beneficiaries by the plan or issuer on an annual or 

19 other more frequent periodic basis. 

20 ‘‘(h) RELATION TO STATE LAWS.—Nothing in this 

21 section shall be construed to preempt or otherwise limit 

22 any State law with respect to health insurance coverage 

23 that requires more extensive coverage than is otherwise 

24 required under this section.’’. 


jbell on PROD1PC69 with BILLS
8 

•HR 2292 IH

1 (2) INDIVIDUAL MARKET.—Subpart 3 of part B 

2 of title XXVII of such Act (42 U.S.C. 300gg–51 et 

3 seq.) is amended by adding at the end the following 

4 new section: 

5 ‘‘SEC. 2753. COVERAGE OF PREVENTIVE CARE FOR CHIL6 DREN. 

7 ‘‘The provisions of section 2707 shall apply to health 

8 insurance coverage offered by a health insurance issuer 

9 in the individual market in the same manner as they apply 

10 to health insurance coverage offered by a health insurance 

11 issuer in connection with a group health plan in the small 

12 or large group market.’’. 

13 (c) AMENDMENTS TO THE INTERNAL REVENUE

14 CODE.— 

15 (1) IN GENERAL.—Subchapter B of chapter 

16 100 of the Internal Revenue Code of 1986 (relating 

17 to other group health plan requirements) is amended 

18 by inserting after section 9812 the following new 

19 section: 

20 ‘‘SEC. 9813. COVERAGE OF PREVENTIVE CARE FOR CHIL21 DREN. 

22 ‘‘(a) IN GENERAL.—A group health plan shall pro23 vide coverage for appropriate preventive care for each 

24 qualified dependent child of the participant. 


jbell on PROD1PC69 with BILLS
9 

•HR 2292 IH

1 ‘‘(b) APPROPRIATE PREVENTIVE CARE.—For pur2 poses of this section, the term ‘appropriate preventive 

3 care’ means medical care which, under regulations pre4 scribed by the Secretary of Health and Human Services 

5 in consultation with the Secretary and the Secretary of 

6 Labor, meets the most recent Bright Futures Guidelines 

7 for Health Supervision of Infants, Children, and Adoles8 cents. 

9 ‘‘(c) QUALIFIED DEPENDENT CHILD.—For purposes 

10 of this section, the term ‘qualified dependent child’ means 

11 a child of the participant who— 

12 ‘‘(1) is not more than 18 years of age, and 

13 ‘‘(2) is a dependent child, under the terms of 

14 the plan or coverage, of the participant. 

15 ‘‘(d) COST-SHARING PROHIBITED.—A group health 

16 plan may not impose deductibles, copayments, coinsur17 ance, or other cost-sharing in relation to services provided 

18 pursuant to the requirements of subsection (a). 

19 ‘‘(e) CERTAIN COVERAGE RESTRICTIONS PROHIB20 ITED.—A group health plan may not— 

21 ‘‘(1) deny to a participant or beneficiary eligi22 bility, or continued eligibility, to enroll or to renew 

23 coverage under the terms of the plan solely for the 

24 purpose of avoiding the requirements of this section, 

25 or 


jbell on PROD1PC69 with BILLS
10 

•HR 2292 IH

1 ‘‘(2) penalize, or otherwise reduce or limit the 

2 reimbursement of, an attending provider, or provide 

3 incentives (monetary or otherwise) to an attending 

4 provider, so as to induce the provider to provide care 

5 to a beneficiary in a manner inconsistent with this 

6 section. 

7 ‘‘(f) ALLOWANCE FOR LEVEL OR TYPE OF PROVIDER

8 REIMBURSEMENT.—Nothing in this section shall be con9 strued to prevent a group health plan or a health insur10 ance issuer providing health insurance coverage in connec11 tion with a group health plan from negotiating the level 

12 and type of reimbursement with a provider for care pro13 vided in accordance with this section. 

14 ‘‘(g) NOTICE.—A group health plan shall provide no15 tice to each participant and beneficiary under such plan 

16 regarding the coverage required by this section in accord17 ance with regulations which shall be promulgated by the 

18 Secretary of Labor, in consultation with the Secretary and 

19 the Secretary of Health and Human Services. Such notice 

20 shall be in writing and prominently positioned in any lit21 erature or correspondence made available or distributed 

22 to participants and beneficiaries by the plan or issuer on 

23 an annual or other more frequent periodic basis. 

24 ‘‘(h) RELATION TO STATE LAWS.—Nothing in this 

25 section shall be construed to preempt or otherwise limit 


jbell on PROD1PC69 with BILLS
11 

•HR 2292 IH

1 any State law with respect to health insurance coverage 

2 that requires more extensive coverage than is otherwise 

3 required under this section.’’. 

4 (2) CONFORMING AMENDMENT.—The table of 

5 sections for subchapter B of chapter 100 of such 

6 Code is amended by inserting after the item relating 

7 to section 9812 the following new item: 

‘‘Sec. 9813. Coverage of preventive care for children.’’. 

8 (d) EFFECTIVE DATE.—The amendments made by 

9 this Act shall apply with respect to plan years beginning 

10 on or after January 1, 2010. 

11 (e) INITIAL NOTICE.—Each group health plan and 

12 health insurance issuer to which the notice requirements 

13 of section 714(g) of the Employee Retirement Income Se14 curity Act of 1974, section 2707(g) of the Public Health 

15 Service Act, or section 9813(g) of the Internal Revenue 

16 Code of 1986 apply shall be deemed not in compliance 

17 with such requirements with respect to the first plan year 

18 beginning on or after January 1, 2010, unless, not later 

19 than January 1, 2010, the plan or issuer includes the in20 formation described in such section in a notice which is 

21 provided to each participant and beneficiary in writing. 

22 SEC. 3. COVERAGE OF PREVENTATIVE CARE FOR CHIL23 DREN UNDER HEALTH SAVINGS ACCOUNTS. 

24 (a) IN GENERAL.—Paragraph (2) of section 223(c) 

25 of the Internal Revenue Code of 1986 (defining high deVerDate Nov 24 2008 04:31 May 08, 2009 Jkt 079200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2292.IH H2292

jbell on PROD1PC69 with BILLS
12 

•HR 2292 IH

1 ductible health plan) is amended by adding at the end the 

2 following new subparagraph: 

3 ‘‘(E) SPECIAL RULE FOR PREVENTATIVE

4 CARE FOR CHILDREN.— 

5 ‘‘(i) IN GENERAL.—A plan shall not 

6 be treated as a high deductible health plan 

7 unless such plan meets the requirements of 

8 section 9813 (relating to coverage of pre9 ventative care for children). 

10 ‘‘(ii) PLAN TREATED AS GROUP

11 HEALTH PLAN.—For purposes of clause 

12 (i), the plan shall be treated as a group 

13 health plan.’’. 

14 (b) EFFECTIVE DATE.—The amendment made by 

15 this section shall apply to taxable years beginning after 

16 December 31, 2009. 

Æ 


jbell on PROD1PC69 with BILLS