I 

111TH CONGRESS 

1ST SESSION H. R. 2402 

To amend the Public Health Service Act to ensure fairness in the coverage 

of women in the individual health insurance market. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 13, 2009 

Mr. NEAL of Massachusetts (for himself and Mrs. DAVIS of California) introduced the following bill; which was referred to the Committee on Energy 

and Commerce 

A BILL 

To amend the Public Health Service Act to ensure fairness 

in the coverage of women in the individual health insurance market. 

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 ‘‘Woman’s Health In5 surance Fairness Act of 2009’’. 

6 SEC. 2. ELIMINATION OF GENDER RATING IN THE INDI7 VIDUAL INSURANCE MARKET. 

8 (a) IN GENERAL.—Subpart 2 of part B of title 

9 XXVII of the Public Health Service Act (42 U.S.C. May 


hsrobinson on PROD1PC76 with BILLS
2 

•HR 2402 IH

1 4, 2009 300gg–51 et seq.) is amended by adding at the 

2 end the following: 

3 ‘‘SEC. 2754. ELIMINATION OF GENDER RATING. 

4 ‘‘A health insurance issuer offering health insurance 

5 coverage in the individual market may not consider the 

6 gender of an enrollee when determining the amount of pre7 miums to assess such enrollee for such coverage.’’. 

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

9 subsection (a) shall apply with respect to health insurance 

10 coverage in the individual market for plan years beginning 

11 on or after the date that is months after the date of enact12 ment of this Act. 

13 SEC. 3. PREVENTING INSURERS FROM DENYING OR LIM14 ITING COVERAGE BASED ON PREGNANCY 

15 AND COVERAGE OF MATERNITY CARE. 

16 (a) IN GENERAL.—Subpart 2 of part B of title 

17 XXVII of the Public Health Service Act (42 U.S.C. 18 

18 300gg–51 et seq.), as amended by section 2, is further 

19 amended by adding at the end the following: 

20 ‘‘SEC. 2755. STANDARDS RELATING TO PREGNANCY AND 

21 MATERNITY CARE. 

22 ‘‘(a) PREGNANCY, METHOD OF DELIVERY, AND OUT23 COME.—A health insurance issuer offering health insur24 ance coverage in the individual market may not impose 

25 any preexisting condition exclusion (as such term is deVerDate Nov 24 2008 23:15 May 21, 2009 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2402.IH H2402

hsrobinson on PROD1PC76 with BILLS
3 

•HR 2402 IH

1 fined in section 2701(b)(1)(A)) relating to pregnancy as 

2 a preexisting condition, impose any waiting period, deny, 

3 refuse to issue, renew, or reissue, substandard rate, re4 underwrite, cancel or otherwise terminate a policy, add 

5 any surcharge or rating factor to the premium, exclude, 

6 limit, or cap benefits relating to a condition, or otherwise 

7 discriminate in the provision of coverage, or in assessing 

8 premiums for such coverage, against women on the basis 

9 of a current or past pregnancy, or past or future method 

10 of delivery, and past pregnancy outcome. 

11 ‘‘(b) MATERNITY CARE.— 

12 ‘‘(1) IN GENERAL.—The Secretary shall— 

13 ‘‘(A) propose a rule to develop a minimum 

14 benefit standard for the provision of com15 prehensive maternity coverage under an indi16 vidual health plan, which standard shall require 

17 coverage for the full scope of maternity services 

18 from preconception through postpartum, as de19 termined by the Secretary; and 

20 ‘‘(B) periodically review the minimum ben21 efit standard for the provision of comprehensive 

22 maternity coverage under an individual health 

23 plan to ensure the minimum benefit standard 

24 reflects current standards of care. 


hsrobinson on PROD1PC76 with BILLS
4 

•HR 2402 IH

1 ‘‘(2) REQUIREMENT.—A health insurance 

2 issuer offering health insurance coverage in the indi3 vidual market shall ensure that the minimum benefit 

4 standard developed under paragraph (1) is included 

5 in any such coverage.’’. 

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

7 subsection (a) shall apply with respect to health insurance 

8 coverage in the individual market for plan years beginning 

9 on or after the date that is 6 months after the date of 

10 enactment of this Act. 

11 SEC. 4. ENFORCEMENT AND COMPLIANCE. 

12 (a) PROVISION OF DATA.—The Secretary of Health 

13 and Human Services shall promulgate regulations to re14 quire health insurance issuers that offer health insurance 

15 coverage in the individual market provide data to the Sec16 retary to enable the Secretary to monitor the compliance 

17 of such issuers with the requirements of the amendment 

18 made by this Act. 

19 (b) FAILURE TO COMPLY.—Any health insurance 

20 issuer that fails to submit the data required under the reg21 ulations promulgated under subsection (a) shall be subject 

22 to a civil monetary penalty in an amount that is not less 

23 than $10,000 (as determined by the Secretary). 


hsrobinson on PROD1PC76 with BILLS
5 

•HR 2402 IH

1 (c) DEFINITIONS.—The definitions contained in sec2 tion 2791 of the Public Health Service Act (42 U.S.C. 

3 3 300gg–91) shall apply for purposes of this section. 

4 SEC. 5. STUDY OF THE INDIVIDUAL MARKET. 

5 Not later than December 31, 2010, the Comptroller 

6 General of the United States shall submit to the appro7 priate committees of Congress, a report concerning health 

8 insurance coverage offered on the individual insurance 

9 market in all 50 States and the District of Columbia, on 

10 problems remaining for women after the enactment of this 

11 Act. 

Æ 


hsrobinson on PROD1PC76 with BILLS