I 

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. 

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 Con5 sumer Protection Act’’. 


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1 TITLE I—NO MORE NARROW 

2 NETWORKS 

3 SEC. 101. SHORT TITLE. 

4 This title may be cited as the ‘‘No More Narrow Net5 works Act of 2021’’. 

6 SEC. 102. REQUIRING EXCHANGES TO ESTABLISH NET7 WORK ADEQUACY STANDARDS FOR QUALI8 FIED HEALTH PLANS. 

9 (a) IN GENERAL.—Section 1311(d) of the Patient 

10 Protection and Affordable Care Act (42 U.S.C. 18031(d)) 

11 is amended by adding at the end the following new para12 graph: 

13 ‘‘(8) NETWORK ADEQUACY STANDARDS.— 

14 ‘‘(A) CERTAIN EXCHANGES.—In the case 

15 of an Exchange operated by the Secretary pur16 suant section 1321(c)(1) or an Exchange de17 scribed in section 155.200(f) of title 42, Code 

18 of Federal Regulations (or a successor regula19 tion), the Exchange shall require each qualified 

20 health plan offered through such Exchange to 

21 meet such quantitative network adequacy stand22 ards as the Secretary may prescribe for pur23 poses of this subparagraph. 

24 ‘‘(B) STATE EXCHANGES.—In the case of 

25 an Exchange not described in subparagraph 


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1 (A), the Exchange shall establish quantitative 

2 network adequacy standards with respect to 

3 qualified health plans offered through such Ex4 change and require such plans to meet such 

5 standards.’’. 

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

7 this section shall apply with respect to plan years begin8 ning on or after January 1, 2023. 

9 TITLE II—PROTECTING CON10 SUMERS FROM UNREASON11 ABLE RATES 

12 SEC. 201. SHORT TITLE. 

13 This title may be cited as the ‘‘Protecting Consumers 

14 from Unreasonable Rates Act’’. 

15 SEC. 202. PROTECTION OF CONSUMERS FROM EXCESSIVE, 

16 UNJUSTIFIED, OR UNFAIRLY DISCRIMINA17 TORY RATES. 

18 (a) PROTECTION FROM EXCESSIVE, UNJUSTIFIED, 

19 OR UNFAIRLY DISCRIMINATORY RATES.—The first sec20 tion 2794 of the Public Health Service Act (42 U.S.C. 

21 300gg–94), as added by section 1003 of the Patient Pro22 tection and Affordable Care Act (Public Law 111–148), 

23 is amended by adding at the end the following new sub24 section: 


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

2 OR UNFAIRLY DISCRIMINATORY RATES.— 

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

4 section shall be construed to prohibit a State from 

5 imposing requirements (including requirements re6 lating to rate review standards and procedures and 

7 information reporting) on health insurance issuers 

8 with respect to rates that are in addition to the re9 quirements of this section and are more protective of 

10 consumers than such requirements. 

11 ‘‘(2) CONSULTATION IN RATE REVIEW PROC12 ESS.—In carrying out this section, the Secretary 

13 shall consult with the National Association of Insur14 ance Commissioners and consumer groups. 

15 ‘‘(3) DETERMINATION OF WHO CONDUCTS RE16 VIEWS FOR EACH STATE.—The Secretary shall de17 termine, after the date of enactment of this section 

18 and periodically thereafter, the following: 

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

20 State insurance commissioner or relevant State 

21 regulator shall undertake the corrective actions 

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

23 determination that the State regulator is ade24 quately undertaking and utilizing such actions 

25 in that market. 


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

2 Secretary shall undertake the corrective actions 

3 under paragraph (4), in cooperation with the 

4 relevant State insurance commissioner or State 

5 regulator, based on the Secretary’s determina6 tion that the State is not adequately under7 taking and utilizing such actions in that mar8 ket. 

9 ‘‘(4) CORRECTIVE ACTION FOR EXCESSIVE, UN10 JUSTIFIED, OR UNFAIRLY DISCRIMINATORY

11 RATES.—In accordance with the process established 

12 under this section, the Secretary or the relevant 

13 State insurance commissioner or State regulator 

14 shall take corrective actions to ensure that any ex15 cessive, unjustified, or unfairly discriminatory rates 

16 are corrected prior to implementation, or as soon as 

17 possible thereafter, through mechanisms such as— 

18 ‘‘(A) denying rates; 

19 ‘‘(B) modifying rates; or 

20 ‘‘(C) requiring rebates to consumers. 

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

22 any corrective action taken by the Secretary under 

23 this subsection may result in the application of civil 

24 monetary penalties under section 2723 and, if the 

25 Secretary determines appropriate, make the plan inVerDate Sep 11 2014 23:05 May 12, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1890.IH H1890

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1 volved ineligible for classification as a qualified 

2 health plan.’’. 

3 (b) CLARIFICATION OF REGULATORY AUTHORITY.— 

4 Such section is further amended— 

5 (1) in subsection (a)— 

6 (A) in the heading, by striking ‘‘PRE7 MIUM’’ and inserting ‘‘RATE’’; 

8 (B) in paragraph (1), by striking ‘‘unrea9 sonable increases in premiums’’ and inserting 

10 ‘‘potentially excessive, unjustified, or unfairly 

11 discriminatory rates, including premiums,’’; and 

12 (C) in paragraph (2)— 

13 (i) by striking ‘‘an unreasonable pre14 mium increase’’ and inserting ‘‘a poten15 tially excessive, unjustified, or unfairly dis16 criminatory rate’’; 

17 (ii) by striking ‘‘the increase’’ and in18 serting ‘‘the rate’’; and 

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

20 inserting ‘‘such rates’’; and 

21 (2) in subsection (b)— 

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

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

24 (B) in paragraph (2)(B), by striking ‘‘pre25 mium’’ and inserting ‘‘rate’’. 


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1 (c) CONFORMING AMENDMENTS.—Title XXVII of 

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

3 is amended— 

4 (1) in section 2723 (42 U.S.C. 300gg–22)— 

5 (A) in subsection (a)— 

6 (i) in paragraph (1), by inserting ‘‘, 

7 section 2794,’’ after ‘‘this part’’; and 

8 (ii) in paragraph (2), by inserting ‘‘, 

9 section 2794,’’ after ‘‘this part’’; and 

10 (B) in subsection (b)— 

11 (i) in paragraph (1), by inserting ‘‘, 

12 section 2794,’’ after ‘‘this part’’; and 

13 (ii) in paragraph (2)— 

14 (I) in subparagraph (A), by in15 serting ‘‘, section 2794,’’ after ‘‘this 

16 part’’; and 

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

18 inserting ‘‘, section 2794,’’ after ‘‘this 

19 part’’; and 

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

21 (A) in subsection (a)— 

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

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

24 (ii) in paragraph (2)— 


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1 (I) by inserting ‘‘or section 

2 2794’’ after ‘‘set forth in this part’’; 

3 and 

4 (II) by inserting ‘‘and section 

5 2794’’ after ‘‘the requirements of this 

6 part’’; and 

7 (B) in subsection (b)— 

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

9 after ‘‘this part’’; and 

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

11 after ‘‘part A’’. 

12 (d) APPLICABILITY TO GRANDFATHERED PLANS.— 

13 Section 1251(a)(4)(A) of the Patient Protection and Af14 fordable Care Act (Public Law 111–148), as added by sec15 tion 2301 of the Health Care and Education Reconcili16 ation Act of 2010 (Public Law 111–152), is amended by 

17 adding at the end the following: 

18 ‘‘(v) Section 2794 (relating to reason19 ableness of rates with respect to health in20 surance coverage).’’. 

21 (e) AUTHORIZATION OF APPROPRIATIONS.—There 

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

23 such sums as may be necessary. 

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

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


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1 this Act and shall be implemented with respect to health 

2 plans beginning not later than January 1, 2023. 

Æ 


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