II

104TH CONGRESS

1ST SESSION S. 524

To prohibit insurers from denying health insurance coverage, benefits, or

varying premiums based on the status of an individual as a victim

of domestic violence, and for other purposes.

IN THE SENATE OF THE UNITED STATES

MARCH 9 (legislative day, MARCH 6), 1995

Mr. WELLSTONE (for himself, Mr. KENNEDY, Mr. REID, Mr. BRADLEY, and

Mrs. MURRAY) introduced the following bill; which was read twice and

referred to the Committee on Labor and Human Resources

A BILL

To prohibit insurers from denying health insurance coverage,

benefits, or varying premiums based on the status of

an individual as a victim of domestic violence, and for

other purposes.

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 ‘‘Victims of Abuse Ac5 cess to Health Insurance Act’’.
2

•S 524 IS

1 SEC. 2. PROHIBITION OF HEALTH INSURANCE DISCRIMINA2 TION RELATING TO VICTIMS OF CERTAIN

3 CRIMES.

4 (a) IN GENERAL.—No insurer may engage in a prac5 tice that has the effect of denying, canceling, or limiting

6 health insurance coverage or health benefits, or establish7 ing, increasing, or varying the premium charged for the

8 coverage or benefits—

9 (1) to or for an individual on the basis that the

10 individual is, has been, or may be the victim of do11 mestic violence; or

12 (2) to or for a group or employer on the basis

13 that the group includes or the employer employs, or

14 provides or subsidizes insurance for, an individual

15 described in paragraph (1).

16 (b) PREEXISTING CONDITIONS.—

17 (1) IN GENERAL.—A health benefit plan may

18 not consider a condition or injury that occurred as

19 a result of domestic violence as a preexisting condi20 tion.

21 (2) PREEXISTING CONDITION.—As used in

22 paragraph (1), the term ‘‘preexisting condition’’

23 means, with respect to coverage under a health bene24 fit plan, a condition which was diagnosed, or which

25 was treated, prior to the first date of such coverage

26 (without regard to any waiting period).
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•S 524 IS

1 SEC. 3. CIVIL AND CRIMINAL REMEDIES AND PENALTIES.

2 (a) IN GENERAL.—Whoever violates the provisions of

3 this Act shall be—

4 (1) subject to a fine in an amount provided for

5 under title 18, United States Code, for a class A

6 misdemeanor not resulting in death;

7 (2) subject to the imposition of a civil monetary

8 penalty; and

9 (3) subject to the commencement by the ag10 grieved party of a civil action under subsection (b).

11 (b) CIVIL REMEDIES.—

12 (1) IN GENERAL.—Any individual aggrieved by

13 reason of the conduct prohibited in this Act may

14 commence a civil action for the relief set forth in

15 paragraph (2).

16 (2) RELIEF.—In any action under paragraph

17 (1), the court may award appropriate relief, includ18 ing temporary, preliminary, or permanent injunctive

19 relief and compensatory and punitive damages, as

20 well as the costs of suit and reasonable fees for

21 plaintiff’s attorneys and expert witnesses. With re22 spect to compensatory damages, the plaintiff may

23 elect, at any time prior to the rendering of final

24 judgment, to recover, in lieu of actual damages, an

25 award of statutory damages in the amount of $5,000

26 per violation.
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1 (3) CONCURRENT JURISDICTION.—Both Fed2 eral and State courts shall have concurrent jurisdic3 tion over actions brought pursuant to this section.

4 SEC. 4. DEFINITIONS.

5 For purposes of this Act:

6 (1) DOMESTIC VIOLENCE.—The term ‘‘domestic

7 violence’’ means the occurrence of one or more of

8 the following acts between household or family (in9 cluding in-laws or extended family) members,

10 spouses or former spouses, or individuals engaged in

11 or formerly engaged in a sexually intimate relation12 ship:

13 (A) Attempting to cause or intentionally,

14 knowingly, or recklessly causing bodily injury,

15 rape, assault, sexual assault, or involuntary sex16 ual intercourse.

17 (B) Knowingly engaging in a course of

18 conduct or repeatedly committing acts toward

19 another individual, including following the indi20 vidual, without proper authority, under cir21 cumstances that place the individual in reason22 able fear of bodily injury.

23 (C) Subjecting another to false imprison24 ment.

25 (2) INSURER.—
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•S 524 IS

1 (A) IN GENERAL.—The term ‘‘insurer’’

2 means a health benefit plan, a health care pro3 vider, an entity that self-insures, or a Federal

4 or State agency or entity that conducts activi5 ties related to the protection of public health.

6 (B) HEALTH BENEFIT PLAN.—The term

7 ‘‘health benefit plan’’ means any public or pri8 vate entity or program that provides for pay9 ments for health care, including—

10 (i) a group health plan (as defined in

11 section 607 of the Employee Retirement

12 Income Security Act of 1974) or a multiple

13 employer welfare arrangement (as defined

14 in section 3(40) of such Act) that provides

15 health benefits;

16 (ii) any other health insurance ar17 rangement, including any arrangement

18 consisting of a hospital or medical expense

19 incurred policy or certificate, hospital or

20 medical service plan contract, or health

21 maintenance organization subscriber con22 tract;

23 (iii) workers’ compensation or similar

24 insurance to the extent that it relates to

25 workers’ compensation medical benefits (as
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•S 524 IS

1 defined by the Secretary of Health and

2 Human Services); and

3 (iv) automobile medical insurance to

4 the extent that it relates to medical bene5 fits (as defined by the Secretary of Health

6 and Human Services).

7 SEC. 5. INAPPLICABILITY OF MCCARRAN-FERGUSON ACT.

8 For purposes of section 2(b) of the Act of March 9,

9 1945 (15 U.S.C. 1012(b)); commonly known as the

10 McCarran-Ferguson Act), this Act shall be considered to

11 specifically relate to the business of insurance.

12 SEC. 6. REGULATIONS.

13 The Secretary of Health and Human Services shall

14 issue regulations to carry out this Act.

15 SEC. 7. EFFECTIVE DATE.

16 This Act shall take effect 90 days after the date of

17 the enactment of this Act.

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