I 

111TH CONGRESS 

1ST SESSION H. R. 3824 

To allow States to establish interstate compacts for the purpose of expanding 

health insurance options. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 15, 2009 

Mr. DEAL of Georgia (for himself, Mr. BURGESS, Mr. PITTS, Mr. BLUNT, Mr. 

BARTON of Texas, and Mr. BUYER) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To allow States to establish interstate compacts for the 

purpose of expanding health insurance options. 

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 ‘‘Expanded Health In5 surance Options Act of 2009’’. 

6 SEC. 2. EXPANDING HEALTH INSURANCE OPTIONS. 

7 (a) MORE AFFORDABLE HEALTH COVERAGE

8 THROUGH STATE COMPACTS.— 

9 (1) AUTHORIZING COMPACTS.—States may 

10 enter into arrangements with other States for the 


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1 purposes of forming one or more interstate com2 pacts— 

3 (A) that meet the requirements of this sub4 section; and 

5 (B) under which health insurance issuers 

6 would offer health insurance coverage meeting 

7 the requirements of this subsection under a uni8 fied regulatory structure to residents of the 

9 States that are parties to the compact. 

10 (2) REGULATORY STRUCTURE.—The regulatory 

11 structure under such a compact may include regula12 tions relating to the issuance, renewal, rating, man13 dated benefits, and similar items with respect to 

14 health insurance coverage. 

15 (3) REGULATION; GRIEVANCES.—Health insur16 ance coverage offered in a State that is a party to 

17 such a compact shall be regulated by the State in18 volved in the manner specified in the compact and 

19 any grievances with respect to such coverage shall be 

20 handled in the State in which the covered individual 

21 resides. 

22 (4) CONTINUATION OF ANTI-FRAUD ACTIVI23 TIES.—Nothing in this section shall be construed to 

24 prohibit a State from engaging in anti-fraud activiVerDate Nov 24 2008 04:17 Oct 16, 2009 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3824.IH H3824

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1 ties for the purposes of enforcing regulations or 

2 other provisions within such a compact. 

3 (5) INDEPENDENT EXTERNAL APPEALS.—Each 

4 interstate compact shall ensure that individuals who 

5 are insured in a State that participates in an inter6 state compact are able to access an independent ex7 ternal appeals process to review decisions made by 

8 health insurance issuers relating to the health insur9 ance coverage of such individual. 

10 (b) RESPONSIBILITY OF PRIMARY STATE.—In the 

11 case of an activity described in paragraph (1)(A) that oc12 curs in a State that is participating in an interstate com13 pact, the primary State, or the State in which the insur14 ance issuer is licensed, is responsible for the enforcement 

15 of applicable laws, regulations, agreements, and orders 

16 governing the health insurance issuers and health insur17 ance coverage involved, including laws relating to the fol18 lowing: 

19 (1) The offer, sale, rating, renewal, and 

20 issuance of individual health insurance coverage. 

21 (2) The coverage of health care and insurance 

22 related services. 

23 (3) Management, operations, and investment 

24 activities of a health insurance issuer. 


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1 (4) Liability loss control and claims administra2 tion. 

3 (c) RESPONSIBILITY OF SECONDARY STATE.—The 

4 secondary State that is participating in an interstate com5 pact, or the State in which the individual resides, may re6 quire a health insurance issuer— 

7 (1) to pay premiums and taxes; 

8 (2) to submit to examination of financial condi9 tion; 

10 (3) to comply with State laws regarding fraud 

11 and abuse; and 

12 (4) to comply with laws regarding unfair claims 

13 practices. 

14 (d) DISCLOSURE.—The health insurance issuer must 

15 provide a clear disclosure to the individual that the issuer 

16 is in a secondary State and all laws and regulations of 

17 the secondary State are applicable. 

18 (e) EFFECTIVE DATE.—This subsection shall apply 

19 beginning 1 year after the date of the enactment of this 

20 Act. 

21 (f) DEFINITIONS.—In this section: 

22 (1) The terms ‘‘health insurance coverage’’ and 

23 ‘‘health insurance issuer’’ have the meanings given 

24 such terms in section 2791 of the Public Health 

25 Service Act. 


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1 (2) The term ‘‘State’’ means each of the 50 

2 States and the District of Columbia. 

Æ 


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