II 

110TH CONGRESS 

2D SESSION S. 3115 

To amend title I of the Employee Retirement Income Security Act of 1974, 

title XXVII of the Public Health Service Act, and the Internal Revenue 

Code of 1986 to prohibit preexisting condition exclusions for children 

in group health plans and health insurance coverage in the group and 

individual markets. 

IN THE SENATE OF THE UNITED STATES 

JUNE 11, 2008 

Mr. LAUTENBERG (for himself and Mr. BROWN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend title I of the Employee Retirement Income Security Act of 1974, title XXVII of the Public Health Service Act, and the Internal Revenue Code of 1986 to prohibit preexisting condition exclusions for children in 

group health plans and health insurance coverage in 

the group and individual markets. 

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 ‘‘Children’s Health Pro5 tection Act of 2008’’. 


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1 SEC. 2. PROHIBITION OF PREEXISTING CONDITION EXCLU2 SIONS FOR CHILDREN UNDER GROUP 

3 HEALTH PLANS. 

4 (a) AMENDMENTS TO THE EMPLOYEE RETIREMENT

5 INCOME SECURITY ACT OF 1974.—Section 701(d) of the 

6 Employee Retirement Income Security Act of 1974 (29 

7 U.S.C. 1181(d)) is amended— 

8 (1) by striking paragraph (1) and inserting the 

9 following: 

10 ‘‘(1) EXCLUSION NOT APPLICABLE TO CHIL11 DREN.—A group health plan, and a health insurance 

12 issuer offering group health insurance coverage, may 

13 not impose any preexisting condition exclusion in the 

14 case of an individual who has not attained 19 years 

15 of age.’’; 

16 (2) by striking paragraphs (2) and (4); and 

17 (3) by redesignating paragraph (3) as para18 graph (2). 

19 (b) AMENDMENTS TO THE PUBLIC HEALTH SERVICE

20 ACT.—Section 2701(d) of the Public Health Service Act 

21 (42 U.S.C. 300gg(d)) is amended— 

22 (1) by striking paragraph (1) and inserting the 

23 following: 

24 ‘‘(1) EXCLUSION NOT APPLICABLE TO CHIL25 DREN.—A group health plan, and a health insurance 

26 issuer offering group health insurance coverage, may 


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1 not impose any preexisting condition exclusion in the 

2 case of an individual who has not attained 19 years 

3 of age.’’; 

4 (2) by striking paragraphs (2) and (4); and 

5 (3) by redesignating paragraph (3) as para6 graph (2). 

7 (c) AMENDMENTS TO THE INTERNAL REVENUE

8 CODE OF 1986.—Subsection (d) of section 9801 of the 

9 Internal Revenue Code of 1986 (relating to exceptions) is 

10 amended— 

11 (1) by striking paragraph (1) and inserting the 

12 following: 

13 ‘‘(1) EXCLUSION NOT APPLICABLE TO CHIL14 DREN.—A group health plan may not impose any 

15 preexisting condition exclusion in the case of an indi16 vidual who has not attained 19 years of age.’’; 

17 (2) by striking paragraphs (2) and (4); and 

18 (3) by redesignating paragraph (3) as para19 graph (2). 

20 (d) EFFECTIVE DATE.— 

21 (1) IN GENERAL.—Except as provided in para22 graph (2), the amendments made by this section 

23 shall apply with respect to group health plans for 

24 plan years beginning after the end of the 12th calVerDate Aug 31 2005 00:29 Jun 12, 2008 Jkt 069200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3115.IS S3115

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1 endar month following the date of the enactment of 

2 this Act. 

3 (2) SPECIAL RULE FOR COLLECTIVE BAR4 GAINING AGREEMENTS.—In the case of a group 

5 health plan maintained pursuant to one or more col6 lective bargaining agreements between employee rep7 resentatives and one or more employers ratified be8 fore the date of the enactment of this Act, the 

9 amendments made by this section shall not apply to 

10 plan years beginning before the earlier of— 

11 (A) the date on which the last of the col12 lective bargaining agreements relating to the 

13 plan terminates (determined without regard to 

14 any extension thereof agreed to after the date 

15 of the enactment of this Act), or 

16 (B) 3 years after the date of the enact17 ment of this Act. 

18 For purposes of subparagraph (A), any plan amend19 ment made pursuant to a collective bargaining 

20 agreement relating to the plan which amends the 

21 plan solely to conform to any requirement added by 

22 the amendments made by this section shall not be 

23 treated as a termination of such collective bar24 gaining agreement. 


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1 SEC. 3. PROHIBITION OF PREEXISTING CONDITION EXCLU2 SIONS FOR CHILDREN IN HEALTH INSUR3 ANCE COVERAGE IN THE INDIVIDUAL MAR4 KET. 

5 (a) IN GENERAL.—Section 2741 of the Public Health 

6 Service Act (42 U.S.C. 300gg–41) is amended— 

7 (1) by redesignating the second subsection (e) 

8 (relating to market requirements) and subsection (f) 

9 as subsections (f) and (g), respectively; and 

10 (2) by adding at the end the following new sub11 section: 

12 ‘‘(h) PROHIBITION OF PREEXISTING CONDITION EX13 CLUSIONS FOR CHILDREN.—Each health insurance issuer 

14 that offers health insurance coverage in the individual 

15 market may not impose any preexisting condition exclu16 sion (as defined in section 2701(b)(1)(A)) in the case of 

17 an individual who has not attained 19 years of age.’’. 

18 (b) CONFORMING AMENDMENT.—Section 2744(a)(1) 

19 of such Act (42 U.S.C. 300gg–44(a)(1)) is amended by 

20 inserting ‘‘(other than subsection (h))’’ after ‘‘section 

21 2741’’. 

22 (c) EFFECTIVE DATE.—The amendments made by 

23 this section shall apply with respect to health insurance 

24 coverage offered, sold, issued, renewed, in effect, or oper25 ated in the individual market after the end of the 12th 


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1 calendar month following the date of the enactment of this 

2 Act. 

Æ 


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