I 
118TH CONGRESS 
1ST SESSION H. R. 4195 
To amend title XXVII of the Public Health Service Act, the Employee 
Retirement Income Security Act of 1974, and the Internal Revenue 
Code of 1986 to allow parental choice in the selection of primary health 
insurance coverage or primary coverage under a group health plan for 
certain dependent children. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 16, 2023 
Ms. DAVIDS of Kansas (for herself, Ms. NORTON, Ms. CASTOR of Florida, and 
Ms. PINGREE) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees 
on Ways and Means, and Education and the Workforce, for a period to 
be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To amend title XXVII of the Public Health Service Act, 
the Employee Retirement Income Security Act of 1974, 
and the Internal Revenue Code of 1986 to allow parental 
choice in the selection of primary health insurance cov-
erage or primary coverage under a group health plan 
for certain dependent children. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Empowering Parents’ 
Healthcare Choices Act of 2021’’. 
SEC. 2. ALLOWING PARENTAL CHOICE IN THE SELECTION 
OF PRIMARY HEALTH INSURANCE COVERAGE 
OR PRIMARY COVERAGE UNDER A GROUP 
HEALTH PLAN FOR CERTAIN DEPENDENT 
CHILDREN. 
(a) PUBLIC HEALTH SERVICE ACT.—Part D of title 
XXVII of the Public Health Service Act (42 U.S.C. 
300gg–111 et seq.) is amended by adding at the end the 
following new section: 
‘‘SEC. 2799A–11. PARENTAL CHOICE OF PRIMARY HEALTH 
INSURANCE COVERAGE OR PRIMARY COV-
ERAGE UNDER A GROUP HEALTH PLAN FOR 
CERTAIN DEPENDENT CHILDREN. 
‘‘(a) IN GENERAL.—In the case of a dependent child 
of two individuals where both such individuals, at the time 
of birth of such child, are covered under separate policies 
of health insurance coverage offered by a health insurance 
issuer or separate group health plans, if both such policies 
of health insurance coverage or plans (as applicable) would 
provide coverage of such child, such health insurance cov-
erage or plan (as applicable) shall provide primary cov-
erage of such child if both such individuals submit to the 
issuer of such coverage or to such plan (as applicable), 
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within 60 days of the birth of such child and in a manner 
specified by the Secretary, a notification electing primary 
coverage of such child under such health insurance cov-
erage or plan. Such primary coverage of such child under 
such health insurance coverage or group health plan shall 
continue until the earlier of the following: 
‘‘(1) A submission of a notification, in a man-
ner specified by the Secretary, by both such individ-
uals to the issuer of such health insurance coverage 
or plan electing to discontinue such primary cov-
erage for such child. 
‘‘(2) The loss of coverage under such health in-
surance coverage or plan of such individual who is 
enrolled under such health insurance coverage or 
plan. 
‘‘(b) ELECTION OF PRIMARY COVERAGE WITH RE-
SPECT TO SINGLE COVERAGE OR PLAN.—The provisions 
of subsection (a) shall not apply if both individuals de-
scribed in such paragraph submit notifications for a child 
with respect to multiple policies of health insurance cov-
erage or group health plans.’’. 
(b) EMPLOYEE RETIREMENT INCOME SECURITY ACT 
OF 1974.— 
(1) IN GENERAL.—Subpart B of part 7 of sub-
title B of title I of the Employee Retirement Income 
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Security Act of 1974 is amended by adding at the 
end the following new section: 
‘‘SEC. 726. PARENTAL CHOICE OF PRIMARY HEALTH INSUR-
ANCE COVERAGE OR PRIMARY COVERAGE 
UNDER A GROUP HEALTH PLAN FOR CER-
TAIN DEPENDENT CHILDREN. 
‘‘(a) IN GENERAL.—In the case of a dependent child 
of two individuals where both such individuals, at the time 
of birth of such child, are covered under separate policies 
of health insurance coverage offered by a health insurance 
issuer or separate group health plans, if both such policies 
of health insurance coverage or plans (as applicable) would 
provide coverage of such child, such group health insur-
ance coverage or plan (as applicable) shall provide primary 
coverage of such child if both such individuals submit to 
the issuer of such coverage or to such plan (as applicable), 
within 60 days of the birth of such child and in a manner 
specified by the Secretary, a notification electing primary 
coverage of such child under such group health insurance 
coverage or plan. Such primary coverage of such child 
under such group health insurance coverage or group 
health plan shall continue until the earlier of the following: 
‘‘(1) A submission of a notification, in a man-
ner specified by the Secretary, by both such individ-
uals to the issuer of such group health insurance 
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coverage or plan electing to discontinue such pri-
mary coverage for such child. 
‘‘(2) The loss of coverage under such group 
health insurance coverage or plan of such individual 
who is enrolled under such health insurance coverage 
or plan. 
‘‘(b) ELECTION OF PRIMARY COVERAGE WITH RE-
SPECT TO SINGLE COVERAGE OR PLAN.—The provisions 
of subsection (a) shall not apply if both individuals de-
scribed in such paragraph submit notifications for a child 
with respect to multiple policies of health insurance cov-
erage or group health plans.’’. 
(2) TECHNICAL
AMENDMENT.—The table of 
contents in section 1 of such Act is amended by in-
serting after the item relating to section 725 the fol-
lowing new item: 
‘‘Sec. 726. Parental choice of primary health insurance coverage or primary 
coverage under a group health plan for certain dependent chil-
dren.’’. 
(c) INTERNAL REVENUE CODE OF 1986.— 
(1) IN
GENERAL.—Subchapter B of chapter 
100 of the Internal Revenue Code of 1986 is amend-
ed by adding at the end the following new section: 
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‘‘SEC. 9826. PARENTAL CHOICE OF PRIMARY HEALTH IN-
SURANCE 
COVERAGE 
OR 
PRIMARY 
COV-
ERAGE UNDER A GROUP HEALTH PLAN FOR 
CERTAIN DEPENDENT CHILDREN. 
‘‘(a) IN GENERAL.—In the case of a dependent child 
of two individuals where both such individuals, at the time 
of birth of such child, are covered under separate policies 
of health insurance coverage offered by a health insurance 
issuer or separate group health plans, if both such policies 
of health insurance coverage or plans (as applicable) would 
provide coverage of such child, such group health plan 
shall provide primary coverage of such child if both such 
individuals submit to such plan, within 60 days of the 
birth of such child and in a manner specified by the Sec-
retary, a notification electing primary coverage of such 
child under such plan. Such primary coverage of such 
child under such group health plan shall continue until 
the earlier of the following: 
‘‘(1) A submission of a notification, in a man-
ner specified by the Secretary, by both such individ-
uals to such plan electing to discontinue such pri-
mary coverage for such child. 
‘‘(2) The loss of coverage under such plan of 
such individual who is enrolled under such plan. 
‘‘(b) ELECTION OF PRIMARY COVERAGE WITH RE-
SPECT TO SINGLE COVERAGE OR PLAN.—The provisions 
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of subsection (a) shall not apply if both individuals de-
scribed in such paragraph submit notifications for a child 
with respect to multiple policies of health insurance cov-
erage or group health plans.’’. 
(2) TECHNICAL
AMENDMENT.—The table of 
sections for such subchapter is amended by adding 
at the end the following new item: 
‘‘Sec. 9826. Parental choice of primary health insurance coverage or primary 
coverage under a group health plan for certain dependent chil-
dren.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to children born on 
or after January 1, 2022. 
Æ 
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