I
104TH CONGRESS
2D SESSION
H. R. 3145
To amend the Public Health Service Act to prohibit health insurance
discrimination with respect to victims of domestic violence.
IN THE HOUSE OF REPRESENTATIVES
MARCH 21, 1996
Mrs. MORELLA (for herself and Mr. SCHUMER) introduced the following bill;
which was referred to the Committee on Commerce, and in addition to
the Committee on Economic and Educational Opportunities, 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 the Public Health Service Act to prohibit health
insurance discrimination with respect to victims of do-
mestic violence.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Insurance Protection
for Victims of Domestic Violence Act of 1996’’.
SEC. 2. PROHIBITION OF HEALTH INSURANCE DISCRIMINA-
TION WITH RESPECT TO VICTIMS OF DOMES-
TIC VIOLENCE.
The Public Health Service Act (42 U.S.C. 201 et
seq.) is amended by adding at the end the following new
title:
‘‘TITLE XXVII—PROHIBITION OF
HEALTH 
INSURANCE 
DIS-
CRIMINATION WITH RESPECT
TO VICTIMS OF DOMESTIC VI-
OLENCE
‘‘SEC. 2701. LIMITATIONS ON UNDERWRITING.
‘‘An insurer may not deny or cancel health insurance,
or vary the terms and conditions of health insurance—
‘‘(1) to an individual on the basis that the indi-
vidual or family member—
‘‘(A) is, has been, or may be the subject of
an act of domestic violence;
‘‘(B) has had prior injuries that resulted
from an act of domestic violence;
‘‘(C) seeks, has sought, or should have
sought medical or psychological treatment for
protection against an act of domestic violence;
or
‘‘(D) seeks, has sought, or should have
sought shelter from an act of domestic violence;
or
‘‘(2) to or for a group or employer on the basis
that the group includes or the employer employs, or
provides or subsidizes insurance for, an individual
described in paragraph (1).
‘‘SEC. 2702. LIMITATION ON DISCLOSURE OF INFORMATION.
‘‘(a) PROHIBITION.—Except as provided in para-
graph (2), regardless of the manner in which information
was received, an insurer may not disclose or be compelled
(by subpoena or any other means) to disclose information
concerning the status of an individual as a victim of do-
mestic violence (including the relationship of a medical
condition to an incident or pattern of domestic violence),
or the status of an individual as a family member, em-
ployer, associate, or person in a relationship with an indi-
vidual who is the victim of domestic violence, unless the
individual involved provides a written authorization.
‘‘(b) EXCEPTION.—Notwithstanding paragraph (1),
information concerning the abuse status of an individual
may be disclosed if such disclosure—
‘‘(1) is required under the specific order of a
Federal or State court; or
‘‘(2) is required by the State Insurance Com-
missioner.
‘‘SEC. 2703. ESTABLISHMENT OF STANDARDS.
‘‘(a) ROLE OF NATIONAL ASSOCIATION OF INSUR-
ANCE COMMISSIONERS.—
‘‘(1) IN GENERAL.—The Secretary shall request
the National Association of Insurance Commis-
sioners to develop, in consultation with nonprofit do-
mestic violence victim advocacy organizations, within
9 months after the date of the enactment of this
title, model standards that incorporate the limita-
tions on underwriting set forth in section 2701, and
provide procedures for enforcement for such provi-
sions, including a private right of action.
‘‘(2) REVIEW OF STANDARDS.—If the Associa-
tion develops recommended regulations specifying
the standards within the period, the Secretary shall
review the standards. The review shall be completed
within 90 days after the date the regulations are de-
veloped. Unless the Secretary determines within the
period that such standards do not meet the require-
ments, such standards shall serve as the standards
under this title, with such amendments as the Sec-
retary determines to be necessary.
‘‘(b) CONTINGENCY.—If the Association does not de-
velop the model regulations within the 9 month period be-
ginning on the date of the enactment of this title, or the
Secretary determines that the regulations do not specify
standards that meet the requirements described in sub-
section (a), the Secretary shall specify, within 15 months
after the date of the enactment of this title, standards to
carry out the requirements.
‘‘(c) APPLICATION OF STANDARDS.—
‘‘(1) IN GENERAL.—Each State shall submit to
the Secretary, by the deadline specified in paragraph
(2), a report on actions the State is taking to imple-
ment and enforce the standards established under
this section with respect to insurers and health in-
surance coverage offered or renewed not later than
such deadline.
‘‘(2) DEADLINE
FOR
REPORT.—Each State
shall file the report described in paragraph (1) not
later than 1 year after the date that standards are
established under subsection (a) or, in the event of
the failure of the Association to develop timely model
regulations, under subsection (b).
‘‘(d) FEDERAL ROLE.—
‘‘(1) NOTICE OF DEFICIENCY.—If the Secretary
determines that a State has failed to submit a report
by the deadline specified by subsection (c), or finds
that the State has not implemented and provided
adequate enforcement of the standards established
under subsection (a) or (b), the Secretary shall no-
tify the State and provide the State a period of 60
days in which to submit the report.
‘‘(2) IMPLEMENTATION OF ALTERNATIVE EN-
FORCEMENT MECHANISM.—
‘‘(A) IN GENERAL.—If, after the 60-day
period, the Secretary finds that such a failure
has not been corrected, the Secretary shall
within 30 days provide for a mechanism for the
implementation and enforcement of such stand-
ards in the State as the Secretary determines to
be appropriate.
‘‘(B) CIVIL PENALTY.—Under any imple-
mentation and enforcement mechanism estab-
lished by the Secretary pursuant to this para-
graph, the Secretary shall have the authority to
impose on an insurer a civil monetary penalty
in the amount of $10,000 for each day during
which such insurer violates the requirements
described in section 2701, or the standards de-
veloped under this section. Liability for such
penalty shall begin to accrue on the 30th day
after the Secretary has provided such insurer
with notice of its noncompliance, if the insurer
has failed to correct the deficiency by such date.
‘‘(C) EFFECTIVE PERIOD.—Any such im-
plementation and enforcement mechanism es-
tablished by the Secretary shall take effect with
respect to insurers, and health insurance cov-
erage offered or renewed, on or after 3 months
after the date of the Secretary’s finding under
paragraph (1), and until the date the Secretary
finds that such a failure has been corrected.
‘‘(3) FEDERAL CIVIL RIGHT OF ACTION.—
‘‘(A) IN
GENERAL.—Any individual
aggrieved as a result of conduct prohibited
by section 2701 may bring a civil action in
the appropriate United States district
court against the insurer.
‘‘(B) RELIEF.—Upon proof of such
conduct by a preponderance of the evi-
dence, the insurer shall be subject to a civil
penalty that may include temporary, pre-
liminary, or permanent injunctive relief
and compensatory and punitive damages,
as well as the costs of suit and reasonable
fees for the aggrieved individual’s attor-
neys. With respect to compensatory dam-
ages, the aggrieved individual may elect, at
any time prior to the rendering of final
judgment, to recover in lieu of actual dam-
ages, an award of statutory damages in the
amount of $5,000 for each violation.
‘‘SEC. 2704. APPLICATION TO GROUP HEALTH PLANS AND
ENFORCEMENT.
‘‘(a) APPLICATION.—Subject to subsection (b), the
prohibitions in section 2701 and the standards developed
under section 2702 shall apply to group health plans pro-
viding health coverage in the same manner as they apply
to insurers providing health insurance coverage. The pen-
alty described in section 2702(d)(2)(B) may be imposed
by the Secretary of Labor on group health plans that are
not in compliance with the requirements of sections 2701
and 2702.
‘‘(b) SUBSTITUTION OF FEDERAL OFFICIALS.—For
purposes of subsection (a), any reference in section 2702
to—
‘‘(1) a State or the Secretary of Health and
Human Services is deemed to be a reference to the
Secretary of Labor; and
‘‘(2) an insurer or health insurance coverage is
deemed to be a reference to a group health plan and
health coverage, respectively.
‘‘(c) ENFORCEMENT.—For purposes of part 5 of sub-
title B of title I of the Employee Retirement Income Secu-
rity Act of 1974 (29 U.S.C 1131 et seq.) the provisions
of this title insofar as they relate to group health plans
shall be deemed to be provisions of title I of such Act irre-
spective of exclusions under section 4(b) of such Act.
‘‘(d) REGULATORY AUTHORITY.—With respect to the
regulatory authority of the Secretary of Labor under this
title pursuant to subsection (c), section 505 of the Em-
ployee Retirement Income Security Act of 1974 (29
U.S.C. 1135) shall apply.
‘‘SEC. 2705. DEFINITIONS.
‘‘For purposes of this title:
‘‘(1) ACT OF DOMESTIC VIOLENCE.—The term
‘act of domestic violence’ means the occurrence of
one or more of the following acts between family or
household members, current or former sexual or inti-
mate partners, or persons sharing biological parent-
hood—
‘‘(A) attempting to cause or intentionally,
knowingly, or recklessly causing bodily injury,
rape, or sexual abuse as such term is defined in
section 2242 of title 18, United States Code;
‘‘(B) placing, by physical menace, another
individual in reasonable fear of imminent seri-
ous bodily injury;
‘‘(C) infliction of false imprisonment; or
‘‘(D) physically or sexually abusing minor
children.
‘‘(2) ASSOCIATION.—The term ‘Association’
means the National Association of Insurance Com-
missioners.
‘‘(3) INSURER.—
‘‘(A) IN
GENERAL.—The term ‘insurer’
means a health benefit plan or a health care
provider that conducts activities related to the
protection of public health.
‘‘(B) HEALTH BENEFIT PLAN.—The term
‘health benefit plan’ means any public or pri-
vate entity or program that provides for pay-
ments for health care, including—
‘‘(i) a group health plan (as defined in
section 607 of the Employee Retirement
Income Security Act of 1974 (29 U.S.C.
1167)) or a multiple employer welfare ar-
rangement (as defined in section 3(40) of
such Act) that provides health benefits;
and
‘‘(ii) any other health insurance ar-
rangement, including any arrangement
consisting of a hospital or medical expense
incurred policy or certificate, hospital or
medical service plan contract, or health
maintenance organization subscriber con-
tract.
‘‘(C) HEALTH CARE PROVIDER.—The term
‘health care provider’ means a provider of serv-
ices (as defined in section 1861(u) of the Social
Security Act (42 U.S.C. 1395u)), a physician,
a supplier, or any other person furnishing
health care, including a Federal or State pro-
gram that provides directly for the provision of
health care to beneficiaries.’’.
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