I 
111TH CONGRESS 
1ST SESSION H. R. 1619 
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 pre-existing condition exclusions for children 
in group health plans and health insurance coverage in the group and 
individual markets. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 19, 2009 
Ms. SCHWARTZ (for herself, Ms. BERKLEY, Mr. BERMAN, Mr. BISHOP of New 
York, Mr. BLUMENAUER, Mr. BRADY of Pennsylvania, Mr. CARNEY, Ms. 
CLARKE, Mr. CLAY, Mr. CLEAVER, Mr. DEFAZIO, Ms. DELAURO, Mr. 
DOGGETT, Mr. ENGEL, Mr. FARR, Mr. FATTAH, Mr. ISRAEL, Ms. EDDIE 
BERNICE JOHNSON of Texas, Ms. KAPTUR, Ms. KILPATRICK of Michi-
gan, Mrs. LOWEY, Mr. MCDERMOTT, Mr. MORAN of Virginia, Mr. NAD-
LER of New York, Ms. SCHAKOWSKY, Mr. SERRANO, Ms. SLAUGHTER, 
Ms. SUTTON, Ms. WASSERMAN SCHULTZ, Ms. WATSON, Ms. WOOLSEY, 
Mr. WU, Ms. BALDWIN, Mrs. CAPPS, Mr. LANGEVIN, Ms. PINGREE of 
Maine, Mr. MURPHY of Connecticut, Mr. PATRICK J. MURPHY of Penn-
sylvania, Mr. BARROW, Ms. MOORE of Wisconsin, Mr. TIERNEY, Mr. 
MURTHA, Mr. CROWLEY, Mr. ALTMIRE, Ms. LEE of California, Mr. 
LARSON of Connecticut, Mr. PALLONE, Mr. MICHAUD, Mr. CLYBURN, 
Mr. CONNOLLY of Virginia, Mr. WATT, Mr. ARCURI, Ms. EDWARDS of 
Maryland, Ms. DEGETTE, Mr. COHEN, Mr. WAXMAN, Mrs. HALVORSON, 
Ms. KILROY, Mr. THOMPSON of Mississippi, Mr. BRALEY of Iowa, Mr. 
HOLT, Mr. YARMUTH, Mr. SIRES, Ms. RICHARDSON, Ms. MATSUI, Mr. 
TONKO, Ms. FUDGE, Mr. HASTINGS of Florida, Mr. PERLMUTTER, Mr. 
BUTTERFIELD, Mr. KUCINICH, Mr. LOEBSACK, Ms. CORRINE BROWN of 
Florida, Ms. HIRONO, Ms. ROS-LEHTINEN, Mr. BOUCHER, Mr. DOYLE, 
Mr. MCGOVERN, Ms. LINDA T. SA´NCHEZ of California, Mr. KAGEN, Mr. 
SCHIFF, Mr. WEINER, and Mr. ELLISON) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committees on Education and Labor and Ways and 
Means, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
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A BILL 
To amend title I of the Employee Retirement Income Secu-
rity Act of 1974, title XXVII of the Public Health Serv-
ice Act, and the Internal Revenue Code of 1986 to pro-
hibit pre-existing condition exclusions for children in 
group health plans and health insurance coverage in 
the group and individual markets. 
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 ‘‘Children’s Health Pro-
tection Act of 2009’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) According to the Bureau of the Census, 
8,100,000 children and young adults are uninsured 
at some point during the year. Young adults between 
the ages of 18 and 25 years old make up 21 percent 
of the total uninsured population. 
(2) According to a recent study, approximately 
20 percent of school-aged children suffer from a 
chronic illness. 
(3) Thirteen States have passed legislation that 
increased the age of dependency for young adults for 
purposes of private insurance coverage to age 25. 
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(4) When a child or young adult has a 63-day 
gap in insurance coverage, pre-existing condition ex-
clusions, such as coverage limits or waiting periods, 
can be applied when the child or young adult be-
comes insured under a new health insurance policy. 
(5) Eliminating pre-existing condition exclu-
sions for children is a vital safeguard to ensure all 
children have access to health care when in need. 
(6) High-risk pools were created to help individ-
uals with pre-existing conditions purchase insurance 
with the assistance of government subsidies. How-
ever, State high-risk pools are often underfunded, 
unaffordable for patients, have long waiting lists and 
impose pre-existing condition waiting periods once 
enrolled. 
(7) Pre-existing condition limitation periods for 
children in the private market discourage families 
from moving off Medicaid or the Children’s Health 
Insurance Program. 
SEC. 3. PROHIBITION OF PRE-EXISTING CONDITION EXCLU-
SIONS 
FOR 
CHILDREN 
UNDER 
GROUP 
HEALTH PLANS. 
(a) AMENDMENTS TO THE EMPLOYEE RETIREMENT 
INCOME SECURITY ACT OF 1974.—Section 701(d) of the 
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Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1181(d)) is amended— 
(1) by striking paragraph (1) and inserting the 
following: 
‘‘(1) EXCLUSION
NOT
APPLICABLE
TO
CHIL-
DREN.—A group health plan, and a health insurance 
issuer offering group health insurance coverage, may 
not impose any pre-existing condition exclusion in 
the case of an individual who has not attained 25 
years of age.’’; 
(2) by striking paragraphs (2) and (4); and 
(3) by redesignating paragraph (3) as para-
graph (2). 
(b) AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT.—Section 2701(d) of the Public Health Service Act 
(42 U.S.C. 300gg(d)) is amended— 
(1) by striking paragraph (1) and inserting the 
following: 
‘‘(1) EXCLUSION
NOT
APPLICABLE
TO
CHIL-
DREN.—A group health plan, and a health insurance 
issuer offering group health insurance coverage, may 
not impose any pre-existing condition exclusion in 
the case of an individual who has not attained 25 
years of age.’’; 
(2) by striking paragraphs (2) and (4); and 
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