I 
110TH CONGRESS 
1ST SESSION H. R. 2833 
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 provide additional limitations on preexisting condition 
exclusions in group health plans and health insurance coverage in the 
group and individual markets. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 22, 2007 
Mr. COURTNEY (for himself and Mr. GEORGE MILLER of California) intro-
duced 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 jurisdiction of the committee concerned 
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-
vide additional limitations on preexisting condition exclu-
sions in group health plans and health insurance cov-
erage 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, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Preexisting Condition 
Exclusion Patient Protection Act of 2007’’. 
SEC. 2. AMENDMENTS RELATING TO PREEXISTING CONDI-
TION EXCLUSIONS UNDER GROUP HEALTH 
PLANS. 
(a) AMENDMENTS TO THE EMPLOYEE RETIREMENT 
INCOME SECURITY ACT OF 1974.— 
(1) REDUCTION IN LOOK-BACK PERIOD.—Sec-
tion 701(a)(1) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1181(a)(1)) is 
amended by striking ‘‘6-month period’’ and inserting 
‘‘30-day period’’. 
(2) REDUCTION
IN
PERMITTED
PREEXISTING 
CONDITION LIMITATION PERIOD.—Section 701(a)(2) 
of such Act (29 U.S.C. 1181(a)(2)) is amended by 
striking ‘‘12 months’’ and inserting ‘‘3 months’’, 
and by striking ‘‘18 months’’ and inserting ‘‘9 
months’’. 
(b) AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT.— 
(1) REDUCTION IN LOOK-BACK PERIOD.—Sec-
tion 2701(a)(1) of the Public Health Service Act (42 
U.S.C. 300gg(a)(1)) is amended by striking ‘‘6- 
month period’’ and inserting ‘‘30-day period’’. 
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(2) REDUCTION
IN
PERMITTED
PREEXISTING 
CONDITION
LIMITATION
PERIOD.—Section 
2701(a)(2) of such Act (42 U.S.C. 300gg(a)(2)) is 
amended by striking ‘‘12 months’’ and inserting ‘‘3 
months’’, and by striking ‘‘18 months’’ and inserting 
‘‘9 months’’. 
(c) AMENDMENTS
TO
THE INTERNAL REVENUE 
CODE OF 1986.— 
(1) REDUCTION IN LOOK-BACK PERIOD.—Para-
graph (1) of section 9801(a) of the Internal Revenue 
Code of 1986 (relating to limitation on preexisting 
condition exclusion period and crediting for periods 
of previous coverage) is amended by striking ‘‘6- 
month period’’ and inserting ‘‘30-day period’’. 
(2) REDUCTION
IN
PERMITTED
PREEXISTING 
CONDITION LIMITATION PERIOD.—Paragraph (2) of 
section 9801(a) of such Code is amended by striking 
‘‘12 months’’ and inserting ‘‘3 months’’, and by 
striking ‘‘18 months’’ and inserting ‘‘9 months’’. 
(d) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section 
shall apply with respect to group health plans for 
plan years beginning after the end of the 12th cal-
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endar month following the date of the enactment of 
this Act. 
(2) SPECIAL
RULE
FOR
COLLECTIVE
BAR-
GAINING
AGREEMENTS.—In the case of a group 
health plan maintained pursuant to one or more col-
lective bargaining agreements between employee rep-
resentatives and one or more employers ratified be-
fore the date of the enactment of this Act, the 
amendments made by this section shall not apply to 
plan years beginning before the earlier of— 
(A) the date on which the last of the col-
lective bargaining agreements relating to the 
plan terminates (determined without regard to 
any extension thereof agreed to after the date 
of the enactment of this Act), or 
(B) 3 years after the date of the enact-
ment of this Act. 
For purposes of subparagraph (A), any plan amend-
ment made pursuant to a collective bargaining 
agreement relating to the plan which amends the 
plan solely to conform to any requirement added by 
the amendments made by this section shall not be 
treated as a termination of such collective bar-
gaining agreement. 
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SEC. 3. AMENDMENTS RELATING TO PREEXISTING CONDI-
TION EXCLUSIONS IN HEALTH INSURANCE 
COVERAGE IN THE INDIVIDUAL MARKET. 
(a) APPLICABILITY OF GROUP HEALTH INSURANCE 
LIMITATIONS ON IMPOSITION OF PREEXISTING CONDI-
TION EXCLUSIONS.— 
(1) IN GENERAL.—Section 2741 of the Public 
Health Service Act (42 U.S.C. 300gg–41) is amend-
ed— 
(A) by redesignating the second subsection 
(e) (relating to market requirements) and sub-
section (f) as subsections (f) and (g), respec-
tively; and 
(B) by adding at the end the following new 
subsection: 
‘‘(h) APPLICATION OF GROUP HEALTH INSURANCE 
LIMITATIONS ON IMPOSITION OF PREEXISTING CONDI-
TION EXCLUSIONS.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), a 
health insurance issuer that provides individual 
health insurance coverage may not impose a pre-
existing condition exclusion (as defined in subsection 
(b)(1)(A) of section 2701) with respect to such cov-
erage except to the extent that such exclusion could 
be imposed consistent with such section if such cov-
erage were group health insurance coverage. 
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‘‘(2) LIMITATION.—In the case of an individual 
who— 
‘‘(A) is enrolled in individual health insur-
ance coverage; 
‘‘(B) during the period of such enrollment 
has a condition for which no medical advice, di-
agnosis, care, or treatment had been rec-
ommended or received as of the enrollment 
date; and 
‘‘(C) seeks to enroll under other individual 
health insurance coverage which provides bene-
fits different from those provided under the cov-
erage referred to in subparagraph (A) with re-
spect to such condition, 
the issuer of the individual health insurance cov-
erage described in subparagraph (C) may impose a 
preexisting condition exclusion with respect to such 
condition and any benefits in addition to those pro-
vided under the coverage referred to in subpara-
graph (A), but such exclusion may not extend for a 
period of more than 3 months.’’. 
(2) ELIMINATION OF COBRA REQUIREMENT.— 
Subsection (b) of such section is amended— 
(A) by adding ‘‘and’’ at the end of para-
graph (2); 
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