I 
111TH CONGRESS 
1ST SESSION H. R. 2402 
To amend the Public Health Service Act to ensure fairness in the coverage 
of women in the individual health insurance market. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 13, 2009 
Mr. NEAL of Massachusetts (for himself and Mrs. DAVIS of California) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce 
A BILL 
To amend the Public Health Service Act to ensure fairness 
in the coverage of women in the individual health insur-
ance market. 
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 ‘‘Woman’s Health In-
surance Fairness Act of 2009’’. 
SEC. 2. ELIMINATION OF GENDER RATING IN THE INDI-
VIDUAL INSURANCE MARKET. 
(a) IN GENERAL.—Subpart 2 of part B of title 
XXVII of the Public Health Service Act (42 U.S.C. May 
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4, 2009 300gg–51 et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 2754. ELIMINATION OF GENDER RATING. 
‘‘A health insurance issuer offering health insurance 
coverage in the individual market may not consider the 
gender of an enrollee when determining the amount of pre-
miums to assess such enrollee for such coverage.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to health insurance 
coverage in the individual market for plan years beginning 
on or after the date that is months after the date of enact-
ment of this Act. 
SEC. 3. PREVENTING INSURERS FROM DENYING OR LIM-
ITING COVERAGE BASED ON PREGNANCY 
AND COVERAGE OF MATERNITY CARE. 
(a) IN GENERAL.—Subpart 2 of part B of title 
XXVII of the Public Health Service Act (42 U.S.C. 18 
300gg–51 et seq.), as amended by section 2, is further 
amended by adding at the end the following: 
‘‘SEC. 2755. STANDARDS RELATING TO PREGNANCY AND 
MATERNITY CARE. 
‘‘(a) PREGNANCY, METHOD OF DELIVERY, AND OUT-
COME.—A health insurance issuer offering health insur-
ance coverage in the individual market may not impose 
any preexisting condition exclusion (as such term is de-
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fined in section 2701(b)(1)(A)) relating to pregnancy as 
a preexisting condition, impose any waiting period, deny, 
refuse to issue, renew, or reissue, substandard rate, re-
underwrite, cancel or otherwise terminate a policy, add 
any surcharge or rating factor to the premium, exclude, 
limit, or cap benefits relating to a condition, or otherwise 
discriminate in the provision of coverage, or in assessing 
premiums for such coverage, against women on the basis 
of a current or past pregnancy, or past or future method 
of delivery, and past pregnancy outcome. 
‘‘(b) MATERNITY CARE.— 
‘‘(1) IN GENERAL.—The Secretary shall— 
‘‘(A) propose a rule to develop a minimum 
benefit standard for the provision of com-
prehensive maternity coverage under an indi-
vidual health plan, which standard shall require 
coverage for the full scope of maternity services 
from preconception through postpartum, as de-
termined by the Secretary; and 
‘‘(B) periodically review the minimum ben-
efit standard for the provision of comprehensive 
maternity coverage under an individual health 
plan to ensure the minimum benefit standard 
reflects current standards of care. 
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‘‘(2) 
REQUIREMENT.—A 
health 
insurance 
issuer offering health insurance coverage in the indi-
vidual market shall ensure that the minimum benefit 
standard developed under paragraph (1) is included 
in any such coverage.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to health insurance 
coverage in the individual market for plan years beginning 
on or after the date that is 6 months after the date of 
enactment of this Act. 
SEC. 4. ENFORCEMENT AND COMPLIANCE. 
(a) PROVISION OF DATA.—The Secretary of Health 
and Human Services shall promulgate regulations to re-
quire health insurance issuers that offer health insurance 
coverage in the individual market provide data to the Sec-
retary to enable the Secretary to monitor the compliance 
of such issuers with the requirements of the amendment 
made by this Act. 
(b) FAILURE TO COMPLY.—Any health insurance 
issuer that fails to submit the data required under the reg-
ulations promulgated under subsection (a) shall be subject 
to a civil monetary penalty in an amount that is not less 
than $10,000 (as determined by the Secretary). 
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