IB 
Union Calendar No. 22 
116TH CONGRESS 
1ST SESSION 
H. R. 986 
[Report No. 116–44, Part I] 
To provide that certain guidance related to waivers for State innovation 
under the Patient Protection and Affordable Care Act shall have no 
force or effect. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 6, 2019 
Ms. KUSTER of New Hampshire (for herself, Mr. BEYER, and Mr. COURTNEY) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committee on 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 
APRIL 30, 2019 
Additional sponsors: Mr. WELCH, Ms. SCHAKOWSKY, Ms. CASTOR of Florida, 
Mr. GOLDEN, Ms. BLUNT ROCHESTER, Mrs. DINGELL, Mr. KENNEDY, 
Mr. RUSH, Mr. RUIZ, Mr. PALLONE, Ms. ESHOO, Ms. MATSUI, Mr. VAN 
DREW, Ms. CLARKE of New York, Ms. MCCOLLUM, Mr. SCHRADER, and 
Ms. MUCARSEL-POWELL 
APRIL 30, 2019 
Reported from the Committee on Energy and Commerce 
APRIL 30, 2019 
Committee on Ways and Means discharged; committed to the Committee of 
the Whole House on the State of the Union and ordered to be printed 
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A BILL 
To provide that certain guidance related to waivers for State 
innovation under the Patient Protection and Affordable 
Care Act shall have no force or effect. 
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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 ‘‘Protecting Americans 
with Preexisting Conditions Act of 2019’’. 
SEC. 2. PROVIDING THAT CERTAIN GUIDANCE RELATED TO 
WAIVERS FOR STATE INNOVATION UNDER 
THE PATIENT PROTECTION AND AFFORD-
ABLE CARE ACT SHALL HAVE NO FORCE OR 
EFFECT. 
Beginning April 1, 2019, the Secretary of Health and 
Human Services and the Secretary of the Treasury may 
not take any action to implement, enforce, or otherwise 
give effect to the guidance entitled ‘‘State Relief and Em-
powerment Waivers’’ (83 Fed. Reg. 53575 (October 24, 
2018)), and the Secretaries may not promulgate any sub-
stantially similar guidance or rule. 
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H986
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Union Calendar No. 22 
116TH CONGRESS 
1ST SESSION 
H. R. 986 
[Report No. 116–44, Part I] 
A BILL 
To provide that certain guidance related to waivers 
for State innovation under the Patient Protection 
and Affordable Care Act shall have no force or 
effect. 
APRIL 30, 2019 
Reported from the Committee on Energy and Commerce 
APRIL 30, 2019 
Committee on Ways and Means discharged; committed to 
the Committee of the Whole House on the State of the 
Union and ordered to be printed 
VerDate Sep 11 2014 
21:46 Apr 30, 2019
Jkt 089200
PO 00000
Frm 00004
Fmt 6651
Sfmt 6651
E:\BILLS\H986.RH
H986
amozie on DSK9F9SC42PROD with BILLS