TITLE I—NO MORE NARROW 
NETWORKS 
SEC. 101. SHORT TITLE. 
This title may be cited as the ‘‘No More Narrow Net-
works Act of 2021’’. 
SEC. 102. REQUIRING EXCHANGES TO ESTABLISH NET-
WORK ADEQUACY STANDARDS FOR QUALI-
FIED HEALTH PLANS. 
(a) IN GENERAL.—Section 1311(d) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18031(d)) 
is amended by adding at the end the following new para-
graph: 
‘‘(8) NETWORK ADEQUACY STANDARDS.— 
‘‘(A) CERTAIN EXCHANGES.—In the case 
of an Exchange operated by the Secretary pur-
suant section 1321(c)(1) or an Exchange de-
scribed in section 155.200(f) of title 42, Code 
of Federal Regulations (or a successor regula-
tion), the Exchange shall require each qualified 
health plan offered through such Exchange to 
meet such quantitative network adequacy stand-
ards as the Secretary may prescribe for pur-
poses of this subparagraph. 
‘‘(B) STATE EXCHANGES.—In the case of 
an Exchange not described in subparagraph 
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(A), the Exchange shall establish quantitative 
network adequacy standards with respect to 
qualified health plans offered through such Ex-
change and require such plans to meet such 
standards.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply with respect to plan years begin-
ning on or after January 1, 2023. 
TITLE 
II—PROTECTING 
CON-
SUMERS 
FROM 
UNREASON-
ABLE RATES 
SEC. 201. SHORT TITLE. 
This title may be cited as the ‘‘Protecting Consumers 
from Unreasonable Rates Act’’. 
SEC. 202. PROTECTION OF CONSUMERS FROM EXCESSIVE, 
UNJUSTIFIED, OR UNFAIRLY DISCRIMINA-
TORY RATES. 
(a) PROTECTION FROM EXCESSIVE, UNJUSTIFIED, 
OR UNFAIRLY DISCRIMINATORY RATES.—The first sec-
tion 2794 of the Public Health Service Act (42 U.S.C. 
300gg–94), as added by section 1003 of the Patient Pro-
tection and Affordable Care Act (Public Law 111–148), 
is amended by adding at the end the following new sub-
section: 
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‘‘(e) PROTECTION FROM EXCESSIVE, UNJUSTIFIED, 
OR UNFAIRLY DISCRIMINATORY RATES.— 
‘‘(1) AUTHORITY OF STATES.—Nothing in this 
section shall be construed to prohibit a State from 
imposing requirements (including requirements re-
lating to rate review standards and procedures and 
information reporting) on health insurance issuers 
with respect to rates that are in addition to the re-
quirements of this section and are more protective of 
consumers than such requirements. 
‘‘(2) CONSULTATION
IN
RATE
REVIEW
PROC-
ESS.—In carrying out this section, the Secretary 
shall consult with the National Association of Insur-
ance Commissioners and consumer groups. 
‘‘(3) DETERMINATION OF WHO CONDUCTS RE-
VIEWS FOR EACH STATE.—The Secretary shall de-
termine, after the date of enactment of this section 
and periodically thereafter, the following: 
‘‘(A) In which markets in each State the 
State insurance commissioner or relevant State 
regulator shall undertake the corrective actions 
under paragraph (4), based on the Secretary’s 
determination that the State regulator is ade-
quately undertaking and utilizing such actions 
in that market. 
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‘‘(B) In which markets in each State the 
Secretary shall undertake the corrective actions 
under paragraph (4), in cooperation with the 
relevant State insurance commissioner or State 
regulator, based on the Secretary’s determina-
tion that the State is not adequately under-
taking and utilizing such actions in that mar-
ket. 
‘‘(4) CORRECTIVE ACTION FOR EXCESSIVE, UN-
JUSTIFIED, 
OR
UNFAIRLY
DISCRIMINATORY 
RATES.—In accordance with the process established 
under this section, the Secretary or the relevant 
State insurance commissioner or State regulator 
shall take corrective actions to ensure that any ex-
cessive, unjustified, or unfairly discriminatory rates 
are corrected prior to implementation, or as soon as 
possible thereafter, through mechanisms such as— 
‘‘(A) denying rates; 
‘‘(B) modifying rates; or 
‘‘(C) requiring rebates to consumers. 
‘‘(5) NONCOMPLIANCE.—Failure to comply with 
any corrective action taken by the Secretary under 
this subsection may result in the application of civil 
monetary penalties under section 2723 and, if the 
Secretary determines appropriate, make the plan in-
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volved ineligible for classification as a qualified 
health plan.’’. 
(b) CLARIFICATION OF REGULATORY AUTHORITY.— 
Such section is further amended— 
(1) in subsection (a)— 
(A) in the heading, by striking ‘‘PRE-
MIUM’’ and inserting ‘‘RATE’’; 
(B) in paragraph (1), by striking ‘‘unrea-
sonable increases in premiums’’ and inserting 
‘‘potentially excessive, unjustified, or unfairly 
discriminatory rates, including premiums,’’; and 
(C) in paragraph (2)— 
(i) by striking ‘‘an unreasonable pre-
mium increase’’ and inserting ‘‘a poten-
tially excessive, unjustified, or unfairly dis-
criminatory rate’’; 
(ii) by striking ‘‘the increase’’ and in-
serting ‘‘the rate’’; and 
(iii) by striking ‘‘such increases’’ and 
inserting ‘‘such rates’’; and 
(2) in subsection (b)— 
(A) by striking ‘‘premium increases’’ each 
place it appears and inserting ‘‘rates’’; and 
(B) in paragraph (2)(B), by striking ‘‘pre-
mium’’ and inserting ‘‘rate’’. 
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