I 
111TH CONGRESS 
1ST SESSION H. R. 2292 
To amend the Employee Retirement Income Security Act of 1974, the Public 
Health Service Act, and the Internal Revenue Code of 1986 to require 
coverage of preventive care for children. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 6, 2009 
Mr. THOMPSON of California (for himself and Mr. BLUMENAUER) introduced 
the following bill; which was referred to the Committee on Ways and 
Means, and in addition to the Committees on Education and Labor and 
Energy and Commerce, 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 the Employee Retirement Income Security Act 
of 1974, the Public Health Service Act, and the Internal 
Revenue Code of 1986 to require coverage of preventive 
care for children. 
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 ‘‘Healthy Kids for Healthy 
Futures Act of 2009’’. 
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SEC. 2. COVERAGE OF PREVENTIVE CARE FOR CHILDREN. 
(a) AMENDMENTS OF ERISA.— 
(1) IN GENERAL.—Subpart B of part 7 of title 
I of the Employee Retirement Income Security Act 
of 1974 (29 U.S.C. 1185 et seq.) is amended by 
adding at the end the following: 
‘‘SEC. 714. COVERAGE OF PREVENTIVE CARE FOR CHIL-
DREN. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer providing health insurance cov-
erage in connection with a group health plan, shall provide 
coverage for appropriate preventive care for each qualified 
dependent child of the participant. 
‘‘(b) APPROPRIATE PREVENTIVE CARE.—For pur-
poses of this section, the term ‘appropriate preventive 
care’ means medical care which, under regulations pre-
scribed by the Secretary of Health and Human Services, 
in consultation with the Secretary and the Secretary of 
the Treasury, meets the most recent Bright Futures 
Guidelines for Health Supervision of Infants, Children, 
and Adolescents. 
‘‘(c) QUALIFIED DEPENDENT CHILD.—For purposes 
of this section, the term ‘qualified dependent child’ means 
a child of the participant who— 
‘‘(1) is not more than 18 years of age, and 
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‘‘(2) is a dependent child, under the terms of 
the plan or coverage, of the participant. 
‘‘(d) COST-SHARING PROHIBITED.—A group health 
plan and health insurance coverage provided in connection 
with a group health plan may not impose deductibles, co-
payments, coinsurance, or other cost-sharing in relation 
to services provided pursuant to the requirements of sub-
section (a). 
‘‘(e) CERTAIN COVERAGE RESTRICTIONS PROHIB-
ITED.—A group health plan, and a health insurance issuer 
providing coverage in connection with a group health plan, 
may not— 
‘‘(1) deny to a participant or beneficiary eligi-
bility, or continued eligibility, to enroll or to renew 
coverage under the terms of the plan solely for the 
purpose of avoiding the requirements of this section, 
or 
‘‘(2) penalize, or otherwise reduce or limit the 
reimbursement of, an attending provider, or provide 
incentives (monetary or otherwise) to an attending 
provider, so as to induce the provider to provide care 
to a beneficiary in a manner inconsistent with this 
section. 
‘‘(f) ALLOWANCE FOR LEVEL OR TYPE OF PROVIDER 
REIMBURSEMENT.—Nothing in this section shall be con-
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strued to prevent a group health plan or a health insur-
ance issuer providing health insurance coverage in connec-
tion with a group health plan from negotiating the level 
and type of reimbursement with a provider for care pro-
vided in accordance with this section. 
‘‘(g) NOTICE.—A group health plan, and a health in-
surance issuer providing health insurance coverage in con-
nection with a group health plan, shall provide notice to 
each participant and beneficiary under such plan regard-
ing the coverage required by this section in accordance 
with regulations which shall be promulgated by the Sec-
retary, in consultation with the Secretary of Health and 
Human Services and the Secretary of the Treasury. Such 
notice shall be in writing and prominently positioned in 
any literature or correspondence made available or distrib-
uted to participants and beneficiaries by the plan or issuer 
on an annual or other more frequent periodic basis. 
‘‘(h) RELATION TO STATE LAWS.—Nothing in this 
section shall be construed to preempt or otherwise limit 
any State law with respect to health insurance coverage 
that requires more extensive coverage than is otherwise 
required under this section.’’. 
(2) CONFORMING AMENDMENT.—The table of 
contents in section 1 of such Act is amended by in-
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serting after the item relating to section 713 the fol-
lowing new item: 
‘‘Sec. 714. Coverage of preventive care for children.’’. 
(b) AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT.— 
(1) GROUP MARKETS.—Subpart 2 of part A of 
title XXVII of the Public Health Service Act (42 
U.S.C. 300gg–4 et seq.) is amended by adding at 
the end the following new section: 
‘‘SEC. 2707. COVERAGE OF PREVENTIVE CARE FOR CHIL-
DREN. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer providing health insurance cov-
erage in connection with a group health plan, shall provide 
coverage for appropriate preventive care for each qualified 
dependent child of the participant. 
‘‘(b) APPROPRIATE PREVENTIVE CARE.—For pur-
poses of this section, the term ‘appropriate preventive 
care’ means medical care which, under regulations pre-
scribed by the Secretary, in consultation with the Sec-
retary of Labor and the Secretary of the Treasury, meets 
the most recent Bright Futures Guidelines for Health Su-
pervision of Infants, Children, and Adolescents. 
‘‘(c) QUALIFIED DEPENDENT CHILD.—For purposes 
of this section, the term ‘qualified dependent child’ means 
a child of the participant who— 
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‘‘(1) is not more than 18 years of age, and 
‘‘(2) is a dependent child, under the terms of 
the plan or coverage, of the participant. 
‘‘(d) COST-SHARING PROHIBITED.—A group health 
plan and health insurance coverage provided in connection 
with a group health plan may not impose deductibles, co-
payments, coinsurance, or other cost-sharing in relation 
to services provided pursuant to the requirements of sub-
section (a). 
‘‘(e) CERTAIN COVERAGE RESTRICTIONS PROHIB-
ITED.—A group health plan, and a health insurance issuer 
providing coverage in connection with a group health plan, 
may not— 
‘‘(1) deny to a participant or beneficiary eligi-
bility, or continued eligibility, to enroll or to renew 
coverage under the terms of the plan solely for the 
purpose of avoiding the requirements of this section, 
or 
‘‘(2) penalize, or otherwise reduce or limit the 
reimbursement of, an attending provider, or provide 
incentives (monetary or otherwise) to an attending 
provider, so as to induce the provider to provide care 
to a beneficiary in a manner inconsistent with this 
section. 
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‘‘(f) ALLOWANCE FOR LEVEL OR TYPE OF PROVIDER 
REIMBURSEMENT.—Nothing in this section shall be con-
strued to prevent a group health plan or a health insur-
ance issuer providing health insurance coverage in connec-
tion with a group health plan from negotiating the level 
and type of reimbursement with a provider for care pro-
vided in accordance with this section. 
‘‘(g) NOTICE.—A group health plan, and a health in-
surance issuer providing health insurance coverage in con-
nection with a group health plan, shall provide notice to 
each participant and beneficiary under such plan regard-
ing the coverage required by this section in accordance 
with regulations which shall be promulgated by the Sec-
retary of Labor, in consultation with the Secretary and 
the Secretary of the Treasury. Such notice shall be in writ-
ing and prominently positioned in any literature or cor-
respondence made available or distributed to participants 
and beneficiaries by the plan or issuer on an annual or 
other more frequent periodic basis. 
‘‘(h) RELATION TO STATE LAWS.—Nothing in this 
section shall be construed to preempt or otherwise limit 
any State law with respect to health insurance coverage 
that requires more extensive coverage than is otherwise 
required under this section.’’. 
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(2) INDIVIDUAL MARKET.—Subpart 3 of part B 
of title XXVII of such Act (42 U.S.C. 300gg–51 et 
seq.) is amended by adding at the end the following 
new section: 
‘‘SEC. 2753. COVERAGE OF PREVENTIVE CARE FOR CHIL-
DREN. 
‘‘The provisions of section 2707 shall apply to health 
insurance coverage offered by a health insurance issuer 
in the individual market in the same manner as they apply 
to health insurance coverage offered by a health insurance 
issuer in connection with a group health plan in the small 
or large group market.’’. 
(c) AMENDMENTS
TO
THE INTERNAL REVENUE 
CODE.— 
(1) IN
GENERAL.—Subchapter B of chapter 
100 of the Internal Revenue Code of 1986 (relating 
to other group health plan requirements) is amended 
by inserting after section 9812 the following new 
section: 
‘‘SEC. 9813. COVERAGE OF PREVENTIVE CARE FOR CHIL-
DREN. 
‘‘(a) IN GENERAL.—A group health plan shall pro-
vide coverage for appropriate preventive care for each 
qualified dependent child of the participant. 
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‘‘(b) APPROPRIATE PREVENTIVE CARE.—For pur-
poses of this section, the term ‘appropriate preventive 
care’ means medical care which, under regulations pre-
scribed by the Secretary of Health and Human Services 
in consultation with the Secretary and the Secretary of 
Labor, meets the most recent Bright Futures Guidelines 
for Health Supervision of Infants, Children, and Adoles-
cents. 
‘‘(c) QUALIFIED DEPENDENT CHILD.—For purposes 
of this section, the term ‘qualified dependent child’ means 
a child of the participant who— 
‘‘(1) is not more than 18 years of age, and 
‘‘(2) is a dependent child, under the terms of 
the plan or coverage, of the participant. 
‘‘(d) COST-SHARING PROHIBITED.—A group health 
plan may not impose deductibles, copayments, coinsur-
ance, or other cost-sharing in relation to services provided 
pursuant to the requirements of subsection (a). 
‘‘(e) CERTAIN COVERAGE RESTRICTIONS PROHIB-
ITED.—A group health plan may not— 
‘‘(1) deny to a participant or beneficiary eligi-
bility, or continued eligibility, to enroll or to renew 
coverage under the terms of the plan solely for the 
purpose of avoiding the requirements of this section, 
or 
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‘‘(2) penalize, or otherwise reduce or limit the 
reimbursement of, an attending provider, or provide 
incentives (monetary or otherwise) to an attending 
provider, so as to induce the provider to provide care 
to a beneficiary in a manner inconsistent with this 
section. 
‘‘(f) ALLOWANCE FOR LEVEL OR TYPE OF PROVIDER 
REIMBURSEMENT.—Nothing in this section shall be con-
strued to prevent a group health plan or a health insur-
ance issuer providing health insurance coverage in connec-
tion with a group health plan from negotiating the level 
and type of reimbursement with a provider for care pro-
vided in accordance with this section. 
‘‘(g) NOTICE.—A group health plan shall provide no-
tice to each participant and beneficiary under such plan 
regarding the coverage required by this section in accord-
ance with regulations which shall be promulgated by the 
Secretary of Labor, in consultation with the Secretary and 
the Secretary of Health and Human Services. Such notice 
shall be in writing and prominently positioned in any lit-
erature or correspondence made available or distributed 
to participants and beneficiaries by the plan or issuer on 
an annual or other more frequent periodic basis. 
‘‘(h) RELATION TO STATE LAWS.—Nothing in this 
section shall be construed to preempt or otherwise limit 
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any State law with respect to health insurance coverage 
that requires more extensive coverage than is otherwise 
required under this section.’’. 
(2) CONFORMING AMENDMENT.—The table of 
sections for subchapter B of chapter 100 of such 
Code is amended by inserting after the item relating 
to section 9812 the following new item: 
‘‘Sec. 9813. Coverage of preventive care for children.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this Act shall apply with respect to plan years beginning 
on or after January 1, 2010. 
(e) INITIAL NOTICE.—Each group health plan and 
health insurance issuer to which the notice requirements 
of section 714(g) of the Employee Retirement Income Se-
curity Act of 1974, section 2707(g) of the Public Health 
Service Act, or section 9813(g) of the Internal Revenue 
Code of 1986 apply shall be deemed not in compliance 
with such requirements with respect to the first plan year 
beginning on or after January 1, 2010, unless, not later 
than January 1, 2010, the plan or issuer includes the in-
formation described in such section in a notice which is 
provided to each participant and beneficiary in writing. 
SEC. 3. COVERAGE OF PREVENTATIVE CARE FOR CHIL-
DREN UNDER HEALTH SAVINGS ACCOUNTS. 
(a) IN GENERAL.—Paragraph (2) of section 223(c) 
of the Internal Revenue Code of 1986 (defining high de-
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