I 
113TH CONGRESS 
2D SESSION 
H. R. 5328 
To amend the Public Health Service Act to prohibit application of preexisting 
condition exclusions and to guarantee availability of health insurance 
coverage in the individual and group market, contingent on the enactment 
of legislation repealing the Patient Protection and Affordable Care Act, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 31, 2014 
Mr. COFFMAN (for himself, Mr. PEARCE, and Mr. VALADAO) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to prohibit applica-
tion of preexisting condition exclusions and to guarantee 
availability of health insurance coverage in the individual 
and group market, contingent on the enactment of legis-
lation repealing the Patient Protection and Affordable 
Care Act, and for other purposes. 
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 ‘‘Guaranteed Health 
Coverage for Pre-Existing Conditions Act of 2014’’. 
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SEC. 2. PROHIBITION OF PREEXISTING CONDITION EXCLU-
SIONS. 
(a) GROUP MARKET.—Subpart 1 of part A of title 
XXVII of the Public Health Service Act (42 U.S.C. 300gg 
et seq.) is amended by striking section 2701 and inserting 
the following: 
‘‘SEC. 2701. PROHIBITION OF PREEXISTING CONDITION EX-
CLUSIONS. 
‘‘(a) IN GENERAL.—A group health plan or a health 
insurance issuer offering group health insurance coverage 
may not impose any preexisting condition exclusion with 
respect to such plan or coverage. 
‘‘(b) DEFINITIONS.—For purposes of this section: 
‘‘(1) PREEXISTING CONDITION EXCLUSION.— 
‘‘(A) IN GENERAL.—The term ‘preexisting 
condition exclusion’ means, with respect to a 
group health plan or health insurance coverage, 
a limitation or exclusion of benefits relating to 
a condition based on the fact that the condition 
was present before the date of enrollment in 
such plan or for such coverage, whether or not 
any medical advice, diagnosis, care, or treat-
ment was recommended or received before such 
date. 
‘‘(B) TREATMENT OF GENETIC INFORMA-
TION.—Genetic information shall not be treated 
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as a preexisting condition in the absence of a 
diagnosis of the condition related to such infor-
mation. 
‘‘(2) DATE OF ENROLLMENT.—The term ‘date 
of enrollment’ means, with respect to an individual 
covered under a group health plan or health insur-
ance coverage, the date of enrollment of the indi-
vidual in the plan or coverage or, if earlier, the first 
day of the waiting period for such enrollment. 
‘‘(3) WAITING PERIOD.—The term ‘waiting pe-
riod’ means, with respect to a group health plan and 
an individual who is a potential participant or bene-
ficiary in the plan, the period that must pass with 
respect to the individual before the individual is eli-
gible to be covered for benefits under the terms of 
the plan.’’. 
(b) INDIVIDUAL MARKET.—Subpart 1 of part B of 
title XXVII of the Public Health Service Act (42 U.S.C. 
300gg–41 et seq.) is amended by adding at the end the 
following: 
‘‘SEC. 2746. PROHIBITION OF PREEXISTING CONDITION EX-
CLUSIONS 
OR 
OTHER 
DISCRIMINATION 
BASED ON HEALTH STATUS. 
‘‘The provisions of section 2701 shall apply to health 
insurance coverage offered to individuals by a health in-
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surance issuer in the individual market in the same man-
ner as it applies to health insurance coverage offered by 
a health insurance issuer in the group market.’’. 
SEC. 3. GUARANTEED AVAILABILITY OF COVERAGE. 
(a) GROUP MARKET.—Subpart 3 of part A of title 
XXVII of the Public Health Service Act is amended by 
striking section 2711 (42 U.S.C. 300gg–11) and inserting 
the following: 
‘‘SEC. 2711. GUARANTEED AVAILABILITY OF COVERAGE. 
‘‘(a) GUARANTEED ISSUANCE OF COVERAGE IN THE 
GROUP MARKET.—Subject to subsection (b), each health 
insurance issuer that offers health insurance coverage in 
the group market in a State shall accept every employer 
and every individual in a group in the State that applies 
for such coverage. 
‘‘(b) ENROLLMENT.— 
‘‘(1) RESTRICTION.—A health insurance issuer 
described in subsection (a) may restrict enrollment 
in coverage described in such subsection to open or 
special enrollment periods. 
‘‘(2) ESTABLISHMENT.—A health insurance 
issuer described in subsection (a) shall establish spe-
cial enrollment periods for qualifying events (as such 
term is defined in section 603 of the Employee Re-
tirement Income Security Act of 1974).’’. 
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(b) INDIVIDUAL MARKET.—Subpart 1 of part B of 
title XXVII of the Public Health Service Act is amended 
by striking section 2741 of such Act (42 U.S.C. 300gg– 
41) and inserting the following: 
‘‘SEC. 2741. GUARANTEED AVAILABILITY OF COVERAGE. 
‘‘The provisions of section 2711 shall apply to health 
insurance coverage offered to individuals by a health in-
surance issuer in the individual market in the same man-
ner as such provisions apply to health insurance coverage 
offered to employers by a health insurance issuer in con-
nection with health insurance coverage in the group mar-
ket. For purposes of this section, the Secretary shall treat 
any reference of the word ‘employer’ in such section as 
a reference to the term ‘individual’.’’. 
SEC. 4. EFFECTIVE DATE CONTINGENT ON REPEAL OF 
PPACA. 
(a) IN GENERAL.—Sections 2 and 3 and the amend-
ments made by such section shall take effect upon the en-
actment of PPACA repeal legislation described in sub-
section (b) and such sections and amendments shall have 
no force or effect if such PPACA repeal legislation is not 
enacted. 
(b) PPACA REPEAL LEGISLATION DESCRIBED.— 
For purposes of subsection (a), PPACA repeal legislation 
described in this subsection is legislation that— 
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(1) repeals Public Law 111–148, and restores 
or revives the provisions of law amended or repealed, 
respectively, by such Act as if such Act had not been 
enacted and without further amendment to such 
provisions of law; and 
(2) repeals title I and subtitle B of title II of 
the Health Care and Education Reconciliation Act of 
2010 (Public Law 111–152), and restores or revives 
the provisions of law amended or repealed, respec-
tively, by such title or subtitle, respectively, as if 
such title and subtitle had not been enacted and 
without further amendment to such provisions of 
law. 
Æ 
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