I
104TH CONGRESS
1ST SESSION
H. R. 1191
To prohibit insurers from denying health insurance coverage or benefits or
varying premiums based on the status of an individual as a victim
of domestic violence, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH 9, 1995
Mr. SCHUMER introduced the following bill; which was referred to the Com-
mittee on Commerce, and in addition to the Committees on the Judiciary,
and Economic and Educational Opportunities, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
A BILL
To prohibit insurers from denying health insurance coverage
or benefits or varying premiums based on the status
of an individual as a victim of domestic violence, 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 ‘‘Victims of Abuse Ac-
cess to Health Insurance Act’’.
SEC. 2. PROHIBITION OF HEALTH INSURANCE DISCRIMINA-
TION RELATING TO VICTIMS OF CERTAIN
CRIMES.
(a) IN GENERAL.—No insurer may engage in a prac-
tice that has the effect of denying, canceling, or limiting
health insurance coverage or health benefits, or establish-
ing, increasing, or varying the premium charged for the
coverage or benefits—
(1) to or for an individual on the basis that the
individual is, has been, or may be the victim of do-
mestic violence; or
(2) to or for a group or employer on the basis
that the group includes or the employer employs, or
provides or subsidizes insurance for, an individual
described in paragraph (1).
(b) PRE-EXISTING CONDITIONS.—
(1) IN GENERAL.—A health benefit plan may
not consider a condition or injury that occurred as
a result of domestic violence as a pre-existing condi-
tion.
(2) PREEXISTING
CONDITION.—As used in
paragraph (1), the term ‘‘preexisting condition’’
means, with respect to coverage under a health bene-
fit plan, a condition which was diagnosed, or which
was treated, prior to the first date of such coverage
(without regard to any waiting period).
SEC. 3. CIVIL AND CRIMINAL REMEDIES AND PENALTIES.
(a) IN GENERAL.—Whoever violates the provisions of
this Act shall be—
(1) subject to a fine in an amount provided for
under title 18, United States Code, for a class A
misdemeanor not resulting in death;
(2) subject to the imposition of a civil monetary
penalty; and
(3) subject to the commencement by the ag-
grieved party of a civil action under subsection (b).
(b) CIVIL REMEDIES.—
(1) IN GENERAL.—Any individual aggrieved by
reason of the conduct prohibited in this Act may
commence a civil action for the relief set forth in
paragraph (2).
(2) RELIEF.—In any action under paragraph
(1), the court may award appropriate relief, includ-
ing temporary, preliminary, or permanent injunctive
relief and compensatory and punitive damages, as
well as the costs of suit and reasonable fees for
plaintiffs attorneys and expert witnesses. With re-
spect to compensatory damages, the plaintiff may
elect, at any time prior to the rendering of final
judgment, to recover, in lieu of actual damages, an
award of statutory damages in the amount of $5,000
per violation.
(3) CONCURRENT
JURISDICTION.—Both Fed-
eral and State courts shall have concurrent jurisdic-
tion over actions brought pursuant to this section.
SEC. 4. DEFINITIONS.
For purposes of this Act:
(1) DOMESTIC VIOLENCE.—The term ‘‘domestic
violence’’ means the occurrence of one or more of
the following acts between household or family (in-
cluding in-laws or extended family) members,
spouses or former spouses, or individuals engaged in
or formerly engaged in a sexually intimate relation-
ship:
(A) Attempting to cause or intentionally,
knowingly, or recklessly causing bodily injury,
rape, assault, sexual assault, or involuntary sex-
ual intercourse.
(B) Knowingly engaging in a course of
conduct or repeatedly committing acts toward
another individual, including following the indi-
vidual, without proper authority, under cir-
cumstances that place the individual in reason-
able fear of bodily injury.
(C) Subjecting another to false imprison-
ment.
(2) INSURER.—
(A) IN
GENERAL.—The term ‘‘insurer’’
means a health benefit plan, a health care pro-
vider, an entity that self-insures, or a Federal
or State agency or entity that conducts activi-
ties related to the protection of public health.
(B) HEALTH BENEFIT PLAN.—The term
‘‘health benefit plan’’ means any public or pri-
vate entity or program that provides for pay-
ments for health care, including—
(i) a group health plan (as defined in
section 607 of the Employee Retirement
Income Security Act of 1974) or a multiple
employer welfare arrangement (as defined
in section 3(40) of such Act) that provides
health benefits;
(ii) any other health insurance ar-
rangement, including any arrangement
consisting of a hospital or medical expense
incurred policy or certificate, hospital or
medical service plan contract, or health
maintenance organization subscriber con-
tract;
(iii) workers’ compensation or similar
insurance to the extent that it relates to
workers’ compensation medical benefits (as
defined by the Secretary of Health and
Human Services); and
(iv) automobile medical insurance to
the extent that it relates to medical bene-
fits (as defined by the Secretary of Health
and Human Services).
SEC. 5. INAPPLICABILITY OF MCCARRAN-FERGUSON ACT.
For purposes of section 2(b) of the Act of March 9,
1945 (15 U.S.C. 1012(b); commonly known as the
McCarran-Ferguson Act), this Act shall be considered to
specifically relate to the business of insurance.
SEC. 6. REGULATIONS.
The Secretary of Health and Human Services shall
issue regulations to carry out this Act.
SEC. 7. EFFECTIVE DATE.
This Act shall take effect 90 days after the date of
the enactment of this Act.
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