I
105TH CONGRESS
1ST SESSION
H. R. 2532
To amend the Internal Revenue Code of 1986, the Public Health Service
Act, and the Employee Retirement Income Security Act of 1974 to
expand access to health insurance coverage without pre-existing condition
exclusions in the group and individual health insurance markets.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 23, 1997
Mr. STARK introduced the following bill; which was referred to the Committee
on Commerce, and in addition to the Committees on Ways and Means,
and Education and the Workforce, for a period to be subsequently deter-
mined 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 Internal Revenue Code of 1986, the Public
Health Service Act, and the Employee Retirement In-
come Security Act of 1974 to expand access to health
insurance coverage without pre-existing condition exclu-
sions in the group and individual health insurance mar-
kets.
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 ‘‘Health Insurance Ac-
cess Amendments of 1997’’.
SEC. 2. PHASE-DOWN OF APPLICATION OF PREEXISTING
CONDITION EXCLUSIONS IN GROUP MARKET.
Section 9801 of the Internal Revenue Code of 1986,
section 701 of the Employee Retirement Income Security
Act of 1974 (29 U.S.C. 1181), and section 2701 of the
Public Health Service Act (42 U.S.C. 300g) are each
amended as follows:
(1) Effective with respect to group health plans
for plan years beginning on or after January 1,
2000, in subsection (a), strike ‘‘not more than 12
months (or 18 months in the case of a late enrollee)
after the enrollment date’’ and insert ‘‘not more
than 6 months after the enrollment date’’.
(2) Effective with respect to group health plans
for plan years beginning on or after January 1,
2001, in subsection (a) (as amended by paragraph
(1)), strike ‘‘not more than 6 months after the en-
rollment date’’ and insert ‘‘not more than 3 months
after the enrollment date’’.
(3) Effective with respect to group health plans
for plan years beginning on or after January 1,
2002, in subsection (a) (as amended by paragraph
(1)), strike ‘‘3 months’’ and insert ‘‘one month’’.
SEC. 3. EXTENDING AVAILABILITY OF COVERAGE IN INDI-
VIDUAL MARKET WITHOUT APPLICATION OF
PREEXISTING CONDITION EXCLUSIONS.
(a) PHASE-DOWN IN ELIGIBILITY RESTRICTIONS.—
Section 2741(b)(1)(A) of the Public Health Service Act
(42 U.S.C. 300g–41(b)(1)(A)) is amended as follows:
(1) Effective with respect to health insurance
coverage offered, sold, issued, renewed, in effect, or
operated in the individual market on or after Janu-
ary 1, 2000, strike ‘‘18 or more months’’ and insert
‘‘12 or more months’’.
(2) Effective with respect to health insurance
coverage offered, sold, issued, renewed, in effect, or
operated in the individual market on or after Janu-
ary 1, 2001, strike ‘‘12 or more months’’ (as in-
serted by paragraph (1)) and insert ‘‘6 or more
months’’.
(3) Effective with respect to health insurance
coverage offered, sold, issued, renewed, in effect, or
operated in the individual market on or after Janu-
ary 1, 2002, strike ‘‘6 or more months’’ (as inserted
by paragraph (2)) and insert ‘‘one month’’.
SEC. 4. EXPANSION OF GUARANTEED ISSUE PROTECTIONS
TO LARGE GROUP MARKET.
(a) IN GENERAL.—Section 2711 of the Public Health
Service Act (42 U.S.C. 300g–11) is amended—
(1) by striking ‘‘SMALL
GROUP’’, ‘‘SMALL
GROUP’’, and ‘‘small group’’ each place it appears
and inserting ‘‘RELEVANT
GROUP’’, ‘‘RELEVANT
GROUP’’, and ‘‘relevant group’’, respectively;
(2) in paragraph (1)(A), by striking ‘‘small em-
ployer (as defined in section 2791(e)(4)’’ and insert-
ing ‘‘relevant employer (as defined in subsection
(b)(2))’’;
(3) by striking ‘‘small employer’’ and ‘‘small
employers’’ each other place it appears and inserting
‘‘relevant employer’’ and ‘‘relevant employers’’, re-
spectively; and
(4) by striking subsection (b) and inserting the
following:
‘‘(b) RELEVANT EMPLOYER AND GROUP DEFINED.—
For purposes of this subpart:
‘‘(1) RELEVANT
EMPLOYER.—The term ‘rel-
evant employer’ means—
‘‘(A) for periods before January 1, 2000, a
small 
employer 
(as 
defined 
in 
section
2791(e)(4)),
‘‘(B) for the period beginning on January
1, 2000, and ending December 31, 2001, an
employer that would be a small employer if