I 
113TH CONGRESS 
1ST SESSION H. R. 3504 
To provide improved consumer protection and rate review for health insurance 
coverage in the individual market, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 15, 2013 
Ms. SCHAKOWSKY introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To provide improved consumer protection and rate review 
for health insurance coverage in the individual market, 
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 ‘‘Consumer Protection 
and Rate Review Act of 2013’’. 
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SEC. 2. REQUIRING STATE INSURANCE COMMISSIONERS TO 
INVESTIGATE INSTANCES OF INADEQUATE 
NOTICES OF CANCELLATION OR CONVER-
SION OF INDIVIDUAL HEALTH INSURANCE 
POLICIES. 
(a) IN GENERAL.—Each State insurance commis-
sioner shall investigate and take appropriate administra-
tive or other actions (such as the imposition of a fine) 
on cases of inadequate notices of cancellations or conver-
sions of health insurance coverage in the individual market 
that take effect on or after January 1, 2014. 
(b) INADEQUATE NOTICE.—In this section, a notice 
of the cancellation or conversion of individual health insur-
ance coverage shall be treated as inadequate if the no-
tice— 
(1) fails to contain information— 
(A) on obtaining health insurance coverage 
through an Exchange under the Patient Protec-
tion and Affordable Care Act; 
(B) on the possible availability of assist-
ance under such Act towards payment of the 
premiums and cost-sharing for such coverage; 
and 
(C) on the improved benefits for coverage 
through an Exchange, compared to health in-
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surance coverage not offered through an Ex-
change; 
(2) fails to be transparent by inappropriately 
steering individuals to more expensive plans provided 
by the cancelling issuer; or 
(3) fails to otherwise comply with requirements 
of law. 
(c) REPORTS.— 
(1) STATE COMMISSIONERS TO HHS.—Not later 
than March 31, 2014, each State insurance commis-
sioner shall submit to the Secretary of Health and 
Human Services a report on the investigations and 
actions described in subsection (a). 
(2) HHS REPORT
TO
CONGRESS.—Not later 
than April 30, 2014, the Secretary shall submit to 
Congress a report on such investigations and ac-
tions. 
(d) DEFINITIONS OF STATE, HEALTH INSURANCE 
COVERAGE, AND INDIVIDUAL MARKET.—In this section, 
the terms ‘‘State’’, ‘‘health insurance coverage’’, and ‘‘in-
dividual market’’ have the meanings given such terms for 
purposes of title I of the Patient Protection and Afford-
able Care Act. 
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SEC. 3. PROTECTION OF CONSUMERS FROM EXCESSIVE, 
UNJUSTIFIED, OR UNFAIRLY DISCRIMINA-
TORY RATES øFROM H.R. 1019¿. 
(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: 
‘‘(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-
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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), as a condition of the 
State receiving the grant in subsection (c), 
based on the Secretary’s determination that the 
State regulator is adequately undertaking and 
utilizing such actions in that market. 
‘‘(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 
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