To amend title XXVII of the Public Health Service Act to permit a health insurance issuer an alternative to guaranteed issue of health insurance coverage in the small group market in order to promote affordable access to portable health insurance coverage.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``HSA Accessibility and Portability 
Act of 2006''.

SEC. 2. PROMOTING ACCESSIBILITY AND AFFORDABILITY OF COVERAGE IN THE 
              SMALL GROUP MARKET.

    Section 2711 of the Public Health Service Act (42 U.S.C. 300gg-11) 
is amended--
            (1) in subsection (a)(1), by striking ``(f)'' and inserting 
        ``(g)''; and
            (2) by adding at the end the following new subsection:
    ``(g) Election of Alternative to Guaranteed Issue Requirement.--
            ``(1) Election.--
                    ``(A) In general.--A health insurance issuer may 
                elect, with respect to any small employer (as defined 
                in section 2791(e)(4)), to meet the requirements of 
                paragraphs (2) and (3) instead of complying with the 
                guaranteed issue requirement of subsection (a).
                    ``(B) Requirement of accepting or rejecting all 
                eligible individuals within entire group at time of 
                election.--An election made under subparagraph (A) with 
                respect to a small employer shall apply with respect to 
                all eligible individuals of that small employer at the 
                time of such election.
                    ``(C) Subsequent eligible individuals.--In the case 
                of an individual who becomes an eligible individual 
                with respect to a small employer after an election has 
                been made under subparagraph (A), the health insurance 
                issuer is not required to provide group health 
                insurance coverage for such individual.
            ``(2) Portability for individuals covered.--If an election 
        is made under paragraph (1)(A) and under such election group 
        health insurance coverage is provided by a health insurance 
        issuer for an eligible individual of a small employer, the 
        health insurance issuer shall guarantee continuation of 
        coverage to the individual (and to covered dependents), through 
        issuance of individual health insurance coverage, after the 
        date the individual no longer qualifies as an eligible 
        individual of such employer, at a rate that does not exceed 150 
        percent of the standard individual rate applicable to such 
        individual coverage in the State in which the policy was 
        initially issued.
            ``(3) Information on elections.--Any health insurance 
        issuer making an election under paragraph (1)(A) shall furnish 
        to the Secretary such information as the Secretary may require 
        in order to monitor the impact of such election on access to, 
        and affordability, of health insurance coverage in the small 
        group market and in the individual market. Such information 
        shall include at least information relating to the following:
                    ``(A) Rejection rate.--The characteristics of small 
                employers denied health insurance coverage because of 
                this subsection.
                    ``(B) Premium rates.--The rates charged for 
                coverage offered under an election made under this 
                subsection (in comparison to rates that are otherwise 
                charged if this subsection were not in effect).
            ``(4) Limitation.--An election under paragraph (1)(A) may 
        only be made with respect to coverage of a small employer under 
        health insurance coverage that consists of a high deductible 
        health plan (as defined in section 223(c)(2) of the Internal 
        Revenue Code of 1986) and a contribution to a health savings 
        account (as defined in section 223(d) of such Code).
            ``(5) Report.--At least 6 months before the end of the 5-
        year period beginning on the date of the enactment of this 
        subsection, the Secretary shall submit to Congress a report on 
        the impact of this subsection on the availability and 
        affordability of health insurance coverage in the small group 
        market and in the individual market. Such report shall include 
        recommendations on whether this subsection should be extended 
        beyond such period and whether it should be expanded to cover 
        health insurance coverage in addition to the coverage described 
        in paragraph (4).
            ``(6) Contingent sunset.--This subsection shall not apply 
        to elections for small employers made by a health insurance 
        issuer after the end of the 5-year period described in 
        paragraph (5) if the Secretary, in the report to Congress under 
        such paragraph, recommends that this subsection should not be 
        extended beyond such period. If the Secretary makes such a 
        recommendation, this subsection shall still continue to apply 
        to elections made before the end of such 5-year period.''.

Summary: HSA Accessibility and Portability Act of 2006 - Amends the Public Health Service Act to authorize a health insurance issuer to elect, instead of complying with the guaranteed issue requirements (that require a health insurance issuer offering coverage in the small group market in a state to accept every small employer that applies and to accept all eligible individuals without certain restrictions), to: (1) guarantee continuation of coverage through individual health insurance for an individual who no longer qualifies as an eligible individual of the employer at a rate that does not exceed 150% of the standard individual rate applicable to individual coverage in the state; and (2) furnish information for the Secretary of Health and Human Services to monitor the impact of such election on access to, and affordability of, health insurance coverage in the small group market and in the individual market.

Requires such an election to apply to all eligible individuals of that small employer at the time of such election, but does not require applicability to an individual who becomes eligible after such election. Allows an election under this Act to be made only with respect to coverage of a small employer under health insurance coverage that consists of a high deductible health plan and a contribution to a health savings account.