Title: Ensuring Health Care Opportunities Act
Policy area: Health

Summary:
Ensuring Health Care Opportunities Act
This bill waives certain health insurance benefit requirements in states with a county where only one health insurer offers individual coverage. In these states, health plans are not required to provide essential health benefits to be offered in the individual or small group market or through the health insurance exchange. (Plans offered in the individual market or through an exchange fulfill the requirement for individuals to maintain minimum essential coverage.)

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 208 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 208

To waive the essential health benefits requirements for certain States.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 3, 2017

 Mr. Young of Alaska introduced the following bill; which was referred 
                to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To waive the essential health benefits requirements for certain States.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Health Care Opportunities 
Act''.

SEC. 2. WAIVER OF ESSENTIAL HEALTH BENEFITS REQUIREMENTS.

    (a) In General.--In the case of a State in which the applicable 
State authority (as defined in section 2791(d)(1) of the Public Health 
Service Act (42 U.S.C. 300gg-91(d)(1))) certifies to the Secretary of 
Health and Human Services that, with respect to at least one county 
(or, in the case of a State that does not have counties, equivalent 
municipality), only one health insurance issuer offers coverage in the 
individual market for a plan year, the following shall not apply to 
health plans in such State for such plan year:
            (1) The requirement under section 1301(a)(1) of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18021(a)(1)) 
        that, to be a qualified health plan eligible to be offered 
        through an Exchange in the State, such plan provide the 
        essential health benefits package described in section 1302(a) 
        of such Act (42 U.S.C. 18022(a)).
            (2) The requirement under section 2707(a) of the Public 
        Health Service Act (42 U.S.C. 300gg-6(a)) that health insurance 
        coverage offered in the individual or small group market in the 
        State includes the essential health benefits package required 
        under section 1302(a) of the Patient Protection and Affordable 
        Care Act (42 U.S.C. 18022(a)).
    (b) State Certification.--To be eligible for a waiver under 
subsection (a), a State shall make the certification described in 
subsection (a) not later than--
            (1) 90 days after the date of enactment of this Act, in the 
        case of a State in which, on the date of enactment of this Act, 
        at least one county in the State (or, in the case of a State 
        that does not have counties, equivalent municipality), only one 
        health insurance issuer offers coverage in the individual 
        market for the plan year in effect on such date of enactment; 
        and
            (2) 90 days after the applicable State authority (as 
        defined in section 2791(d)(1) of the Public Health Service Act 
        (42 U.S.C. 300gg-91(d)(1))) first discovers, or reasonably 
        should discover, that, in at least one county in the State (or, 
        in the case of a State that does not have counties, equivalent 
        municipality), only one health insurance issuer offers in the 
        current plan year, or will offer in a future plan year, 
        coverage in the individual market for the current plan year or 
        a future plan year, as applicable, in the case of a State not 
        described in paragraph (1).
    (c) Term of Waiver.--A waiver under this section may extend over a 
period of not more than 5 years, provided that the State continues to 
meet the criteria for eligibility for the waiver under subsection (a). 
A State that continues to meet such criteria for more than 5 years may 
recertify under subsection (a) every 5 years.
    (d) Plans Offering Essential Health Benefits.--Nothing in this Act 
prevents a health insurance issuer from offering in a State to which a 
waiver under subsection (a) applies health insurance coverage that 
includes the essential health benefits package described in section 
1302(a) of the Patient Protection and Affordable Care Act (42 U.S.C. 
18022(a)).
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