Title: Educating Consumers on the Risks of Short-Term Plans Act of 2019
Policy area: Health

Summary:
Educating Consumers on the Risks of Short-Term Plans Act of 2019This bill requires health insurers offering short-term, limited-duration insurance coverage to prominently disclose all medical conditions for which an individual may be denied coverage, limited in coverage, or subject to a premium increase. (Short-term, limited-duration insurance coverage is designed to fill a temporary gap in insurance coverage.)Insurers must further disclose that this type of coverage is temporary, provides limited benefits, and is subject to termination. Insurers may not enroll an individual in a short-term, limited-duration insurance plan during any time in which that individual is eligible for open enrollment in coverage through the health insurance exchange.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1143 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 1143

  To amend title XXVII of the Public Health Service Act to require a 
health insurance issuer offering short-term limited duration insurance 
   to include a standardized disclosure and certain information with 
  respect to coverage exclusions and premium variations in marketing, 
 application, and enrollment materials distributed in connection with 
   such insurance and prohibiting the sale of such insurance during 
                            certain periods.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 11, 2019

  Ms. Eshoo introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend title XXVII of the Public Health Service Act to require a 
health insurance issuer offering short-term limited duration insurance 
   to include a standardized disclosure and certain information with 
  respect to coverage exclusions and premium variations in marketing, 
 application, and enrollment materials distributed in connection with 
   such insurance and prohibiting the sale of such insurance during 
                            certain periods.

    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 ``Educating Consumers on the Risks of 
Short-Term Plans Act of 2019''.

SEC. 2. REQUIRING A HEALTH INSURANCE ISSUER OFFERING SHORT-TERM LIMITED 
              DURATION INSURANCE TO INCLUDE A STANDARDIZED DISCLOSURE 
              AND CERTAIN INFORMATION WITH RESPECT TO COVERAGE 
              EXCLUSIONS AND PREMIUM VARIATIONS IN MARKETING, 
              APPLICATION, AND ENROLLMENT MATERIALS DISTRIBUTED IN 
              CONNECTION WITH SUCH INSURANCE AND PROHIBITING THE SALE 
              OF SUCH INSURANCE DURING CERTAIN PERIODS.

    (a) In General.--Subpart II of part A of title XXVII of the Public 
Health Service Act (42 U.S.C. 300gg-11 et seq.) is amended by adding at 
the end the following new section:

``SEC. 2730. INFORMATION REQUIRED TO BE INCLUDED IN MARKETING, 
              APPLICATION, AND ENROLLMENT MATERIALS DISTRIBUTED IN 
              CONNECTION WITH SHORT-TERM LIMITED DURATION INSURANCE; 
              LIMITATION ON ENROLLMENT PERIOD.

    ``(a) Provision of Information.--
            ``(1) In general.--A health insurance issuer offering 
        short-term limited duration insurance shall include in any 
        marketing, application, or enrollment materials distributed by 
        such issuer in connection with such insurance, in a prominent 
        location set apart from other information--
                    ``(A) the standardized disclosure established by 
                the Secretary under paragraph (2); and
                    ``(B) a list of all medical conditions, including 
                both physical and mental health conditions--
                            ``(i) which may result in an individual 
                        being denied the ability to enroll under such 
                        insurance;
                            ``(ii) for which such issuer may apply a 
                        preexisting condition exclusion (as defined in 
                        section 2704(b)(1)) with respect to an enrollee 
                        under such insurance;
                            ``(iii) which may result in an increase in 
                        premium amounts for such an enrollee compared 
                        to what such amounts would have otherwise been 
                        for such enrollee absent such condition; or
                            ``(iv) for which such issuer may terminate 
                        coverage under such insurance with respect to 
                        such an enrollee.
            ``(2) Establishment of disclosure.--For purposes of 
        paragraph (1)(A), the Secretary shall establish a standardized 
        disclosure with respect to short-term limited duration 
        insurance offered by a health insurance issuer that includes 
        the following information:
                    ``(A) A notification that such insurance may not 
                cover preexisting conditions of an enrollee, including 
                past physical or mental health conditions, regardless 
                of whether such enrollee was aware of such conditions 
                or had sought treatment for such conditions on or 
                before the date of enrollment in such insurance.
                    ``(B) A notification that such issuer may rescind 
                coverage under such insurance if an enrollee seeks 
                treatment for such a preexisting condition, regardless 
                of whether such enrollee was aware of such condition or 
                had sought treatment for such condition on or before 
                the date of enrollment in such insurance.
                    ``(C) A notification that such insurance provides 
                limited benefits compared to individual health 
                insurance coverage and does not include all benefits 
                required to be covered under the Patient Protection and 
                Affordable Care Act (including the essential health 
                benefits package (as defined in section 1302(a) of such 
                Act)) or under this title.
                    ``(D) A notification that coverage under such 
                insurance is temporary and may not cover the costs of 
                an enrollee for most hospital or other medical items 
                and services, including both physical and mental health 
                items and services.
                    ``(E) A notification that an individual should 
                carefully review the benefits provided under such 
                insurance before enrolling in such insurance.
                    ``(F) A notification informing individuals of the 
                opportunity to purchase comprehensive individual health 
                insurance coverage through Exchanges established under 
                the Patient Protection and Affordable Care Act that 
                provides coverage for preexisting conditions without 
                premium increases for such conditions and for which 
                such individuals may be eligible for financial 
                assistance. Such notification shall include information 
                on how such individuals may access such Exchanges.
    ``(b) Limitation on Enrollment Period.--A health insurance issuer 
offering short-term limited duration insurance may not enroll any 
individual in such insurance during any annual open enrollment period 
applicable to such individual with respect to an Exchange.''.
    (b) Conforming Amendments.--
            (1) Enforcement.--Section 2723 of the Public Health Service 
        Act (42 U.S.C. 300gg-22) is amended--
                    (A) in subsection (a)--
                            (i) in paragraph (1), by inserting ``, or 
                        short-term limited duration insurance in the 
                        State,'' after ``group market''; and
                            (ii) in paragraph (2), by inserting ``(or, 
                        in the case of such a failure with respect to 
                        section 2730, in connection with short-term 
                        limited duration insurance)'' after 
                        ``individual health insurance coverage''; and
                    (B) in subsection (b)(1)(B), by inserting ``, 
                short-term limited duration insurance,'' after 
                ``individual health insurance coverage''.
            (2) Preemption.--Section 2724(a)(1) of such Act (42 U.S.C. 
        300gg-23(a)(1)) is amended by inserting ``or short-term limited 
        duration insurance'' after ``group health insurance coverage''.
    (c) Effective Date.--The amendments made by this section shall 
apply with respect to marketing, application, and enrollment materials 
distributed in connection with short-term limited duration insurance on 
or after September 1, 2019.
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