Title: Vaccine Accountability and Premium Protection Act
Policy area: Health

Summary:
Vaccine Accountability and Premium Protection Act
This bill permits a health insurer to increase an individual's plan premium by not more than 50% of the base amount during any portion of the COVID-19 public health emergency if the insured individual is not fully vaccinated. An insurer may not apply the premium increase unless certain conditions are met.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5622 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 5622

  To amend title XXVII of the Public Health Service Act to allow for 
 premium rates in the group and individual health insurance markets to 
vary during the COVID-19 emergency period based on COVID-19 vaccination 
                    status, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 19, 2021

 Mr. Gallego introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   the Judiciary, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To amend title XXVII of the Public Health Service Act to allow for 
 premium rates in the group and individual health insurance markets to 
vary during the COVID-19 emergency period based on COVID-19 vaccination 
                    status, and for other purposes.

    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 ``Vaccine Accountability and Premium 
Protection Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) More than 700,000 COVID-19 deaths have been reported in 
        the United States and many public health experts believe this 
        to be an undercount of the actual death toll of the virus.
            (2) There are three vaccines that have received either FDA 
        approval or Emergency Use Authorization, have undergone 
        rigorous testing, and have been proven to be safe and highly 
        effective.
            (3) These vaccines are free and widely available in the 
        United States to protect individuals against COVID-19.
            (4) Full vaccination has been proven to reduce the risk of 
        moderate to severe COVID-19 infection by five times and 
        hospitalization and death by more than ten times.
            (5) Over 20 percent of Americans eligible to receive the 
        vaccine remain unvaccinated.
            (6) COVID-19 hospitalizations of unvaccinated individuals 
        have cost the U.S. health system an estimated $5.7 billion 
        between June 2021 and August 2021.
            (7) Some health insurers have proposed or predicted 
        increases in premium costs due to higher health care costs and 
        higher utilization because of COVID-19-related services.
            (8) Evidence shows that the ongoing COVID-19 pandemic 
        continues to impact Americans' physical and mental health 
        negatively, has increased substance use and drug overdoses, and 
        has led to hospitals rationing care for non-COVID-19-related 
        care.
            (9) The over 20 percent of eligible Americans who have not 
        been vaccinated against COVID-19 are jeopardizing their own 
        health, the health of their communities, and the ability of 
        local health systems to provide comprehensive, high-quality 
        care to everyone who needs it.
            (10) The over 20 percent of eligible Americans who have not 
        been vaccinated against COVID-19 are disproportionately 
        responsible for the continuation of community spread of COVID-
        19 and the public health emergency in America, as well as its 
        associated economic consequences.

SEC. 3. ALLOWING PREMIUM RATES IN GROUP AND INDIVIDUAL HEALTH INSURANCE 
              MARKETS TO VARY BASED ON COVID-19 VACCINATION STATUS.

    Section 2701(a) of the Public Health Service Act (300gg(a)) is 
amended--
            (1) in paragraph (1)(A)--
                    (A) in clause (iii), by striking at the end 
                ``and'';
                    (B) by adding at the end the following new clause:
                            ``(v) during any portion of the emergency 
                        period (as described in section 1135(g)(1)(B) 
                        of the Social Security Act) (beginning on or 
                        after the date of the enactment of this 
                        clause), consistent with paragraph (6), status 
                        as not being fully vaccinated (as defined by 
                        the Centers for Disease Control and Prevention) 
                        for COVID-19, except that such rate shall not 
                        vary by more than 1.5 to 1; and'';
            (2) in paragraph (4)--
                    (A) in the header, by striking ``or tobacco use'' 
                and inserting ``, tobacco use, or vaccination status''; 
                and
                    (B) by striking ``clauses (iii) and (iv)'' and 
                inserting ``clauses (iii), (iv), and (v)''; and
            (3) by adding at the end the following new paragraph:
            ``(6) Conditions for varying premiums by vaccination 
        status.--A health insurance issuer offering health insurance 
        coverage in the individual or small group market (or, if 
        applicable under paragraph (5), the large group market), may 
        vary the premium rate with respect to the particular plan or 
        coverage involved by the factor described in paragraph 
        (1)(A)(v) during any portion of the period described in such 
        paragraph only if each of the following conditions are met:
                    ``(A) An increase pursuant to paragraph (1)(A)(v) 
                may be made to the premium rate of an enrollee with 
                respect to the particular plan or coverage only with 
                respect to months during such portion of such period 
                with respect to which each of the following applies to 
                the enrollee:
                            ``(i) The enrollee is, based on guidelines 
                        of the Food and Drug Administration and of the 
                        Centers for Disease Control and Prevention, 
                        eligible for a COVID-19 vaccine.
                            ``(ii) The enrollee is not fully vaccinated 
                        (as defined by the Centers for Disease Control 
                        and Prevention) for COVID-19.
                            ``(iii) The enrollee is not an individual 
                        who has not been fully vaccinated by reason of 
                        a verified medical condition or an objection to 
                        the vaccine on the basis of sincerely held 
                        religious beliefs.
                    ``(B) The amount of premium applied with respect to 
                an enrollee with respect to the particular plan or 
                coverage during such portion of such period after 
                application of such paragraph (1)(A)(v) does not result 
                in a premium rate that exceeds an amount equal to 10 
                percent of the enrollee's household income for such 
                portion of such period.
                    ``(C) The issuer pays to the Secretary of the 
                Treasury an amount equal to 25 percent of the amount by 
                which--
                            ``(i) the total premiums charged with 
                        respect to the particular plan or coverage 
                        during such portion of such period after 
                        application of such paragraph (1)(A)(v); 
                        exceeds
                            ``(ii) the total premiums that would have 
                        been charged with respect to such plan or 
                        coverage during such portion of such period 
                        without application of such paragraph.
                    ``(D) The issuer certifies to the Secretary of 
                Health and Human Services that the premium rate applied 
                with respect to enrollees who are fully vaccinated (as 
                defined by the Centers for Disease Control and 
                Prevention) for COVID-19 with respect to the particular 
                plan or coverage on vaccinated individuals will not be 
                increased during such portion of such period by reason 
                of increased costs associated with the emergency period 
                described in paragraph (1)(A)(v).
                    ``(E) Before applying an increase to the premium 
                rate pursuant to paragraph (1)(A)(v), the issuer 
                notifies each enrollee with respect to the particular 
                plan or coverage who will be subject to such increase 
                in premium rate and provides each such enrollee with 
                information on where and how to receive a vaccine for 
                COVID-19 without cost to such enrollee for such 
                vaccine.''.

SEC. 4. SENSE OF CONGRESS RELATED TO THE SERIOUSNESS OF PRESENTING, 
              CREATING, OR DISTRIBUTING FRAUDULENT VACCINATION CARDS.

    It is the sense of Congress that--
            (1) any individual falsely representing themselves as 
        vaccinated against COVID-19 undermines mitigation efforts, 
        endangers public health, and puts those around them at 
        increased risk for contracting COVID-19;
            (2) the presentation, sale, purchase, or distribution of 
        counterfeit COVID-19 vaccination cards appearing to be issued 
        by the Centers for Disease Control and Prevention or official 
        vaccination cards filled out with information falsely 
        indicating that a person who has not received the COVID-19 
        vaccination is indeed vaccinated is a serious crime in 
        violation of Federal law;
            (3) an individual guilty of the crime of presenting or 
        purchasing a fraudulent vaccination card should, in accordance 
        with law, be subject to a fine of not less than $5,000; and
            (4) an individual or organization guilty of the crime of 
        selling or distributing a fraudulent vaccination card should 
        receive the maximum penalty permissible under section 1017 of 
        title 18, United States Code, in accordance with the scope of 
        the crime.
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