Protecting Americans with Preexisting Conditions Act of 2019

Bill: 116-hr-986
Sponsor: full_name: Rep. Kuster, Ann M. [D-NH-2]
Introduced: 2019-02-06
Policy area: Health
Subjects: Administrative law and regulatory procedures

Department of Health and Human Services

Department of the Treasury

Health care costs and insurance

Health care coverage and access

State and local government operations
Latest action: action_date: 2019-05-15
text: Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 90.

Summaries:
action_date: 2019-02-06
action_desc: Introduced in House
text: <p><b>Protecting Americans with Preexisting Conditions Act of 2019</b></p> <p>This bill nullifies the Department of the Treasury and the Department of Health and Human Services guidance titled &quot;State Relief and Empowerment Waivers,&quot; published on October 24, 2018. The guidance pertains to Section 1332 waivers (also known as State Innovation Waivers or State Relief and Empowerment Waivers), which allow states to forego certain requirements of the Patient Protection and Affordable Care Act in order to implement experimental plans for health care coverage, as long as the resulting coverage meets certain statutory criteria. </p> <p>The guidance, which supersedes earlier guidance from 2015, alters agency interpretation of how states may satisfy the statutory criteria for waiver approval. For example, the guidance (1) redefines acceptable coverage under such waivers to include short-term, limited-duration insurance and association health plans; (2) allows the comprehensiveness and affordability of coverage under such waivers to be assessed based on projected availability, rather than enrollment; and (3) allows the level of coverage to be assessed based on the effects over the entire course of the waiver, rather than per year.</p>

action_date: 2019-04-30
action_desc: Reported to House, Part I
text: <p><b>Protecting Americans with Preexisting Conditions Act of 2019</b></p> <p>This bill nullifies the Department of the Treasury and the Department of Health and Human Services guidance titled &quot;State Relief and Empowerment Waivers,&quot; published on October 24, 2018. The guidance pertains to Section 1332 waivers (also known as State Innovation Waivers or State Relief and Empowerment Waivers), which allow states to forego certain requirements of the Patient Protection and Affordable Care Act in order to implement experimental plans for health care coverage, as long as the resulting coverage meets certain statutory criteria. </p> <p>The guidance, which supersedes earlier guidance from 2015, alters agency interpretation of how states may satisfy the statutory criteria for waiver approval. For example, the guidance (1) redefines acceptable coverage under such waivers to include short-term, limited-duration insurance and association health plans; (2) allows the comprehensiveness and affordability of coverage under such waivers to be assessed based on projected availability, rather than enrollment; and (3) allows the level of coverage to be assessed based on the effects over the entire course of the waiver, rather than per year.</p>

action_date: 2019-05-09
action_desc: Passed House
text: <p><b>Protecting Americans with Preexisting Conditions Act of 2019</b></p> <p>(Sec. 3) This bill nullifies guidance from the Department of the Treasury and the Department of Health and Human Services titled <em>State Relief and Empowerment Waivers</em>, published on October 24, 2018. The guidance pertains to Section 1332 waivers (also known as State Innovation Waivers or State Relief and Empowerment Waivers), which allow states to forego certain requirements of the Patient Protection and Affordable Care Act in order to implement experimental plans for health care coverage, as long as the resulting coverage meets certain statutory criteria. </p> <p>The guidance, which supersedes earlier guidance from 2015, alters agency interpretation of how states may satisfy the statutory criteria for waiver approval. For example, the guidance (1) redefines acceptable coverage under such waivers to include short-term, limited-duration insurance and association health plans; (2) allows the comprehensiveness and affordability of coverage under such waivers to be assessed based on projected availability, rather than enrollment; and (3) allows the level of coverage to be assessed based on the effects over the entire course of the waiver, rather than per year.</p> <p>(Sec. 4) The Government Accountability Office must report on the number of individuals that would have been expected to lose access to health insurance coverage, as well as the expected effect on mental health care treatment, in the absence of this bill.</p>

tv_txt: I 116th CONGRESS 1st Session H. R. 986 IN THE HOUSE OF REPRESENTATIVES February 6, 2019 Ms. Kuster of New Hampshire (for herself, Mr. Beyer , and Mr. Courtney ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committee on Ways and Means , 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 provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect.

1. Short title This Act may be cited as the Protecting Americans with Preexisting Conditions Act of 2019 . 2. Providing that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect Beginning April 1, 2019, the Secretary of Health and Human Services and the Secretary of the Treasury may not take any action to implement, enforce, or otherwise give effect to the guidance entitled State Relief and Empowerment Waivers (83 Fed. Reg. 53575 (October 24, 2018)), and the Secretaries may not promulgate any substantially similar guidance or rule.

tv_txt: IB Union Calendar No. 22 116th CONGRESS 1st Session H. R. 986 [Report No. 116–44, Part I] IN THE HOUSE OF REPRESENTATIVES February 6, 2019 Ms. Kuster of New Hampshire (for herself, Mr. Beyer , and Mr. Courtney ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committee on Ways and Means , 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 April 30, 2019 Additional sponsors: Mr. Welch , Ms. Schakowsky , Ms. Castor of Florida , Mr. Golden , Ms. Blunt Rochester , Mrs. Dingell , Mr. Kennedy , Mr. Rush , Mr. Ruiz , Mr. Pallone , Ms. Eshoo , Ms. Matsui , Mr. Van Drew , Ms. Clarke of New York , Ms. McCollum , Mr. Schrader , and Ms. Mucarsel-Powell April 30, 2019 Reported from the Committee on Energy and Commerce April 30, 2019 Committee on Ways and Means discharged; committed to the Committee of the Whole House on the State of the Union and ordered to be printed A BILL To provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect.

1. Short title This Act may be cited as the Protecting Americans with Preexisting Conditions Act of 2019 . 2. Providing that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect Beginning April 1, 2019, the Secretary of Health and Human Services and the Secretary of the Treasury may not take any action to implement, enforce, or otherwise give effect to the guidance entitled State Relief and Empowerment Waivers (83 Fed. Reg. 53575 (October 24, 2018)), and the Secretaries may not promulgate any substantially similar guidance or rule.

April 30, 2019 Reported from the Committee on Energy and Commerce April 30, 2019 Committee on Ways and Means discharged; committed to the Committee of the Whole House on the State of the Union and ordered to be printed

tv_txt: IB 116th CONGRESS 1st Session H. R. 986 IN THE HOUSE OF REPRESENTATIVES AN ACT To provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect.

1. Short title This Act may be cited as the Protecting Americans with Preexisting Conditions Act of 2019 . 2. Findings Congress finds the following: (1) On October 24, 2018, the administration published new guidance to carry out section 1332 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18052 ) entitled “State Relief and Empowerment Waivers” (83 Fed. Reg. 53575). (2) The new guidance encourages States to provide health insurance coverage through insurance plans that may discriminate against individuals with preexisting health conditions, including the one in four Americans living with a disability. (3) The implementation and enforcement of the new guidance weakens protections for the millions of Americans living with preexisting health conditions and jeopardizes Americans’ access to quality, affordable health insurance coverage. 3. Providing that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect Beginning April 1, 2019, the Secretary of Health and Human Services and the Secretary of the Treasury may not take any action to implement, enforce, or otherwise give effect to the guidance entitled State Relief and Empowerment Waivers (83 Fed. Reg. 53575 (October 24, 2018)), including any such action that would result in individuals losing health insurance coverage that includes the essential health benefits package (as defined in subsection (a) of section 1302 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) without regard to any waiver of any provision of such package under a waiver under such section 1332), including the maternity and newborn care essential health benefit described in subsection (b)(1)(D) of such section, including any such action that would result in a decrease in the number of such individuals enrolled in coverage that is at least as comprehensive as the coverage defined in section 1302(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) compared to the number of such individuals who would have been so enrolled in such coverage had such action not been taken, including any such action that would, with respect to individuals with substance use disorders, including opioid use disorders, reduce the availability or affordability of coverage that is at least as comprehensive as the coverage defined in section 1302(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) compared to the availability or affordability, respectively, of such coverage had such action not been taken, including any such action that would result, with respect to vulnerable populations (including low-income individuals, elderly individuals, and individuals with serious health issues or who have a greater risk of developing serious health issues), in a decrease in the availability of coverage that is at least as comprehensive as the coverage defined in section 1302(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) with coverage and cost sharing protections required under section 1332(b)(1)(B) of such Act ( 42 U.S.C. 18052(b)(1)(B) ), including any such action that would, with respect to individuals with preexisting conditions, reduce the affordability of coverage that is at least as comprehensive as the coverage defined in section 1302(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) compared to the affordability of such coverage had such action not been taken, including any such action that would result in higher health insurance premiums for individuals enrolled in health insurance coverage that is at least as comprehensive as the coverage defined in section 1302(b) of such Act ( 42 U.S.C. 18022(b) ), and the Secretaries may not promulgate any substantially similar guidance or rule. Nothing in the previous sentence shall be construed to affect the approval of waivers under section 1332 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18052 ) that establish reinsurance programs that are consistent with the requirements under subsection (b)(1) of such section ( 42 U.S.C. 18052(b)(1) ), lower health insurance premiums, and protect health insurance coverage for people with preexisting conditions. 4. GAO report on affect of State innovation waivers on coverage of individuals and on mental health health care treatment Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the number of individuals expected to lose access to health insurance coverage (as defined in section 2791 of the Public Health Service Act ( 42 U.S.C. 300gg–91 )) if section 2 were not enacted and waivers under section 1332 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18052 ) were approved under the guidance described in such section 2. Such report shall include an analysis of the expected effect such waivers approved under such guidance would have on mental health care treatment.

Passed the House of Representatives May 9, 2019. Cheryl L. Johnson, Clerk.

tv_txt: II Calendar No. 90 116th CONGRESS 1st Session H. R. 986 IN THE SENATE OF THE UNITED STATES May 14, 2019 Received; read the first time May 15, 2019 Read the second time and placed on the calendar AN ACT To provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect.

1. Short title This Act may be cited as the Protecting Americans with Preexisting Conditions Act of 2019 . 2. Findings Congress finds the following: (1) On October 24, 2018, the administration published new guidance to carry out section 1332 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18052 ) entitled “State Relief and Empowerment Waivers” (83 Fed. Reg. 53575). (2) The new guidance encourages States to provide health insurance coverage through insurance plans that may discriminate against individuals with preexisting health conditions, including the one in four Americans living with a disability. (3) The implementation and enforcement of the new guidance weakens protections for the millions of Americans living with preexisting health conditions and jeopardizes Americans’ access to quality, affordable health insurance coverage. 3. Providing that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect Beginning April 1, 2019, the Secretary of Health and Human Services and the Secretary of the Treasury may not take any action to implement, enforce, or otherwise give effect to the guidance entitled State Relief and Empowerment Waivers (83 Fed. Reg. 53575 (October 24, 2018)), including any such action that would result in individuals losing health insurance coverage that includes the essential health benefits package (as defined in subsection (a) of section 1302 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) without regard to any waiver of any provision of such package under a waiver under such section 1332), including the maternity and newborn care essential health benefit described in subsection (b)(1)(D) of such section, including any such action that would result in a decrease in the number of such individuals enrolled in coverage that is at least as comprehensive as the coverage defined in section 1302(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) compared to the number of such individuals who would have been so enrolled in such coverage had such action not been taken, including any such action that would, with respect to individuals with substance use disorders, including opioid use disorders, reduce the availability or affordability of coverage that is at least as comprehensive as the coverage defined in section 1302(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) compared to the availability or affordability, respectively, of such coverage had such action not been taken, including any such action that would result, with respect to vulnerable populations (including low-income individuals, elderly individuals, and individuals with serious health issues or who have a greater risk of developing serious health issues), in a decrease in the availability of coverage that is at least as comprehensive as the coverage defined in section 1302(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) with coverage and cost sharing protections required under section 1332(b)(1)(B) of such Act ( 42 U.S.C. 18052(b)(1)(B) ), including any such action that would, with respect to individuals with preexisting conditions, reduce the affordability of coverage that is at least as comprehensive as the coverage defined in section 1302(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(a) ) compared to the affordability of such coverage had such action not been taken, including any such action that would result in higher health insurance premiums for individuals enrolled in health insurance coverage that is at least as comprehensive as the coverage defined in section 1302(b) of such Act ( 42 U.S.C. 18022(b) ), and the Secretaries may not promulgate any substantially similar guidance or rule. Nothing in the previous sentence shall be construed to affect the approval of waivers under section 1332 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18052 ) that establish reinsurance programs that are consistent with the requirements under subsection (b)(1) of such section ( 42 U.S.C. 18052(b)(1) ), lower health insurance premiums, and protect health insurance coverage for people with preexisting conditions. 4. GAO report on affect of State innovation waivers on coverage of individuals and on mental health health care treatment Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the number of individuals expected to lose access to health insurance coverage (as defined in section 2791 of the Public Health Service Act ( 42 U.S.C. 300gg–91 )) if section 2 were not enacted and waivers under section 1332 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18052 ) were approved under the guidance described in such section 2. Such report shall include an analysis of the expected effect such waivers approved under such guidance would have on mental health care treatment.

Passed the House of Representatives May 9, 2019. Cheryl L. Johnson, Clerk

May 15, 2019 Read the second time and placed on the calendar