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

I 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 cov- erage 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 dis- closure and certain information with respect to coverage exclusions and premium variations in marketing, applica- tion, 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 Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 23:42 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1143.IH H1143 kjohnson on DSK79L0C42 with BILLS 2 •HR 1143 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Educating Consumers 2 on the Risks of Short-Term Plans Act of 2019’’. 3 SEC. 2. REQUIRING A HEALTH INSURANCE ISSUER OFFER- 4 ING SHORT-TERM LIMITED DURATION INSUR- 5 ANCE TO INCLUDE A STANDARDIZED DISCLO- 6 SURE AND CERTAIN INFORMATION WITH RE- 7 SPECT TO COVERAGE EXCLUSIONS AND PRE- 8 MIUM VARIATIONS IN MARKETING, APPLICA- 9 TION, AND ENROLLMENT MATERIALS DIS- 10 TRIBUTED IN CONNECTION WITH SUCH IN- 11 SURANCE AND PROHIBITING THE SALE OF 12 SUCH INSURANCE DURING CERTAIN PERI- 13 ODS. 14 (a) IN GENERAL.—Subpart II of part A of title 15 XXVII of the Public Health Service Act (42 U.S.C. 16 300gg–11 et seq.) is amended by adding at the end the 17 following new section: 18 ‘‘SEC. 2730. INFORMATION REQUIRED TO BE INCLUDED IN 19 MARKETING, APPLICATION, AND ENROLL- 20 MENT MATERIALS DISTRIBUTED IN CONNEC- 21 TION WITH SHORT-TERM LIMITED DURATION 22 INSURANCE; LIMITATION ON ENROLLMENT 23 PERIOD. 24 ‘‘(a) PROVISION OF INFORMATION.— 25 VerDate Sep 11 2014 23:42 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1143.IH H1143 kjohnson on DSK79L0C42 with BILLS 3 •HR 1143 IH ‘‘(1) IN GENERAL.—A health insurance issuer 1 offering short-term limited duration insurance shall 2 include in any marketing, application, or enrollment 3 materials distributed by such issuer in connection 4 with such insurance, in a prominent location set 5 apart from other information— 6 ‘‘(A) the standardized disclosure estab- 7 lished by the Secretary under paragraph (2); 8 and 9 ‘‘(B) a list of all medical conditions, in- 10 cluding both physical and mental health condi- 11 tions— 12 ‘‘(i) which may result in an individual 13 being denied the ability to enroll under 14 such insurance; 15 ‘‘(ii) for which such issuer may apply 16 a preexisting condition exclusion (as de- 17 fined in section 2704(b)(1)) with respect to 18 an enrollee under such insurance; 19 ‘‘(iii) which may result in an increase 20 in premium amounts for such an enrollee 21 compared to what such amounts would 22 have otherwise been for such enrollee ab- 23 sent such condition; or 24 VerDate Sep 11 2014 23:42 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1143.IH H1143 kjohnson on DSK79L0C42 with BILLS 4 •HR 1143 IH ‘‘(iv) for which such issuer may termi- 1 nate coverage under such insurance with 2 respect to such an enrollee. 3 ‘‘(2) ESTABLISHMENT OF DISCLOSURE.—For 4 purposes of paragraph (1)(A), the Secretary shall es- 5 tablish a standardized disclosure with respect to 6 short-term limited duration insurance offered by a 7 health insurance issuer that includes the following 8 information: 9 ‘‘(A) A notification that such insurance 10 may not cover preexisting conditions of an en- 11 rollee, including past physical or mental health 12 conditions, regardless of whether such enrollee 13 was aware of such conditions or had sought 14 treatment for such conditions on or before the 15 date of enrollment in such insurance. 16 ‘‘(B) A notification that such issuer may 17 rescind coverage under such insurance if an en- 18 rollee seeks treatment for such a preexisting 19 condition, regardless of whether such enrollee 20 was aware of such condition or had sought 21 treatment for such condition on or before the 22 date of enrollment in such insurance. 23 ‘‘(C) A notification that such insurance 24 provides limited benefits compared to individual 25 VerDate Sep 11 2014 23:42 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1143.IH H1143 kjohnson on DSK79L0C42 with BILLS 5 •HR 1143 IH health insurance coverage and does not include 1 all benefits required to be covered under the 2 Patient Protection and Affordable Care Act (in- 3 cluding the essential health benefits package (as 4 defined in section 1302(a) of such Act)) or 5 under this title. 6 ‘‘(D) A notification that coverage under 7 such insurance is temporary and may not cover 8 the costs of an enrollee for most hospital or 9 other medical items and services, including both 10 physical and mental health items and services. 11 ‘‘(E) A notification that an individual 12 should carefully review the benefits provided 13 under such insurance before enrolling in such 14 insurance. 15 ‘‘(F) A notification informing individuals 16 of the opportunity to purchase comprehensive 17 individual health insurance coverage through 18 Exchanges established under the Patient Pro- 19 tection and Affordable Care Act that provides 20 coverage for preexisting conditions without pre- 21 mium increases for such conditions and for 22 which such individuals may be eligible for finan- 23 cial assistance. Such notification shall include 24 VerDate Sep 11 2014 23:42 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1143.IH H1143 kjohnson on DSK79L0C42 with BILLS 6 •HR 1143 IH information on how such individuals may access 1 such Exchanges. 2 ‘‘(b) LIMITATION ON ENROLLMENT PERIOD.—A 3 health insurance issuer offering short-term limited dura- 4 tion insurance may not enroll any individual in such insur- 5 ance during any annual open enrollment period applicable 6 to such individual with respect to an Exchange.’’. 7 (b) CONFORMING AMENDMENTS.— 8 (1) ENFORCEMENT.—Section 2723 of the Pub- 9 lic Health Service Act (42 U.S.C. 300gg–22) is 10 amended— 11 (A) in subsection (a)— 12 (i) in paragraph (1), by inserting ‘‘, or 13 short-term limited duration insurance in 14 the State,’’ after ‘‘group market’’; and 15 (ii) in paragraph (2), by inserting 16 ‘‘(or, in the case of such a failure with re- 17 spect to section 2730, in connection with 18 short-term limited duration insurance)’’ 19 after ‘‘individual health insurance cov- 20 erage’’; and 21 (B) in subsection (b)(1)(B), by inserting ‘‘, 22 short-term limited duration insurance,’’ after 23 ‘‘individual health insurance coverage’’. 24 VerDate Sep 11 2014 23:42 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1143.IH H1143 kjohnson on DSK79L0C42 with BILLS 7 •HR 1143 IH (2) PREEMPTION.—Section 2724(a)(1) of such 1 Act (42 U.S.C. 300gg–23(a)(1)) is amended by in- 2 serting ‘‘or short-term limited duration insurance’’ 3 after ‘‘group health insurance coverage’’. 4 (c) EFFECTIVE DATE.—The amendments made by 5 this section shall apply with respect to marketing, applica- 6 tion, and enrollment materials distributed in connection 7 with short-term limited duration insurance on or after 8 September 1, 2019. 9 Æ VerDate Sep 11 2014 23:42 Feb 21, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\H1143.IH H1143 kjohnson on DSK79L0C42 with BILLS