Health Care Protection Act

I 116TH CONGRESS 2D SESSION H. R. 6810 To establish a Health Care Protection Program Fund to provide grants to employers to ensure continuity of coverage under a group health plan through the COVID–19 pandemic, to provide for premium assist- ance for COBRA benefits, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY 12, 2020 Mr. RODNEY DAVIS of Illinois (for himself, Mr. SCHRADER, Mrs. WAGNER, Ms. KENDRA S. HORN of Oklahoma, Mr. GONZALEZ of Ohio, and Ms. TORRES SMALL of New Mexico) introduced the following bill; which was referred to the Committee on Education and Labor, and in addition to the Committees on Energy and Commerce, and 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 com- mittee concerned A BILL To establish a Health Care Protection Program Fund to provide grants to employers to ensure continuity of cov- erage under a group health plan through the COVID– 19 pandemic, to provide for premium assistance for COBRA benefits, and for other purposes. 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 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 6810 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Health Care Protection 2 Act’’. 3 SEC. 2. SENSE OF CONGRESS. 4 It is the sense of Congress that— 5 (1) the COVID–19 pandemic has caused many 6 individuals to lose access to employer-sponsored 7 health insurance at no fault of their own; 8 (2) individuals should not be forced to cover ad- 9 ditional costs associated with healthcare due to a 10 loss of access to employer-sponsored health insur- 11 ance; 12 (3) employers should utilize all tools provided to 13 them by the Federal Government to bring individ- 14 uals back onto payroll so that they may receive bene- 15 fits such as employer-sponsored health insurance; 16 and 17 (4) individuals unable to rejoin the workforce 18 should receive assistance equal to that received while 19 employed so that when an employer makes an offer 20 of employment, the individual does not have an in- 21 centive to reject. 22 SEC. 3. AMERICAN HEALTH EXCHANGES SPECIAL ENROLL- 23 MENT PERIOD. 24 Section 1311(c)(6) of the Patient Protection and Af- 25 fordable Care Act (42 U.S.C. 18031(c)(6)) is amended— 26 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 6810 IH (1) in subparagraph (C), by striking at the end 1 ‘‘and’’; 2 (2) in subparagraph (D), by striking at the end 3 the period and inserting ‘‘; and’’; and 4 (3) by adding at the end the following new sub- 5 paragraph: 6 ‘‘(E) a special enrollment period during the 7 30-day period following the date of the enact- 8 ment of this subparagraph during which any in- 9 dividual who is otherwise eligible to enroll in a 10 qualified health plan through the Exchange and 11 who is not otherwise enrolled in such a plan 12 may enroll in such a qualified health plan.’’. 13 SEC. 4. PREMIUM ASSISTANCE FOR COBRA BENEFITS. 14 (a) PREMIUM ASSISTANCE FOR COBRA CONTINU- 15 ATION COVERAGE FOR INDIVIDUALS AND THEIR FAMI- 16 LIES.— 17 (1) PROVISION OF PREMIUM ASSISTANCE.— 18 (A) REDUCTION OF PREMIUMS PAY- 19 ABLE.—In the case of any premium for a pe- 20 riod of coverage (not to exceed 6 months) be- 21 ginning on or after the date of the enactment 22 of this Act and on or before January 1, 2021, 23 for COBRA continuation coverage with respect 24 to any assistance eligible individual, such indi- 25 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 6810 IH vidual shall be treated for purposes of any 1 COBRA continuation provision as having paid 2 the amount of such premium if such individual 3 pays (or a person other than such individual’s 4 employer pays on behalf of such individual) a 5 percent of such premium such that the amount 6 of such premium so paid is equal to the amount 7 the covered employee with respect to such cov- 8 erage would have paid with respect to such indi- 9 vidual for such period for coverage under the 10 group health plan under which such employee 11 was enrolled at the time of the qualifying event 12 had such event not occurred (as determined 13 without regard to this subsection). 14 (B) PLAN ENROLLMENT OPTION.— 15 (i) IN GENERAL.—Notwithstanding 16 the COBRA continuation provisions, an as- 17 sistance eligible individual may, not later 18 than 90 days after the date of notice of the 19 plan enrollment option described in this 20 subparagraph, elect to enroll in coverage 21 under a plan offered by the employer in- 22 volved, or the employee organization in- 23 volved (including, for this purpose, a joint 24 board of trustees of a multiemployer trust 25 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 6810 IH affiliated with one or more multiemployer 1 plans), that is different than coverage 2 under the plan in which such individual 3 was enrolled at the time the qualifying 4 event occurred, and such coverage shall be 5 treated as COBRA continuation coverage 6 for purposes of the applicable COBRA con- 7 tinuation coverage provision. 8 (ii) REQUIREMENTS.—An assistance 9 eligible individual may elect to enroll in 10 different coverage as described in clause (i) 11 only if— 12 (I) the employer involved has 13 made a determination that such em- 14 ployer will permit assistance eligible 15 individuals to enroll in different cov- 16 erage as provided for this subpara- 17 graph; 18 (II) the premium for such dif- 19 ferent coverage does not exceed the 20 premium for coverage in which the in- 21 dividual was enrolled at the time the 22 qualifying event occurred; 23 (III) the different coverage in 24 which the individual elects to enroll is 25 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 6810 IH coverage that is also offered to the ac- 1 tive employees of the employer at the 2 time at which such election is made; 3 and 4 (IV) the different coverage is 5 not— 6 (aa) coverage that provides 7 only dental, vision, counseling, or 8 referral services (or a combina- 9 tion of such services); 10 (bb) a flexible spending ar- 11 rangement (as defined in section 12 106(c)(2) of the Internal Rev- 13 enue Code of 1986); or 14 (cc) coverage that provides 15 coverage for services or treat- 16 ments furnished in an on-site 17 medical facility maintained by 18 the employer and that consists 19 primarily of first-aid services, 20 prevention and wellness care, or 21 similar care (or a combination of 22 such care). 23 (C) PREMIUM REIMBURSEMENT.—For pro- 24 visions providing the balance of such premium, 25 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 6810 IH see section 6431 of the Internal Revenue Code 1 of 1986, as added by paragraph (12). 2 (2) LIMITATION OF PERIOD OF PREMIUM AS- 3 SISTANCE.— 4 (A) IN GENERAL.—Paragraph (1)(A) shall 5 not apply with respect to any assistance eligible 6 individual for months of coverage beginning on 7 or after the earlier of— 8 (i) the first date that such individual 9 is eligible for coverage under any other 10 group health plan (other than coverage 11 consisting of only dental, vision, coun- 12 seling, or referral services (or a combina- 13 tion thereof), coverage under a flexible 14 spending arrangement (as defined in sec- 15 tion 106(c)(2) of the Internal Revenue 16 Code of 1986), or coverage of treatment 17 that is furnished in an on-site medical fa- 18 cility maintained by the employer and that 19 consists primarily of first-aid services, pre- 20 vention and wellness care, or similar care 21 (or a combination thereof)) or is eligible 22 for benefits under title XVIII of the Social 23 Security Act, or 24 (ii) the earliest of— 25 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 6810 IH (I) July 1, 2021, 1 (II) the date following the expira- 2 tion of the maximum period of con- 3 tinuation coverage required under the 4 applicable COBRA continuation cov- 5 erage provision, or 6 (III) the date following the expi- 7 ration of the period of continuation 8 coverage allowed under paragraph 9 (4)(B)(ii). 10 (B) TIMING OF ELIGIBILITY FOR ADDI- 11 TIONAL COVERAGE.—For purposes of subpara- 12 graph (A)(i), an individual shall not be treated 13 as eligible for coverage under a group health 14 plan before the first date on which such indi- 15 vidual could be covered under such plan. 16 (C) NOTIFICATION REQUIREMENT.—An 17 assistance eligible individual shall notify in writ- 18 ing the group health plan with respect to which 19 paragraph (1)(A) applies if such paragraph 20 ceases to apply by reason of subparagraph 21 (A)(i). Such notice shall be provided to the 22 group health plan in such time and manner as 23 may be specified by the Secretary of Labor. 24 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 9 •HR 6810 IH (3) ASSISTANCE ELIGIBLE INDIVIDUAL.—For 1 purposes of this section, the term ‘‘assistance eligible 2 individual’’ means any qualified beneficiary if— 3 (A) at any time during the period that be- 4 gins with March 1, 2020, and ends with De- 5 cember 31, 2020, such qualified beneficiary is 6 eligible for COBRA continuation coverage, 7 (B) such qualified beneficiary elects such 8 coverage, and 9 (C) the qualifying event with respect to the 10 COBRA continuation coverage consists of the 11 involuntary termination of the covered employ- 12 ee’s employment and occurred during such pe- 13 riod. 14 (4) EXTENSION OF ELECTION PERIOD AND EF- 15 FECT ON COVERAGE.— 16 (A) IN GENERAL.—For purposes of apply- 17 ing section 605(a) of the Employee Retirement 18 Income Security Act of 1974, section 19 4980B(f)(5)(A) of the Internal Revenue Code 20 of 1986, section 2205(a) of the Public Health 21 Service Act, and section 8905a(c)(2) of title 5, 22 United States Code, in the case of an individual 23 who does not have an election of COBRA con- 24 tinuation coverage in effect on the date of the 25 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 10 •HR 6810 IH enactment of this Act but who would be an as- 1 sistance eligible individual if such election were 2 so in effect, such individual may elect the 3 COBRA continuation coverage under the 4 COBRA continuation coverage provisions con- 5 taining such sections during the period begin- 6 ning on the date of the enactment of this Act 7 and ending 60 days after the date on which the 8 notification required under paragraph (7)(C) is 9 provided to such individual. 10 (B) COMMENCEMENT OF COVERAGE; NO 11 REACH-BACK.—Any COBRA continuation cov- 12 erage elected by a qualified beneficiary during 13 an extended election period under subparagraph 14 (A)— 15 (i) shall commence with the first pe- 16 riod of coverage beginning on or after the 17 date of the enactment of this Act, and 18 (ii) shall not extend beyond the period 19 of COBRA continuation coverage that 20 would have been required under the appli- 21 cable COBRA continuation coverage provi- 22 sion if the coverage had been elected as re- 23 quired under such provision. 24 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 11 •HR 6810 IH (5) EXPEDITED REVIEW OF DENIALS OF PRE- 1 MIUM ASSISTANCE.—In any case in which an indi- 2 vidual requests treatment as an assistance eligible 3 individual and is denied such treatment by the group 4 health plan, the Secretary of Labor (or the Sec- 5 retary of Health and Human Services in connection 6 with COBRA continuation coverage which is pro- 7 vided other than pursuant to part 6 of subtitle B of 8 title I of the Employee Retirement Income Security 9 Act of 1974), in consultation with the Secretary of 10 the Treasury, shall provide for expedited review of 11 such denial. An individual shall be entitled to such 12 review upon application to such Secretary in such 13 form and manner as shall be provided by such Sec- 14 retary. Such Secretary shall make a determination 15 regarding such individual’s eligibility within 15 busi- 16 ness days after receipt of such individual’s applica- 17 tion for review under this paragraph. Either Sec- 18 retary’s determination upon review of the denial 19 shall be de novo and shall be the final determination 20 of such Secretary. A reviewing court shall grant def- 21 erence to such Secretary’s determination. The provi- 22 sions of this paragraph, paragraphs (1) through (4), 23 and paragraph (7) shall be treated as provisions of 24 title I of the Employee Retirement Income Security 25 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H6810.IH H6810 pamtmann on DSKBC07HB2PROD with BILLS 12 •HR 6810 IH Act of 1974 for purposes of part 5 of subtitle B of 1 such title. 2 (6) DISREGARD OF SUBSIDIES FOR PURPOSES 3 OF FEDERAL AND STATE PROGRAMS.—Notwith- 4 standing any other provision of law, any premium 5 reduction with respect to an assistance eligible indi- 6 vidual under this subsection shall not be considered 7 income or resources in determining eligibility for, or 8 the amount of assistance or benefits provided under, 9 any other public benefit provided under Federal law 10 or the law of any State or political subdivision there- 11 of. 12 (7) NOTICES TO INDIVIDUALS.— 13 (A) GENERAL NOTICE.— 14 (i) IN GENERAL.—In the case of no- 15 tices provided under section 606(a)(4) of 16 the Employee Retirement Income Security 17 Act of 1974 (29 U.S.C. 1166(4)), section 18 4980B(f)(6)(D) of the Internal Revenue 19 Code of 1986, section 2206(4) of the Pub- 20 lic Health Service Act (42 U.S.C. 300bb– 21 6(4)), or section 8905a(f)(2)(A) of title 5, 22 United States Code, with respect to indi- 23 viduals who, during the period described in 24 paragraph (3)(A), become entitled to elect 25 VerDate Sep 11 2014 19:42 Jun 01, 2020 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt [Text truncated for display. 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