S 322 — Protect Act

Summary

Protect Act This bill duplicates certain requirements for private health insurance plans with respect to preexisting conditions, enrollment eligibility, genetic testing, and discrimination based on health-related factors.

Bill Text

• Introduced Introduced in Senate Current html February 12, 2021

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

The bill amends the Health Insurance Portability and Accountability Act to prohibit pre-existing condition exclusions and discrimination based on health status.

• Subtitle C of title I of the Health Insurance Portability and Accountability Act of 1996

  SEC. 196. PROHIBITION OF PRE-EXISTING CONDITION EXCLUSIONS. (a) In General.--A group health plan and a health insurance issuer offering group or individual health insurance coverage may not impose any pre-existing condition exclusion with respect to such plan or coverage. (b) Definitions.--For purposes of this section: (1) Pre-existing condition exclusion.-- (A) In general.--The term `pre-existing condition exclusion' means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the enrollment date for such coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before such date. (B) Treatment of genetic information.--Genetic information shall not be treated as a condition described in subparagraph (A) in the absence of a diagnosis of the condition related to such information. (2) Enrollment date.--The term `enrollment date' means, with respect to an individual covered under a group health plan or health insurance coverage, the date of enrollment of the individual in the plan or coverage or, if earlier, the first day of the waiting period for such enrollment. (3) Waiting period.--The term `waiting period' means, with respect to a group health plan and an individual who is a potential participant or beneficiary in the plan, the period that must pass with respect to the individual before the individual is eligible to be covered for benefits under the terms of the plan.

  This addition explicitly prohibits health plans from excluding coverage for pre-existing conditions.

• Subtitle C of title I of the Health Insurance Portability and Accountability Act of 1996

  SEC. 198. PROHIBITING DISCRIMINATION AGAINST INDIVIDUAL PARTICIPANTS AND BENEFICIARIES BASED ON HEALTH STATUS. (a) In General.--A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan or coverage based on any of the following health status-related factors in relation to the individual or a dependent of the individual: ... (9) Any other health status-related factor determined appropriate by the Secretary.

  This new section prohibits discrimination based on various health status-related factors when determining eligibility for health coverage.

Action History

1. February 12, 2021

   Introduced in Senate

2. February 12, 2021

   Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Sponsors

• Thomas Tillis · Primary

Subjects