United States 116th Congress Status: Died 1 D cosponsors

HR 1379 — Ensuring Lasting Smiles Act

Last action — Ordered to be Reported (Amended) by Voice Vote.

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. Died in session

This bill died with 116th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

Ensuring Lasting Smiles Act This bill requires private health insurance plans to cover diagnosis and treatment services for congenital anomalies and birth defects, such as reconstructive services and prosthetics. Coverage must include services that functionally improve, repair, or restore any body part that is medically necessary for normal bodily functions or appearance, as determined by the treating physician.

Bill Text

Sections of law this bill changes

5 sections in 3 laws

From the bill's own amending language, matched to the official United States Code (current through Public Law 119-124).

Employee retirement income security program · 29 U.S.C. ch. 18 2 sections
  • § 1191 Preemption; State flexibility; construction Amends

    29 U.S.C. § 1191 — at 1191(c)

    The law today

    (a) Continued applicability of State law with respect to health insurance issuers (1) In general Subject to paragraph (2) and except as provided in subsection (b), this part shall not be construed to supersede any provision of State law which establishes, implements, or continues in effect any standard or requirement solely relating to health insurance issuers in connection with group health insurance coverage except to the extent that such standard or requirement prevents the application of a requirement of this part. (2) Continued preemption with respect to group health plans Nothing in this part shall be construed to affect or modify the provisions of section 1144 of this title with respect to group health plans. (b) Special rules in case of portability requirements (1) In general Subject to paragraph (2), the provisions of this part relating to health insurance coverage offered by a health insurance issuer supersede any provision of State law which establishes, implements, or continues in effect a standard or requirement applicable to imposition of a preexisting condition exclusion specifically governed by section 1181 of this title which differs from the standards or requirements specified in such section. (2) Exceptions Only in relation to health insurance coverage offered by a health insurance issuer, the provisions of this part do not supersede any provision of State law to the extent that such provision— (A) substitutes for the reference to “6-month period” in section 1181(a)(1) of this title a reference to any shorter period of time; (B) substitutes for the reference to “12 months” and “18 months” in section 1181(a)(2) of this title a reference to any shorter period of time; (C) substitutes for the references to “63 days” in sections 1181(c)(2)(A) and (d)(4)(A) 1 of this title a reference to any greater number of days; (D) substitutes for the reference to “30-day period” in sections 1181(b)(2) 2 and (d)(1) of this title a reference to any greater period; (E) prohibits the imposition of any preexisting condition exclusion in cases not described in section 1181(d) of this title or expands the exceptions described in such section; (F) requires special enrollment periods in addition to those required under section 1181(f) of this title; or (G) reduces the maximum period permitted in an affiliation period under section 1181(g)(1)(B) 3 of this title. (c) Rules of construction Except as provided in section 1185 of this title, nothing in this part shall be construed as requiring a group health plan or health insurance coverage to provide specific benefits under the terms of such plan or coverage. (d) Definitions For purposes of this section— (1) State law The term “State law” includes all laws, decisions, rules, regulations, or other State action having the effect of law, of any State. A law of the United States applicable only to the District of Columbia shall be treated as a State law rather than a law of the United States. (2) State The term “State” includes a State, the Northern Mariana Islands, any political subdivisions of a State or such Islands, or any agency or instrumentality of either.

    8 other bills also change this section · Follow it → Official text at uscode.house.gov ↗

  • § 1191a Special rules relating to group health plans Amends

    29 U.S.C. § 1191a — at 1191a(a)

    The law today

    (a) General exception for certain small group health plans The requirements of this part (other than sections 1185 and 1185o of this title) shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) for any plan year if, on the first day of such plan year, such plan has less than 2 participants who are current employees. (b) Exception for certain benefits The requirements of this part shall not apply to any group health plan (and group health insurance coverage) in relation to its provision of excepted benefits described in section 1191b(c)(1) of this title. (c) Exception for certain benefits if certain conditions met (1) Limited, excepted benefits The requirements of this part shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) in relation to its provision of excepted benefits described in section 1191b(c)(2) of this title if the benefits— (A) are provided under a separate policy, certificate, or contract of insurance; or (B) are otherwise not an integral part of the plan. (2) Noncoordinated, excepted benefits The requirements of this part shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) in relation to its provision of excepted benefits described in section 1191b(c)(3) of this title if all of the following conditions are met: (A) The benefits are provided under a separate policy, certificate, or contract of insurance. (B) There is no coordination between the provision of such benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor. (C) Such benefits are paid with respect to an event without regard to whether benefits are provided with respect to such an event under any group health plan maintained by the same plan sponsor. (3) Supplemental excepted benefits The requirements of this part shall not apply to any group health plan (and group health insurance coverage) in relation to its provision of excepted benefits described in section 1191b(c)(4) of this title if the benefits are provided under a separate policy, certificate, or contract of insurance. (d) Treatment of partnerships For purposes of this part— (1) Treatment as a group health plan Any plan, fund, or program which would not be (but for this subsection) an employee welfare benefit plan and which is established or maintained by a partnership, to the extent that such plan, fund, or program provides medical care (including items and services paid for as medical care) to present or former partners in the partnership or to their dependents (as defined under the terms of the plan, fund, or program), directly or through insurance, reimbursement, or otherwise, shall be treated (subject to paragraph (2)) as an employee welfare benefit plan which is a group health plan. (2) Employer In the case of a group health plan, the term “employer” also includes the partnership in relation to any partner. (3) Participants of group health plans In the case of a group health plan, the term “participant” also includes— (A) in connection with a group health plan maintained by a partnership, an individual who is a partner in relation to the partnership, or (B) in connection with a group health plan maintained by a self-employed individual (under which one or more employees are participants), the self-employed individual, if such individual is, or may become, eligible to receive a benefit under the plan or such individual’s beneficiaries may be eligible to receive any such benefit.

    18 other bills also change this section · Follow it → Official text at uscode.house.gov ↗

Public health service · 42 U.S.C. ch. 6A 2 sections
  • § 300gg-23 Preemption; State flexibility; construction Amends

    42 U.S.C. § 300gg-23 — at 300gg-23(c)

    The law today

    (a) Continued applicability of State law with respect to health insurance issuers (1) In general Subject to paragraph (2) and except as provided in subsection (b), this part, part D, and part C insofar as it relates to this part or part D shall not be construed to supersede any provision of State law which establishes, implements, or continues in effect any standard or requirement solely relating to health insurance issuers in connection with individual or group health insurance coverage except to the extent that such standard or requirement prevents the application of a requirement of this part or part D. (2) Continued preemption with respect to group health plans Nothing in this part or part D shall be construed to affect or modify the provisions of section 1144 of title 29 with respect to group health plans. (b) Special rules in case of portability requirements (1) In general Subject to paragraph (2), the provisions of this part relating to health insurance coverage offered by a health insurance issuer supersede any provision of State law which establishes, implements, or continues in effect a standard or requirement applicable to imposition of a preexisting condition exclusion specifically governed by section 701 1 which differs from the standards or requirements specified in such section. (2) Exceptions Only in relation to health insurance coverage offered by a health insurance issuer, the provisions of this part do not supersede any provision of State law to the extent that such provision— (i) substitutes for the reference to “6-month period” in section 2701(a)(1) 1 a reference to any shorter period of time; (ii) substitutes for the reference to “12 months” and “18 months” in section 2701(a)(2) 1 a reference to any shorter period of time; (iii) substitutes for the references to “63” days in sections 2701(c)(2)(A) 1 and 2701(d)(4)(A) 1 a reference to any greater number of days; (iv) substitutes for the reference to “30-day period” in sections 2701(b)(2) 1 and 2701(d)(1) 1 a reference to any greater period; (v) prohibits the imposition of any preexisting condition exclusion in cases not described in section 2701(d) 1 or expands the exceptions described in such section; (vi) requires special enrollment periods in addition to those required under section 2701(f) 1; or (vii) reduces the maximum period permitted in an affiliation period under section 2701(g)(1)(B) 1. (c) Rules of construction Nothing in this part (other than section 2704) 1 or part D shall be construed as requiring a group health plan or health insurance coverage to provide specific benefits under the terms of such plan or coverage. (d) Definitions For purposes of this section— (1) State law The term “State law” includes all laws, decisions, rules, regulations, or other State action having the effect of law, of any State. A law of the United States applicable only to the District of Columbia shall be treated as a State law rather than a law of the United States. (2) State The term “State” includes a State (including the Northern Mariana Islands), any political subdivisions of a State or such Islands, or any agency or instrumentality of either.

    20 other bills also change this section · Follow it → Official text at uscode.house.gov ↗

  • § 300gg-62 Preemption and application Amends

    42 U.S.C. § 300gg-62 — at 300gg-62(b)(2)

    The law today

    (a) In general Subject to subsection (b), nothing in this part (or part C insofar as it applies to this part) shall be construed to prevent a State from establishing, implementing, or continuing in effect standards and requirements unless such standards and requirements prevent the application of a requirement of this part. (b) Rules of construction (1) Nothing in this part (or part C insofar as it applies to this part) shall be construed to affect or modify the provisions of section 1144 of title 29. (2) Nothing in this part (other than section 300gg–51 of this title) shall be construed as requiring health insurance coverage offered in the individual market to provide specific benefits under the terms of such coverage. (c) Application of part A provisions (1) In general The provisions of part A shall apply to health insurance issuers providing health insurance coverage in the individual market in a State as provided for in such part. (2) Clarification To the extent that any provision of this part conflicts with a provision of part A with respect to health insurance issuers providing health insurance coverage in the individual market in a State, the provisions of such part A shall apply.

    3 other bills also change this section · Follow it → Official text at uscode.house.gov ↗

Quality, affordable health care for all americans · 42 U.S.C. ch. 157 1 section
  • § 18011 Preservation of right to maintain existing coverage Amends

    42 U.S.C. § 18011 — at 18011(a)(4)(A)

    The law today

    (a) No changes to existing coverage (1) In general Nothing in this Act (or an amendment made by this Act) shall be construed to require that an individual terminate coverage under a group health plan or health insurance coverage in which such individual was enrolled on March 23, 2010. (2) Continuation of coverage Except as provided in paragraph (3), with respect to a group health plan or health insurance coverage in which an individual was enrolled on March 23, 2010, this subtitle and subtitle A (and the amendments made by such subtitles) shall not apply to such plan or coverage, regardless of whether the individual renews such coverage after March 23, 2010. (3) Application of certain provisions The provisions of sections 2715 [42 U.S.C. 300gg–15] and 2718 [42 U.S.C. 300gg–18] of the Public Health Service Act (as added by subtitle A) shall apply to grandfathered health plans for plan years beginning on or after March 23, 2010. (4) Application of certain provisions (A) In general The following provisions of the Public Health Service Act [42 U.S.C. 201 et seq.] (as added by this title) 1 shall apply to grandfathered health plans for plan years beginning with the first plan year to which such provisions would otherwise apply: (i) Section 2708 [42 U.S.C. 300gg–7] (relating to excessive waiting periods). (ii) Those provisions of section 2711 [42 U.S.C. 300gg–11] relating to lifetime limits. (iii) Section 2712 [42 U.S.C. 300gg–12] (relating to rescissions). (iv) Section 2714 [42 U.S.C. 300gg–14] (relating to extension of dependent coverage). (B) Provisions applicable only to group health plans (i) Provisions described Those provisions of section 2711 [42 U.S.C. 300gg–11] relating to annual limits and the provisions of section 2704 [42 U.S.C. 300gg–3] (relating to pre-existing condition exclusions) of the Public Health Service Act (as added by this subtitle) shall apply to grandfathered health plans that are group health plans for plan years beginning with the first plan year to which such provisions otherwise apply. (ii) Adult child coverage For plan years beginning before January 1, 2014, the provisions of section 2714 of the Public Health Service Act [42 U.S.C. 300gg–14] (as added by this subtitle) shall apply in the case of an adult child with respect to a grandfathered health plan that is a group health plan only if such adult child is not eligible to enroll in an eligible employer-sponsored health plan (as defined in section 5000A(f)(2) of title 26) other than such grandfathered health plan. (5) Application of additional provisions Sections 300gg–111, 300gg–112, and 300gg–117 of this title shall apply to grandfathered health plans for plan years beginning on or after January 1, 2022. (b) Allowance for family members to join current coverage With respect to a group health plan or health insurance coverage in which an individual was enrolled on March 23, 2010, and which is renewed after such date, family members of such individual shall be permitted to enroll in such plan or coverage if such enrollment is permitted under the terms of the plan in effect as of March 23, 2010. (c) Allowance for new employees to join current plan A group health plan that provides coverage on March 23, 2010, may provide for the enrolling of new employees (and their families) in such plan, and this subtitle and subtitle A (and the amendments made by such subtitles) shall not apply with respect to such plan and such new employees (and their families). (d) Effect on collective bargaining agreements In the case of health insurance coverage maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers that was ratified before March 23, 2010, the provisions of this subtitle and subtitle A (and the amendments made by such subtitles) shall not apply until the date on which the last of the collective bargaining agreements relating to the coverage terminates. Any coverage amendment made pursuan...

    36 other bills also change this section · Follow it → Official text at uscode.house.gov ↗

Also cites: 42 U.S.C. § 300gg-28

How this bill changes current law

4 changes Share ↗

Compared against current U.S. Code AI-generated reading aid — verify against the official bill.

The bill adds requirements for group and individual health insurance coverage to provide treatment for congenital anomalies and birth defects.

  • 42 U.S.C. 300gg

    SEC. 2730. STANDARDS RELATING TO BENEFITS FOR CONGENITAL ANOMALY OR BIRTH DEFECT. (a) Requirements for Care and Reconstructive Treatment.-- (1) In general.--A group health plan, and a health insurance issuer offering group or individual health insurance coverage, shall provide coverage for outpatient and inpatient services related to the diagnosis and treatment of a congenital anomaly or birth defect.

    This creates a new requirement for health plans to cover treatment for congenital anomalies and birth defects.

  • 29 U.S.C. 1191

    SEC. 716. STANDARDS RELATING TO BENEFITS FOR CONGENITAL ANOMALY OR BIRTH DEFECT. (a) Requirements for Reconstructive Treatment.-- (1) In general.--A group health plan, and a health insurance issuer offering group or individual health insurance coverage, shall provide coverage for outpatient and inpatient services related to the diagnosis and treatment of a congenital anomaly or birth defect.

    This establishes a requirement for ERISA plans to cover treatments for congenital anomalies and birth defects.

  • 26 U.S.C. 9816

    SEC. 9816. STANDARDS RELATING TO BENEFITS FOR CONGENITAL ANOMALY OR BIRTH DEFECT. (a) Requirements for Reconstructive Treatment.--A group health plan, and a health insurance issuer offering group or individual health insurance coverage, shall provide coverage for outpatient and inpatient services related to the diagnosis and treatment of a congenital anomaly or birth defect.

    This mandates that health insurance under the Internal Revenue Code also cover treatments for congenital anomalies and birth defects.

  • 42 U.S.C. 18011(a)(4)(A)

    Section 2729 (relating to standards relating to benefits for congenital anomaly or birth defect), as added by section 2(a) of the Ensuring Lasting Smiles Act.

    This clarifies that the new standards for congenital anomaly treatments apply to grandfathered plans.

Action History

  1. Committee Consideration and Mark-up Session Held.

  2. Ordered to be Reported (Amended) by Voice Vote.

  3. Forwarded by Subcommittee to Full Committee by Voice Vote .

  4. Subcommittee Consideration and Mark-up Session Held.

  5. Motion to place bill on Consensus Calendar filed by Mr. Peterson.

  6. Subcommittee Hearings Held.

  7. Referred to the Subcommittee on Health.

  8. Introduced in House

  9. Introduced in House

  10. Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, 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.

  11. Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, 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.

  12. Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, 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.

  13. Referred to the Subcommittee on Health.

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 546 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (546)

546 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
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Frequently asked questions

What does HR 1379 do?
Ensuring Lasting Smiles Act This bill requires private health insurance plans to cover diagnosis and treatment services for congenital anomalies and birth defects, such as reconstructive services and prosthetics. Coverage must include services that functionally improve, repair, or restore any body part that is medically necessary for normal bodily functions or appearance, as determined by the treating physician.
Who sponsors HR 1379?
HR 1379 is sponsored by Peterson, Collin C. (Democratic).
What is the current status of HR 1379?
This bill died with 116th Congress. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track HR 1379?
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