How HR 35 changes current law

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

The bill amends the Social Security Act to enhance rights and protections for individuals seeking Medicare supplemental health insurance policies.

• 42 U.S.C. 1395ss(s)

  (s)(1) Subject to paragraph (2), the issuer of a medicare supplemental policy may not, in the case of an individual entitled to benefits under part A and enrolled under part B-- (A) deny or condition the issuance or effectiveness of a medicare supplemental policy, or discriminate in the pricing of the policy, because of health status, claims experience, receipt of health care, or medical condition; (B) exclude benefits based on a preexisting condition; (C) provide any time period applicable to preexisting conditions, waiting periods, elimination periods, and probationary periods for any benefit; (D) deny or condition the issuance or effectiveness of the policy (including the imposition of any exclusion of benefits under the policy based on a preexisting condition) or discriminate in the pricing of the policy (including the adjustment of premium rates) of an individual on the basis of the genetic information with respect to such individual; (E) deny or condition the issuance or effectiveness of a medicare supplemental policy that is offered and is available for issuance to new enrollees by such issuer; or (F) establish any period limiting enrollment under a medicare supplemental policy to such period for any individual.

  This change prohibits insurance issuers from discriminating against applicants based on health status or other factors.

• 42 U.S.C. 1395ss(r)(1)(A)

  policy, at least 75 percent of the aggregate amount of premiums collected in the case of group policies and at least 65 percent in the case of individual policies; and → policy-- (i) with respect to periods beginning before January 1, 2024, at least 75 percent of the aggregate amount of premiums collected in the case of group policies and at least 65 percent in the case of individual policies; and (ii) with respect to periods beginning on or after January 1, 2024, a percent of the aggregate amount of premiums collected that, in the case of group policies or individual policies, as applicable, is equal to or greater than both-- (I) the applicable percent specified in clause (i) with respect to such policies; and (II) such percent as the National Association of Insurance Commissioners may recommend to the Secretary with respect to such policies for purposes of this paragraph;

  This change updates the medical loss ratio requirements for Medicare supplemental policies to include potential new standards set by the National Association of Insurance Commissioners starting in 2024.

• 42 U.S.C. 1395ss

  (aa) Development of New Standards Relating to Pricing Discrimination.-- (1) In general.--The Secretary shall request the National Association of Insurance Commissioners to review and revise the standards for all benefit packages under subsection (p)(1), including the core benefit package, in order to provide coverage consistent with paragraph (2).

  This provision mandates a review and revision of pricing discrimination standards for Medicare supplemental insurance.

• 42 U.S.C. 1395b-2

  (d) In the case that the Secretary provides for a Medicare plan finder internet website of the Centers for Medicare & Medicaid Services (or a successor website), the Secretary shall, with respect to such website and in accordance with subsection (f)-- (1) make available on such website-- (A) access to provider networks in order to provide to individuals entitled to benefits under part A or enrolled under part B information to assist such individuals in understanding the restrictions on providers and potential costs entailed by their decisions regarding enrollment under parts A and B, under part C, and in medicare supplemental policies under section 1882;

  This amendment requires the creation and maintenance of a Medicare plan finder website that provides comprehensive information to beneficiaries.