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 HR3962 - Division A - Affordable Health Care Choices
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111th Congress
1st Session
H.R.  3962
Introduction

Sec. 1  Short Title; Table of Divisions, Titles and Subtitles
Recorded By:  Chris Mezzolesta

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 Division A
AFFORDABLE HEALTH CARE CHOICES

Sec. 100 -  Purpose; Table of Contents of Division; General Definitions
Recorded By:  Chris Mezzolesta

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Title I   - IMMEDIATE REFORMS
Sec. 101  -  National high-risk pool program

Sec. 102  -  Ensuring value and lower premiums

Sec. 103  -  Ending health insurance rescission abuse
Recorded By:  Cameron Thomas

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Sec. 104  -  Sunshine on price gouging by health insurance issuers

Sec. 105  -  Requiring the option of extension of dependent coverage for uninsured young adults

Sec. 106  -  Limitations on preexisting condition exclusions in group health plans in advance of applicability of new prohibition of preexisting condition exclusions

Sec. 107  -  Prohibiting acts of domestic violence from being treated as preexisting condition exclusions
Recorded By:  Al Remington

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Sec. 108  -  Ending health insurance denials and delays of necessary treatment for children with deformities

Sec. 109  -  Elimination of lifetime benefits

Sec. 110  -  Prohibition against postretirement reductions of retiree health benefits by group health plans

Sec. 111  -  Reinsurance program for retirees

Recorded By:  Sergei Burbank

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Sec. 112  -  Wellness program grants

Sec. 113  -  Extension of COBRA continuation coverage

Sec. 114  -  State Health Access Program grants

Sec. 115  -  Administrative simplification

Recorded By:  Lenny Lyons

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Title II - PROTECTIONS AND STANDARDS FOR QUALIFIED HEALTH BENEFITS PLANS
Subtitle A  -  General Standards
Sec. 201  -  Requirements reforming health insurance marketplace
Sec. 202  -  Protecting the choice to keep current coverage
Recorded By:  Kitzie Stern

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Subtitle B  -  Standards Guaranteeing Access to Affordable Coverage
Sec. 211  -  Prohibiting preexisting condition exclusions
Sec. 212  -  Guaranteed issue and renewal for insured plans and prohibiting rescissions
Sec. 213  -  Insurance rating rules
Sec. 214  -  Nondiscrimination in benefits; parity in mental health and substance abuse disorder benefits
Sec. 215  -  Ensuring adequacy of provider networks
Sec. 216  -  Requiring the option  of extension of dependent coverage for uninsured young adults
Sec. 217  -  Consistency of costs and coverage under qualified health benefits plans during plan year
Recorded By:  Brian Hawkins

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Subtitle C  -  Standards Guaranteeing Access to Essential Benefits
Sec. 221  -  Coverage of essential benefits package
Sec. 222  -  Essential benefits package defined
Sec. 223  -  Health Benefits Advisory Committee
Sec. 224  -  Process for adoption of recommendations; adoption f benefit standards
Recorded By:  Veronica March

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Subtitle D  -  Additional Consumer Protections
Sec. 231  -  Requiring fair marketing practices by health insurers
Sec. 232  -  Requiring fair grievance and appeals mechanisms
Sec. 233  -  Requiring information transparency and plan disclosure
Sec. 234  -  Application to qualified health benefits plans not offered through the Health Insurance Exchange
Sec. 235  -  Timely payment of claims
Sec. 236  -  Standardized rules for coordination and subrogation of benefits
Sec. 237  -  Application of administrative simplification
Sec. 238  -  State prohibitions on discrimination against health care providers
Sec. 239  -  Protection of physician prescriber information
Sec. 240  -  Dissemination of advance care planning information
Recorded By:  Dustin Ebaugh

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Subtitle E  -  Governance
Sec. 241  -  Health Choices Administration; Health Choices Commissioner
Sec. 242  -  Duties and authority of Commissioner
Sec. 243  -  Consultation and coordination
Sec. 244  -  Health Insurance Ombudsman
Recorded By:  Linda Ristig

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Subtitle F  -  Relation to Other Requirements; Miscellaneous
Recorded By:  Diane Havens

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Title III - HEALTH INSURANCE EXCHANGE AND RELATED PROVISIONS
Subtitle A  -  Health Insurance Exchange
Sec. 301  -  Establishment of Health Insurance Exchange; outline of duties; definitions

Sec. 302  -  Exchange-eligible individuals and employers

Sec. 303  -  Benefits package levels

Sec. 304  -  Contracts for the offering of Exchange-participating health benefits plans
Recorded By:  Channe Nolen

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Sec. 305  -  Outreach and enrollment of Exchange-eligible individuals and employers in Exchange-participating health benefits plan

Sec. 306  -  Other functions


Sec. 307  -  Health Insurance Exchange Trust Fund


Sec. 308  -  Optional operation of State-based health insurance exchanges

Sec. 309  -  Interstate health insurance compacts

Sec. 310  -  Health insurance cooperatives

Sec. 311  -  Retention of DoD and VA authority
Recorded By:  Evan Rapp

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 Subtitle B  -  Public Health Insurance Option
Sec. 321  -  Establishment of administration of a public health insurance option as an Exchange-qualified health benefits plan

Sec. 322
  -  Premiums and financing

Sec. 323  -  Payment rates for items and services

Sec. 324  -  Modernized payment initiatives and delivery system reform

Sec. 325  -  Provider participation

Sec. 326  -  Application of fraud and abuse provisions

Sec. 327  -  Application of HIPAA insurance requirements

Sec. 328  -  Application of health information policy, security, and electronic transaction requirements

Sec. 329  -  Enrollment in public health insurance option is voluntary

Sec. 330  -  Enrollment in public health insurance option by Members of Congress

Sec. 331  -  Reimbusement of Secretary of Veterans Affairs

Recorded By:  Diane Havens

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Subtitle C  -  Individual Affordability Credits
Sec. 341  -  Availability through Health Insurance Exchange
Recorded By:  Jan Eliot

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Sec. 342  -  Affordability credit eligible individual

Sec. 343  -  Affordability premium credit

Sec. 344  -  Affordability cost-sharing credit

Sec. 345  -  Income determinations

Sec. 346  -  Special rules for application to territories

Sec. 347  -  No Federal payment for undocumented aliens

Recorded By:  John Zadikian

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Title IV  -  SHARED RESPONSIBILITY
Subtitle A  -  Individual Responsibility
Subtitle B  -  Employer Responsibility
Part 1 - Health Coverage Participation Requirements

Sec. 411  -  Health coverage participation requirements

Sec. 412  -  Employer responsibility to contribute toward employee and dependent coverage

Sec. 413  -  Employer contributions in lien of coverage

Sec. 414  -  Authority related to improper steering

Sec. 415  -  Impact study on employer responsibility requirements

Sec. 416  -  Study on employer hardship exemption


Part 2 - Satisfaction of Health Coverage Participation Requirements


Sec. 421  -  Satisfaction of health coverage participation requirements under the Employer Retirement Income Security Act of 1974
Recorded By:  Lori Furth

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Sec. 422  -  Satisfaction of health coverage participation requirements under the Internal Revenue Code of 1986

Sec. 423  -  Satisfaction of health coverage participation requirements under the Public Health Service Act

Sec. 424  -  Additional rules relating to health coverage participation requirements
Recorded By:  Vanessa Hart

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Title V  -  AMENDMENTS TO INTERNAL REVENUE CODE OF 1986
Subtitle A  -  Provisions Relating to Health Care Reform
Part 1 - Shared Responsibility
Subpart A - Individual Responsibility
Sec. 501  - Tax on individuals without acceptable health care coverage
Subpart B - Employer Responsibility
Sec. 511  -  Election to satisfy health coverage participation requirements

Sec. 512  -  Health care contributions of nonelecting employers
Recorded By:  George Washington III

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Part 2 - Credit for Small Business Employee Health Coverage Expenses

Sec. 521  -  Credit for small business employee health coverage expenses


Part 3 - Limitations of Health Care Related Expenditures


Sec. 531  -  Distributions for medicine qualified only if for prescribed drug or insulin

Sec. 532  -  Limitation on health flexible spending arrangements under cafeteria plans

Sec. 533  -  Increase in penalty for nonqualified distributions from health savings accounts

Sec. 534  -  Denial of deduction for federal subsidies for prescription drug plans which have been excluded from gross income


Part 4 - Other Provisions to Carry Out Health Insurance Reform

Sec. 541  -  Disclosures to carry out health insurance exchange subsidies

Sec. 542  -  Offering of exchange-participating health benefits plans through cafeteria plans

Sec. 543  -  Exclusion from gross income of payments made under reinsurance program for retirees

Sec. 544  -  CLASS program treated in same manner as long-term care insurance

Sec. 545  -  Exclusion from gross income for medical care provided for Indians

Recorded By:  Joe Geoffrey

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Subtitle B - Other Revenue Provisions; Credit for Small Business Employee Health Coverage Expenses
Part 1 - General Provisions

Sec. 551  -  Surcharge on high income individuals

Sec. 552  -  Excise tax on medical devices

Sec. 553  -  Expansion of information reporting requirements

Sec. 554  -  Delay in application of worldwide allocation of interest


Part 2 - Prevention of Tax Avoidance

Sec. 561  -  Limitation on treaty benefits for certain deductible payments

Sec. 562  -  Codification of economic substance doctrine; penalties

Sec. 563  -  Certain large or publicly traded persons made subject to a more likely than not standard for avoiding penalties on underpayments

Recorded By:  Jud Niven

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Part 3 - Parity in Health Benefits

Sec. 571  -  Certain health related benefits applicable to spouses and dependents extended to eligible beneficiaries
Recorded By:  Greg Schweizer

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To Division B----->