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senate Bill S. 623

Pre-existing Condition Patient Protection Act of 2009

bill Progress

  • Not enacted
    The President has not signed this bill
  • The house has not voted
  • The senate has not voted
      senate Committees
      Committee on Health, Education, Labor, and Pensions
    IntroducedMarch 17th, 2009

Bill Details

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Pre-existing Condition Patient Protection Act of 2009

Official Title

A bill to amend title I of the Employee Retirement Income Security Act of 1974, title XXVII of the Public Service Act, and the Internal Revenue Code of 1986 to prohibit preexisting condition exclusions in group health plans and in health insurance coverage in the group and individual markets.


Pre-existing Condition Patient Protection Act of 2009 - Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to prohibit a group health plan from: (1) imposing any preexisting condition exclusion; or (2) providing for an affiliation period for coverage offered by a health maintenance organization (HMO). Defines an "affiliation period" as a period of time before health insurance coverage becomes effective. Requires each health insurance issuer offering coverage in the group market in a state to accept every employer in the state that applies for such coverage. Revises provisions governing individual health insurance coverage to apply certain prohibitions related to denying coverage and preexisting condition exclusions to coverage offered in an area (currently, a state). Requires the Secretary of Health and Human Services to report to Congress concerning the occurrence of adverse selection as a result of this Act. Requires health insurance issuers to which this Act applies to submit to the Secretary specified information on enrollees and claims. Directs the Secretary to require that group health plans and health insurance issuers provide data to the Secretary for compliance purposes. Sets forth civil penalties for violations. Directs the Government Accountability Office (GAO) to report to the Secretary on: (1) the impact of this Act and other relevant federal laws; and (2) this Act's effect on the affordability of health insurance coverage and on the expansion of coverage and reductions in the number of uninsured and underinsured.

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