111th Congress
1st Session
H.R. 3962
Introduction
Sec. 1 Short Title; Table of Divisions, Titles and Subtitles
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Division A
AFFORDABLE HEALTH CARE CHOICES
Sec. 100 - Purpose; Table of Contents of Division; General Definitions
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Subtitle F - Relation to Other Requirements; Miscellaneous
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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
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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
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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
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Subtitle C - Individual Affordability Credits
Sec. 341 - Availability through Health Insurance Exchange
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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
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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
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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
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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
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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
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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
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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
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To Division B----->
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