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I
116TH CONGRESS
2D SESSION
H. R. 6311
To require private health insurers to cover care related to COVID-19 without
cost-sharing and to provide for special enrollment periods for individuals
diagnosed with COVID-19.
IN THE HOUSE OF REPRESENTATIVES
MARCH 19, 2020
Mr. RUIZ (for himself and Mr. MALINOWSKI) introduced the following bill;
which was 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 jurisdic-
tion of the committee concerned
A BILL
To require private health insurers to cover care related to
COVID-19 without cost-sharing and to provide for spe-
cial enrollment periods for individuals diagnosed with
COVID-19.
Be it enacted by the Senate and House of Representa-
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tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘Care for COVID-19
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Act’’.
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SEC. 2. COVERAGE OF SERVICES RELATED TO COVID-19.
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(a) IN GENERAL.—Title XXVII of the Public Health
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Service Act is amended by inserting after section 2719A
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(42 U.S.C. 300gg–19a) the following:
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‘‘SEC. 2720. COVERAGE OF SERVICES RELATED TO COVID-
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19.
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‘‘A group health plan, and a health insurance issuer
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offering group or individual health insurance coverage,
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shall provide coverage for and shall not impose any cost
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sharing requirements for outpatient and inpatient services
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related to the diagnosis, care, and treatment of COVID-
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19, including—
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‘‘(1) diagnostic services related to COVID-19;
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‘‘(2) supportive care for COVID-19;
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‘‘(3) vaccines for the prevention of COVID-19;
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‘‘(4) treatment services, including prescription
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drugs and medical devices, for the treatment of
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COVID-19 and of complications related to COVID-
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19;
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‘‘(5) inpatient and outpatient physician and
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hospital services related to COVID-19; and
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‘‘(6) any other service the Secretary determines
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appropriate.’’.
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(b) APPLICATION.—The amendment made by sub-
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section (a) shall apply with respect to plan years beginning
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on or after January 1, 2020.
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SEC. 3. SPECIAL ENROLLMENT PERIOD.
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(a)
PUBLIC
HEALTH
SERVICE
ACT.—Section
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2702(b)(2) of the Public Health Service Act (42 U.S.C.
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300gg–1(b)(2)) is amended by inserting ‘‘, including a
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special enrollment period for individuals who are diag-
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nosed with or have a presumptive positive diagnosis of
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COVID-19, beginning on the date on which the diagnosis
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or presumptive positive diagnosis is reported to the health
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insurance issuer’’ before the period at the end.
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(b) PATIENT PROTECTION AND AFFORDABLE CARE
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ACT.—Section 1311(c)(6) of the Patient Protection and
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Affordable Care Act (42 U.S.C. 18031(c)(6)) is amend-
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ed—
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(1) in subparagraph (C), by striking ‘‘and’’ at
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the end;
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(2) by redesignating subparagraph (D) as sub-
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paragraph (E); and
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(3) by inserting after subparagraph (C) the fol-
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lowing new subparagraph:
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‘‘(D) a special enrollment period for indi-
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viduals who are diagnosed with or have a pre-
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sumptive positive diagnosis of COVID-19, be-
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ginning on the date on which the diagnosis or
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presumptive positive diagnosis is reported to the
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Exchange; and’’.
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(c)
SPECIAL
ENROLLMENT
PERIODS.—Section
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9801(f) of the Internal Revenue Code of 1986 (26 U.S.C.
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9801(f)) is amended by adding at the end the following
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new paragraph:
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‘‘(4) FOR INDIVIDUALS WHO ARE DIAGNOSED
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WITH OR HAVE A PRESUMPTIVE POSITIVE DIAGNOSIS
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OF COVID-19.—
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‘‘(A) IN GENERAL.—A group health plan
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shall permit an employee who is eligible, but
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not enrolled, for coverage under the terms of
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the plan (or a dependent of such an employee
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if the dependent is eligible, but not enrolled, for
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coverage under such terms) to enroll for cov-
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erage under the terms of the plan upon a diag-
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nosis or a presumptive positive diagnosis of
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COVID-19, with the special enrollment period
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beginning on the date on which the diagnosis or
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presumptive positive diagnosis is reported to the
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group health plan.
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‘‘(B) ENROLLMENT
PERIOD.—The Sec-
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retary shall promulgate regulations with respect
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to the special enrollment period under subpara-
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graph (A), including establishing a time period
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for individuals who are diagnosed with or have
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a presumptive positive diagnosis of COVID-19
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•HR 6311 IH
to enroll in coverage or change coverage, and
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effective date of such coverage.’’.
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(d) ERISA.—Section 701(f) of the Employee Retire-
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ment Income Security Act of 1974 (29 U.S.C. 1181(f))
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is amended by adding at the end the following:
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‘‘(4) FOR INDIVIDUALS WHO ARE DIAGNOSED
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WITH OR HAVE A PRESUMPTIVE POSITIVE DIAGNOSIS
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OF COVID-19.—
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‘‘(A) IN GENERAL.—A group health plan
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or health insurance issuer in connection with a
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group health plan shall permit an employee who
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is eligible, but not enrolled, for coverage under
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the terms of the plan (or a dependent of such
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an employee if the dependent is eligible, but not
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enrolled, for coverage under such terms) to en-
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roll for coverage under the terms of the plan
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upon a diagnosis or presumptive positive diag-
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nosis of COVID-19, with the special enrollment
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period beginning on the date on which the diag-
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nosis or presumptive positive diagnosis is re-
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ported to the group health plan or health insur-
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ance issuer or the diagnosis or presumptive
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positive diagnosis is confirmed by a health care
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provider.
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‘‘(B) ENROLLMENT
PERIOD.—The Sec-
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retary shall promulgate regulations with respect
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to the special enrollment period under subpara-
3
graph (A), including establishing a time period
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for individuals who are diagnosed with or have
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a presumptive positive diagnosis of COVID-19
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to enroll in coverage and effective date of such
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coverage.’’.
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Æ
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