,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #cejd  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #ae1 #bjac   
,ms4 ,s*ak[sky introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce  ,a ,,bill  ,to provide       
improv$ consum] protection & rate review
 = heal? insurance cov]age 9 !          
individual m>ket1 & = o!r purposes4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,consum] ,protection & ,rate ,review    
,act ( #bjac4  #b4 ,requir+ ,/ate       
insurance commission]s to inve/igate    
in/ances ( inadequate notices (         
cancellation or conv]sion ( individual  
heal? insurance policies  7a7 ,9 g5]al  
,ea* ,/ate insurance commission] %all   
inve/igate & take appropriate           
adm9i/rative or o!r actions 7su* z !    
imposition ( a f9e7 on cases (          
inadequate notices ( cancellations or   
conv]sions ( heal? insurance cov]age 9 !
 individual m>ket t take effect on or   
aft] ,janu>y #a1 #bjad4  7b7 ,inadequate
 notice ,9 ?is section1 a notice ( !    

cancellation or conv]sion ( individual  
heal? insurance cov]age %all be treat$ z
 inadequate if ! notice--  7#a7 fails to
 conta9 in=mation--  7,a7 on obta9+     
heal? insurance cov]age ?r\gh an        
,ex*ange "u ! ,pati5t ,protection &     
,af=dable ,c>e ,act2  7,b7 on ! possible
 availability ( assi/ance "u su* ,act   
t[>ds paym5t ( ! premiums & co/-%>+ =   
su* cov]age2 &  7,c7 on ! improv$       
b5efits = cov]age ?r\gh an ,ex*ange1    
comp>$ to heal? insurance cov]age n (f]$
 ?r\gh an ,ex*ange2  7#b7 fails to be   
transp>5t by inappropriately /e]+       
individuals to m exp5sive plans provid$ 
by ! cancell+ issu]2 or  7#c7 fails to  
o!rwise comply ) requirem5ts ( law4  7c7
 ,reports  7#a7 ,/ate commission]s to   
,,hhs ,n lat] ?an ,m>* #ca1 #bjad1 ea*  
,/ate insurance commission] %all submit 
to ! ,secret>y ( ,heal? & ,human        
,s]vices a report on ! inve/igations &  
actions describ$ 9 subsection 7a74  7#b7
 ,,hhs report to ,congress ,n lat] ?an  
,april #cj1 #bjad1 ! ,secret>y %all     

submit to ,congress a report on su*     
inve/igations & actions4  7d7           
,def9itions ( ,/ate1 heal? insurance    
cov]age1 & individual m>ket ,9 ?is      
section1 ! t]ms ,/ate1 heal? insurance  
cov]age1 & individual m>ket h ! mean+s  
giv5 su* t]ms = purposes ( title ,i ( ! 
,pati5t ,protection & ,af=dable ,c>e    
,act4  #c4 ,protection ( consum]s f     
excessive1 unju/ifi$1 or unfairly       
discrim9atory rates f ,h4,r4 #ajai  7a7 
,protection f excessive1 unju/ifi$1 or  
unfairly discrim9atory rates ,! fir/    
section #bgid ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;gg-#id71 z    
add$ by section #ajjc ( ! ,pati5t       
,protection & ,af=dable ,c>e ,act       
7,public ,law #aaa-adh71 is am5d$ by    
add+ at ! end ! foll[+ new subsection3  
7e7 ,protection f excessive1 unju/ifi$1 
or unfairly discrim9atory rates  7#a7   
,au?ority ( ,/ates ,no?+ 9 ?is section  
%all be con/ru$ to prohibit a ,/ate f   
impos+ requirem5ts 7includ+ requirem5ts 
relat+ to rate review /&>ds & proc$ures 

& in=mation report+7 on heal? insurance 
issu]s ) respect to rates t are 9       
addition to ! requirem5ts ( ?is section 
& are m protective ( consum]s ?an su*   
requirem5ts4  7#b7 ,consultation 9 rate 
review process ,9 c>ry+ out ?is section1
 ! ,secret>y %all consult ) ! ,national 
,association ( ,insurance ,commission]s 
& consum] gr\ps4  7#c7 ,det]m9ation ( :o
 conducts reviews = ea* ,/ate ,!        
,secret>y %all det]m9e1 aft] ! date (   
enactm5t ( ?is section & p]iodically    
!reaft]1 ! foll[+3  7,a7 ,9 :i* m>kets 9
 ea* ,/ate ! ,/ate insurance commission]
 or relevant ,/ate regulator %all       
und]take ! corrective actions "u        
p>agraph 7#d71 z a condition ( ! ,/ate  
receiv+ ! grant 9 subsection 7c71 bas$  
on ! ,secret>y's det]m9ation t ! ,/ate  
regulator is adequately und]tak+ &      
utiliz+ su* actions 9 t m>ket4  7,b7 ,9 
:i* m>kets 9 ea* ,/ate ! ,secret>y %all 
und]take ! corrective actions "u        
p>agraph 7#d71 9 coop]ation ) ! relevant
 ,/ate insurance commission] or ,/ate   

regulator1 bas$ on ! ,secret>y's        
det]m9ation t ! ,/ate is n adequately   
und]tak+ & utiliz+ su* actions 9 t      
m>ket4  7#d7 ,corrective action =       
excessive1 unju/ifi$1 or unfairly       
discrim9atory rates ,9 accordance ) !   
process e/abli%$ "u ?is section1 !      
,secret>y or ! relevant ,/ate insurance 
commission] or ,/ate regulator %all take
 corrective actions to ensure t any     
excessive1 unju/ifi$1 or unfairly       
discrim9atory rates are correct$ prior  
to implem5tation1 or z soon z possible  
!reaft]1 ?r\gh me*anisms su* z--  7,a7  
d5y+ rates2  7,b7 modify+ rates2 or     
7,c7 requir+ rebates to consum]s4  7#e7 
,noncompliance ,failure to comply ) any 
corrective action tak5 by ! ,secret>y "u
 ?is subsection may result 9 !          
application ( civil monet>y p5alties &1 
if ! ,secret>y det]m9es appropriate1    
make ! plan involv$ ineligible =        
classification z a ,qualifi$ ,heal?     
,plan4  4  7b7 ,cl>ification (          
,regulatory ,au?ority ,su* section is   

fur!r am5d$--  7#a7 9 subsection 7a7--  
7,a7 9 ! head+1 by /rik+ premium &      
ins]t+ rate2  7,b7 9 p>agraph 7#a71 by  
/rik+ unreasonable increases 9 premiums 
& ins]t+ pot5tially excessive1          
unju/ifi$1 or unfairly discrim9atory    
rates1 includ+ premiums12 &  7,c7 9     
p>agraph 7#b7--  7i7 by /rik+ an        
unreasonable premium increase & ins]t+ a
 pot5tially excessive1 unju/ifi$1 or    
unfairly discrim9atory rate2  7ii7 by   
/rik+ ! increase & ins]t+ ! rate2 &     
7iii7 by /rik+ su* increases & ins]t+   
su* rates2  7#b7 9 subsection 7b7--     
7,a7 by /rik+ premium increases ea*     
place x appe>s & ins]t+ rates2 &  7,b7 9
 p>agraph 7#b77;,b71 by /rik+ premium & 
ins]t+ rate2 &  7#c7 9 subsection       
7c77#a7--  7,a7 9 ! head+1 by /rik+     
,premium & ins]t+ ,rate2  7,b7 by ins]t+
 t satisfy ! condition "u subsection    
7e77#c77;,a7 aft] aw>d grants to ,/ates2
 &  7,c7 9 subp>agraph 7,a71 by /rik+   
premium increases & ins]t+ rates4  7c7  
,con=m+ am5dm5t ,title ,,xxvii ( !      

,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;gg et seq47 is am5d$--   
7#a7 9 section #bgbc 7#db ,u4,s4,c4     
#cjj;gg-#bb71 z r$esignat$ by ! ,pati5t 
,protection & ,af=dable ,c>e ,act--     
7,a7 9 subsection 7a7--  7i7 9 p>agraph 
7#a71 by ins]t+ & section #bgid aft] ?is
 "p2 &  7ii7 9 p>agraph 7#b71 by ins]t+ 
or section #bgid aft] ?is "p2 &  7,b7 9 
subsection 7b7--  7i7 9 p>agraph 7#a71  
by ins]t+ & section #bgid aft] ?is "p2 &
  7ii7 9 p>agraph 7#b7--  7,i7 9        
subp>agraph 7,a71 by ins]t+ or section  
#bgid t is aft] ?is "p2 &  7,,ii7 9     
subp>agraph 7,c77ii71 by ins]t+ or      
section #bgid aft] ?is "p2 &  7#b7 9    
section #bgfa 7#db ,u4,s4,c4            
#cjj;gg-#fa7--  7,a7 9 subsection 7a7-- 
7i7 9 p>agraph 7#a71 by ins]t+ & section
 #bgid aft] ?is "p2 &  7ii7 9 p>agraph  
7#b7--  7,i7 by ins]t+ or section #bgid 
aft] set =? 9 ?is "p2 &  7,,ii7 by      
ins]t+ & section #bgid aft] !           
requirem5ts ( ?is "p2 &  7,b7 9         
subsection 7b7--  7i7 by ins]t+ &       

section #bgid aft] ?is "p2 &  7ii7 by   
ins]t+ & section #bgid aft] "p ,a4  7d7 
,applicability to gr&fa!r$ plans        
,section #abea7;a77#d77;,a7 ( ! ,pati5t 
,protection & ,af=dable ,c>e ,act       
7,public ,law #aaa-adh71 z add$ by      
section #bcja ( ! ,heal? ,c>e &         
,education ,reconciliation ,act ( #bjaj 
7,public ,law #aaa-aeb71 is am5d$ by    
add+ at ! end ! foll[+3  7v7 ,section   
#bgid 7relat+ to reasonabl5ess ( rates )
 respect to heal? insurance cov]age74  4
  7e7 ,au?orization ( appropriations    
,!re are au?oriz$ to be appropriat$ to  
c>ry out ?is section1 su* sums z may be 
necess>y4  7f7 ,effective date ,!       
am5dm5ts made by ?is section %all take  
effect on ! date ( enactm5t ( ?is ,act &
 %all be implem5t$ ) respect to heal?   
plans beg9n+ n lat] ?an ,janu>y #a1     
#bjad4