,,ii #aacth ,,congress #ast ,session ,s4 #dhb ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #f1 #bjac ,mrs4 ,feinstein 7for herself1 ,mrs4 ,boxer1 ,mr4 ,lautenberg1 ,mr4 ,sanders1 and ,mr4 ,tester7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to provide protections for consumers against excessive1 unjustified1 or unfairly discriminatory increases in premium rates4 #a4 ,short title ,this ,act may be cited as the ,health ,insurance ,rate ,review ,act4 #b4 ,protection of consumers from excessive1 unjustified1 or unfairly discriminatory rates 7a7 ,protection from excessive1 unjustified1 or unfairly discriminatory rates ,the first section #bgid of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#id71 as added by section #ajjc of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh71 is amended by adding at the end the following new subsection3 7e7 ,protection from excessive1 unjustified1 or unfairly discriminatory rates 7#a7 ,authority of ,states ,nothing in this section shall be construed to prohibit a ,state from imposing requirements 7including requirements relating to rate review standards and procedures and information reporting7 on health insurance issuers with respect to rates that are in addition to the requirements of this section and are more protective of consumers than such requirements4 7#b7 ,consultation in rate review process ,in carrying out this section1 the ,secretary shall consult with the ,national ,association of ,insurance ,commissioners and consumer groups4 7#c7 ,determination of who conducts reviews for each ,state ,the ,secretary shall determine1 after the date of enactment of this section and periodically thereafter1 the following3 7,a7 ,in which markets in each ,state the ,state insurance commissioner or relevant ,state regulator shall undertake the corrective actions under paragraph 7#d71 as a condition of the ,state receiving the grant in subsection 7c71 based on the ,secretary's determination that the ,state regulator is adequately undertaking and utilizing such actions in that market4 7,b7 ,in which markets in each ,state the ,secretary shall undertake the corrective actions under paragraph 7#d71 in cooperation with the relevant ,state insurance commissioner or ,state regulator1 based on the ,secretary's determination that the ,state is not adequately undertaking and utilizing such actions in that market4 7#d7 ,corrective action for excessive1 unjustified1 or unfairly discriminatory rates ,in accordance with the process established under this section1 the ,secretary or the relevant ,state insurance commissioner or ,state regulator shall take corrective actions to ensure that any excessive1 unjustified1 or unfairly discriminatory rates are corrected prior to implementation1 or as soon as possible thereafter1 through mechanisms such as-- 7,a7 denying rates2 7,b7 modifying rates2 or 7,c7 requiring rebates to consumers4 7#e7 ,noncompliance ,failure to comply with any corrective action taken by the ,secretary under this subsection may result in the application of civil monetary penalties and1 if the ,secretary determines appropriate1 make the plan involved ineligible for classification as a ,qualified ,health ,plan4 4 7b7 ,clarification of ,regulatory ,authority ,such section is further amended-- 7#a7 in subsection 7a7-- 7,a7 in the heading1 by striking premium and inserting rate2 7,b7 in paragraph 7#a71 by striking unreasonable increases in premiums and inserting potentially excessive1 unjustified1 or unfairly discriminatory rates1 including premiums12 and 7,c7 in paragraph 7#b7-- 7i7 by striking an unreasonable premium increase and inserting a potentially excessive1 unjustified1 or unfairly discriminatory rate2 7ii7 by striking the increase and inserting the rate2 and 7iii7 by striking such increases and inserting such rates2 7#b7 in subsection 7b7-- 7,a7 by striking premium increases each place it appears and inserting rates2 and 7,b7 in paragraph 7#b77;,b71 by striking premium and inserting rate2 and 7#c7 in subsection 7c77#a7-- 7,a7 in the heading1 by striking ,premium and inserting ,rate2 7,b7 by inserting that satisfy the condition under subsection 7e77#c77;,a7 after award grants to ,states2 and 7,c7 in subparagraph 7,a71 by striking premium increases and inserting rates4 7c7 ,conforming amendment ,title ,,xxvii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg et seq47 is amended-- 7#a7 in section #bgbc 7#db ,u4,s4,c4 #cjj;gg-#bb71 as redesignated by the ,patient ,protection and ,affordable ,care ,act-- 7,a7 in subsection 7a7-- 7i7 in paragraph 7#a71 by inserting and section #bgid after this part2 and 7ii7 in paragraph 7#b71 by inserting or section #bgid after this part2 and 7,b7 in subsection 7b7-- 7i7 in paragraph 7#a71 by inserting and section #bgid after this part2 and 7ii7 in paragraph 7#b7-- 7,i7 in subparagraph 7,a71 by inserting or section #bgid that is after this part2 and 7,,ii7 in subparagraph 7,c77ii71 by inserting or section #bgid after this part2 and 7#b7 in section #bgfa 7#db ,u4,s4,c4 #cjj;gg-#fa7-- 7,a7 in subsection 7a7-- 7i7 in paragraph 7#a71 by inserting and section #bgid after this part2 and 7ii7 in paragraph 7#b7-- 7,i7 by inserting or section #bgid after set forth in this part2 and 7,,ii7 by inserting and section #bgid after the requirements of this part2 and 7,b7 in subsection 7b7-- 7i7 by inserting and section #bgid after this part2 and 7ii7 by inserting and section #bgid after part ,a4 7d7 ,applicability to grandfathered plans ,section #abea7;a77#d77;,a7 of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh71 as added by section #bcja of the ,health ,care and ,education ,reconciliation ,act of #bjaj 7,public ,law #aaa-aeb71 is amended by adding at the end the following3 7v7 ,section #bgid 7relating to reasonableness of rates with respect to health insurance coverage74 4 7e7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this ,act1 such sums as may be necessary4 7f7 ,effective date ,the amendments made by this section shall take effect on the date of enactment of this ,act and shall be implemented with respect to health plans beginning not later than ,january #a1 #bjad4