,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #hegc  ,,in ,,the ,,house ,,of  
,,representatives  ,october #i1         
#bjbj,ms4 ,schrier introduced the       
following bill2 which was referred to   
the ,committee on ,energy and ,commerce1
 and in addition to the ,committees on  
,ways and ,means1 ,education and ,labor1
 and ,armed ,services1 for a period to  
be subsequently determined by the       
,speaker1 in each case for consideration
 of such provisions as fall within the  
jurisdiction of the committee concerned 
,a ,,bill  ,to prohibit group health    
plans1 health insurance issuers offering
 group or individual health insurance   
coverage1 ,state plans under title ,,xix
 of the ,social ,security ,act1 ,state  
child health plans under title ,,xxi of 
such ,act1 and the ,,tricare program    
from applying a deductible to outpatient
 pediatric services4  #a4 ,short title  
,this ,act may be cited as the ,helping 
,families ,access ,pediatric ,care ,act 
of #bjbj4  #b4 ,prohibiting certain     

health plans from applying a deductible 
to outpatient pediatric services  7a7   
,,erisa  7#a7 ,in general ,subpart ,b of
 part #g of title ,i of the ,employee   
,retirement ,income ,security ,act of   
#aigd 7#bi ,u4,s4,c4 #aahe et seq47 is  
amended by adding at the end the        
following new section3  #gaf4           
,prohibition on application of          
deductible to outpatient pediatric      
services  7a7 ,in general ,a group      
health plan and a health insurance      
issuer offering group health insurance  
coverage may not impose any deductible  
under such plan or coverage 7as         
applicable7 with respect to outpatient  
pediatric services 7as defined in       
subsection 7b77 for which benefits are  
provided under such plan or coverage4   
7b7 ,outpatient pediatric services      
defined ,for purposes of subsection 7a71
 the term outpatient pediatric services 
means any item or service furnished to  
an individual under the age of #ah as an
 outpatient by a health care provider   

acting within the scope of such         
provider's license1 regardless of       
whether such service is furnished       
in-person or through use of a           
telecommunications system4  4  7#b7     
,clerical amendment ,the table of       
contents of the ,employee ,retirement   
,income ,security ,act of #aigd is      
amended by inserting after the item     
relating to section #gad the following3 
,sec4 #gae4 ,additional market reforms4 
,sec4 #gaf4 ,prohibition on application 
of deductible to outpatient pediatric   
services4  4  7b7 ,,phsa ,subpart ,,ii  
of part ,a of title ,,xxvii of the      
,public ,health ,service ,act 7#db      
,u4,s4,c4 #cjj;gg-#aa et seq47 is       
amended by adding at the end the        
following new section3  #bgcj4          
,prohibition on application of          
deductible to outpatient pediatric      
services  7a7 ,in general ,a group      
health plan and a health insurance      
issuer offering group or individual     
health insurance coverage may not impose

 any deductible under such plan or      
coverage 7as applicable7 with respect to
 outpatient pediatric services 7as      
defined in subsection 7b77 for which    
benefits are provided under such plan or
 coverage4  7b7 ,outpatient pediatric   
services defined ,for purposes of       
subsection 7a71 the term outpatient     
pediatric services means any item or    
service furnished to an individual under
 the age of #ah as an outpatient by a   
health care provider acting within the  
scope of such provider's license1       
regardless of whether such service is   
furnished in-person or through use of a 
telecommunications system4  4  7c7 ,,irc
  7#a7 ,in general ,subchapter ,b of    
chapter #ajj of the ,internal ,revenue  
,code of #aihf is amended by adding at  
the end the following new section3      
#ihaf4 ,prohibition on application of   
deductible to outpatient pediatric      
services  7a7 ,in general ,a group      
health plan may not impose any          
deductible under such plan with respect 

to outpatient pediatric services 7as    
defined in subsection 7b77 for which    
benefits are provided under such plan4  
7b7 ,outpatient pediatric services      
defined ,for purposes of subsection 7a71
 the term outpatient pediatric services 
means any item or service furnished to  
an individual under the age of #ah as an
 outpatient by a health care provider   
acting within the scope of such         
provider's license1 regardless of       
whether such service is furnished       
in-person or through use of a           
telecommunications system4  4  7#b7     
,clerical amendment ,the table of       
sections for subchapter ,b of chapter   
#ajj of the ,internal ,revenue ,code of 
#aihf is amended by adding at the end   
the following new items3  ,sec4 #ihae4  
,additional market reforms4 ,sec4 #ihaf4
 ,prohibition on application of         
deductible to outpatient pediatric      
services4  4  7d7 ,medicaid ,section    
#aiaf;,a of the ,social ,security ,act  
7#db ,u4,s4,c4 #acifo-#a7 is amended--  

7#a7 in subsection 7a7-- 7,a7 in        
paragraph 7#a71 by striking paragraph   
7#b7 and inserting paragraphs 7#b7 and  
7#d72 and  7,b7 by adding at the end the
 following new paragraph3  7#d7         
,prohibition on application of deduction
 to outpatient pediatric services ,a    
,state may not impose a deduction under 
the plan with respect to outpatient     
pediatric services 7as defined in       
subsection 7f774  2 and  7#b7 by adding 
at the end the following new subsection3
  7f7 ,outpatient pediatric services    
defined ,for purposes of this section1  
the term outpatient pediatric services  
means any item or service furnished to  
an individual under the age of #ah as an
 outpatient by a health care provider   
acting within the scope of such         
provider's license1 regardless of       
whether such service is furnished       
in-person or through use of a           
telecommunications system4  4  7e7      
,,chip ,section #bajc7;e7 of the ,social
 ,security ,act 7#db ,u4,s4,c4 #acig;cc7

 is amended by adding at the end the    
following new paragraph3  7#e7          
,prohibition on application of deduction
 to outpatient pediatric services  7,a7 
,in general ,the ,state child health    
plan may not impose a deductible with   
respect to outpatient pediatric services
 7as defined in subparagraph 7,b774     
7,b7 ,outpatient pediatric services     
defined ,for purposes of this paragraph1
 the term outpatient pediatric services 
means any item or service furnished to  
an individual under the age of #ah as an
 outpatient by a health care provider   
acting within the scope of such         
provider's license1 regardless of       
whether such service is furnished       
in-person or through use of a           
telecommunications system4  4  7f7      
,first-,dollar coverage allowance for   
outpatient pediatric services for high  
deductible plans ,section #bbf7;c77#b7  
of the ,internal ,revenue ,code of #aihf
 is amended by adding at the end the    
following new subparagraph3  7,f7 ,safe 

harbor for absence of deductible for    
outpatient pediatric services ,a plan   
shall not fail to be treated as a high  
deductible health plan by reason of     
failing to have a deductible for        
outpatient pediatric services 7as       
defined in section #ihaf7;b774  4  7g7  
,,tricare program  7#a7 ,in general     
,section #ajie;d of title #aj1 ,united  
,states ,code1 is amended-- 7,a7 in the 
section heading1 by inserting           
prohibition on and before waiver2  7,b7 
by redesignating subsections 7a7 and 7b7
 as subsections 7b7 and 7c71            
respectively2  7,c7 by inserting before 
subsection 7b71 as so redesignated1 the 
following new subsection 7a73  7a7      
,prohibition on application of          
deductible to outpatient pediatric      
services ,the ,secretary of ,defense may
 not impose any deductible under the    
,,tricare program for medical care      
provided to a covered beneficiary who is
 under the age of #ah as an outpatient1 
regardless of whether such care is      

furnished in-person or through use of a 
telecommunications system4  2 and  7,d7 
in subsection 7b71 as so redesignated1  
by striking ,the ,secretary and         
inserting ,in addition to the           
requirement under subsection 7a71 the   
,secretary4  7#b7 ,clerical amendment   
,the table of sections at the beginning 
of chapter #ee of title #aj1 ,united    
,states ,code1 is amended by striking   
the item relating to section #ajie;d and
 inserting the following new item3      
#ajie;d4 ,,tricare program3 prohibition 
on and waiver of certain deductibles4  4
  7#c7 ,conforming amendment ,section   
#ajge7;d7 of such title is amended by   
adding at the end the following new     
paragraph3  7#e7 ,the ,secretary may not
 impose any deductible amounts for      
outpatient pediatric services pursuant  
to section #ajie;d of this title4  4    
7h7 ,,gao study ,not later than #d years
 after the date of the enactment of this
 ,act1 the ,comptroller ,general of the 
,united ,states shall conduct a study   

and submit to ,congress a report on the 
effects of the amendments made by this  
,act on premiums1 deductibles1 and      
copayment and coinsurance requirements  
with respect to group health plans and  
group and individual health insurance   
coverage 7as such terms are defined in  
section #bgia of the ,public ,health    
,service ,act 7#db ,u4,s4,c4            
#cjj;gg-#ia774  7i7 ,effective date ,the
 amendment 7or amendments7 made by--    
7#a7 subsections 7a7 through 7c7 and    
subsections 7f7 and 7g7 shall apply with
 respect to plan years beginning on or  
after the date that is #b years after   
the date of the enactment of this ,act2 
7#b7 subsection 7d7 shall apply with    
respect to medical assistance furnished 
in calendar quarters beginning on or    
after the date that is #b years after   
the date of the enactment of this ,act2 
and  7#c7 subsection 7c7 shall apply    
with respect to child health assistance 
furnished calendar quarters described in
 paragraph 7#b74