Core Provisions: This bill would amend the Employee Retirement Income Security Act to give the pension plan system more transparency and accountability and to make termination of pension plans more difficult by, inter alia: (1) increasing the rights of workers by allowing them to play a greater role in managing their own pensions; (2) requiring plan administrators to share material investment information with participants; (3) revising portions of ERISA to protect against abuse of the bankruptcy and plan termination processes; and (4) providing that companies who terminate their plans be liable for amounts not covered by the Pension Benefit Guaranty Corporation.
Status: H.R.5754 was introduced in the House by Rep. Peter J. Visclosky (D-Ind.) on April 9, 2008, and was referred immediately to the Committee on Education and Labor and the Committee on the Judiciary.
Core Provisions: This legislation would amend ERISA to require group health plans to administer treatment limitations, beneficiary financial requirements and out-of-network coverage so that mental health benefits are no more restrictive than “substantially all medical and surgical benefits.” This amendment would not apply to group health plans of employers with fewer than 50 employees.
Status: On February 12, 2007, the bill was introduced by Sen. Domenici (R-NM). On September 18, 2007, the Senate passed S.558, and it was referred to the House HELP Subcommittee on October 17, 2007. On March 5, 2008, the White House released a statement urging passage of S.558, because the bill “strikes the necessary balance of treating mental illness with the same urgency as physical illnesses without significantly increasing health care costs.”
Core Provisions: This legislation would amend the Employee Retirement Income Security Act of 1974 (ERISA) and the Public Health Service Act to prohibit group health plans from treating mental health or substance-related disorders differently than other health conditions in terms of treatment limitations, beneficiary financial requirements and out-of-network coverage. The bill specifies that plans must cover treatment for any mental health condition or substance-related disorder included in the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. This amendment would not apply to group health plans of employers with fewer than 50 employees. Provisions from the Genetic Information Nondiscrimination Act (H.R.493), which was passed by the House but not yet acted upon by the Senate, were added to H.R.1424 following passage in the House. The provisions added to this act would prohibit employers from discriminating against individuals on the basis of genetic information, limit genetic testing and information collection by insurers, and prohibit insurers from using genetic information to determine eligibility, premium rates or preexisting condition coverage exclusions.
Status: On March 9, 2007, the bill was introduced by Rep. Kennedy (D-RI). On March 5, 2008, the House passed H.R.1424 by a vote of 268 to 148. On March 5, 2008, the White House released a statement expressing concerns about H.R.1424 and urging Congress to pass S.558 instead. The White House opposes H.R.1424’s preemption provisions and its application to physician-owned hospitals, and is concerned the legislation would “further distort the market for prescription drugs, and discourage innovation in the drug development process.” The White House also expressed concern about H.R.1424’s provisions from the Genetic Information Nondiscrimination Act, but concluded that “the Administration looks forward to working with Congress to address these concerns and pass Mental Health Parity and Genetic Nondiscrimination legislation this year.”
Core Provisions: This legislation would amend the Employee Retirement Income Security Act (ERISA) and the Internal Revenue Code to prohibit pre-existing condition exclusions in all group and individual health coverage policies. The bill would also prohibit HMOs from requiring “affiliation periods,” which must expire before health insurance coverage becomes effective. The legislation would also amend the Public Health Service Act to require all insurers in the group and individual markets to accept applications for coverage from every otherwise eligible employer and individual within the coverage area - a restriction that formerly only applied to insurers in the small group market. An insurer would be left with the ability to deny coverage if it lacked the financial reserves necessary to underwrite additional coverage so long as its denial was applied uniformly without regard to the claims experiences of the employers and their employees, or any health status-related factor relating to the employees and their dependents. The insurer would then be prohibited from offering coverage in that market for at least 180 days, until the insurer has sufficient financial reserves to underwrite additional coverage.
Under this legislation, each insurer would also be required to “charge the same premium price for the same coverage,” and disclose the amount of the premium price that is being charged for the coverage involved. This disclosure would be affected in a manner specified by the Secretary of Labor, including disclosure via the Internet. The uniform premium requirement would apply within geographic areas and “family categories,” but would not prohibit variations in premiums resulting from the application of a uniform monthly premium over different policy years. The legislation’s requirements would not apply to health plans pursuant to collective bargaining agreements for plan years beginning before the later of (a) the termination date of the last collective bargaining agreement or (b) January 1, 2010. The Secretary of Labor would also be authorized to establish rules to deter individuals from enrolling in individual health insurance coverage only after they develop an illness or injury, and from disenrolling from coverage for periods in which they are less likely to require coverage.
Status: On February 14, 2008, H.R.5449 was introduced by Rep. Kagen (D-WI) and referred to the House Committees on Education and Labor, Energy and Commerce, and Ways and Means.
Core Provisions: The Fairness in Autism Treatment Act would amend the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code of 1986 to require that group health plans provide coverage for pervasive developmental disorders such as autism. The expanded coverage would include therapeutic, respite and rehabilitative care for participants or for beneficiaries under the age of 22. In addition, the group health plan may not impose any annual or lifetime dollar limitation on benefits for pervasive developmental disorders unless such limitation applies to all medical and surgical benefits. This amendment would not apply to group health plans of small employers, i.e., those with at least two but less than fifty employees.
Status: On January 16, 2008, the bill was introduced by Rep. Wexler (D-FL), and referred to both the Committee on Education and Labor, and the Committee on Ways and Means.