On Friday, November 15, 2013, the House will consider H.R. 3350, the Keep Your Health Plan Act of 2013, under a rule. H.R. 3350 was introduced on October 28, 2013 by Representative Fred Upton (R-MI), Chairman, House Committee on Energy and Commerce, and has 88 cosponsors.
H.R. 3350 allows providers to continue to offer in 2014 those health insurance plans in effect in the individual market as of January 1, 2013. The plans will be treated as grandfathered health plans for purposes of Section 1501(b).
Section 1251 of the Affordable Care and Patient Protection Act (ACA) states that “[n]othing in this Act (or an amendment made by this Act) shall be construed to require that an individual terminate coverage under a group health plan or health insurance in which such individual was enrolled on the date of enactment of this Act.” The ACA goes on to state that grandfathered plans qualify under the ACA as “minimum essential coverage” for purposes of the meeting the individual mandate.
The ACA is silent as to health insurance plan changes that lead to a loss of grandfathered status. However, on June 17, 2010, the Departments of Health and Human Services, Labor, and Treasury (the departments) issued interim final rules significantly narrowing the interpretation of what constitutes a grandfathered plan. In particular, the departments “identified certain changes to benefits, cost sharing, employer contributions, and access to coverage that would cause the loss of grandfathered status.” Moreover, the departments explicitly “reserved” the right to issue guidance to “clarify or interpret the rules contained in these interim final regulations for maintaining grandfathered status.
In addition, the interim final rules contained analyses on the impact that such interpretation changes would have on grandfathered status. Specifically, the analyses estimated that half of all employer health plans would lose their grandfathered status by the end of 2013, including 45 percent of larger employer plans and 66 percent of small business plans. For the individual market, the analyses estimated that anywhere between 40-67 percent of individual policies would lose their grandfathered status. According to a recent U.S. Census report issued earlier this fall, nearly 64 percent of Americans, 198 million, were covered by private insurance in 2012. 170 million of those individuals were covered by employer-based coverage, with the rest of Americans purchasing health insurance coverage through the individual market. In fact, one out of ten health insurance policies is sold on the individual market. However, over the last several weeks, millions of Americans in the individual markets have witnessed the termination of their health care plans.
 See (See Section 1501(b)).
 See Federal Register, Vol. 75, No. 116, June 17, 2010.
 See CRS, “Grandfathered Health Plans Under the Patient Protection and Affordable Care Act (ACA),” p.4.
 See id (citing the Federal Register, Vol. 75, No. 116, June 17, 2010, p 34545).
 See id, p. 7.
 See id.
 See id.
A CBO cost estimate is not available at this time.
For questions or further information contact the Conference Policy Shop at 5-5107.