BILL ANALYSIS H.B. 491 By: De La Garza 05-08-95 Committee Report (Unamended) BACKGROUND During the 73rd Legislature, H.B. 2055 was passed which amongst other things excluded a preexisting condition as a reason for denying a health care contract to a person for certain health care plans that fell under the small employer health care ability act. However, with that law in the books as passed, insurance companies are still denying health care coverage to people because of "preexisting conditions" because the law allows them for certain health care plans. PURPOSE As proposed, House Bill 491 would exclude a "preexisting condition" as a reason to deny a any health insurance contract to an applicant. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency or institution. SECTION BY SECTION ANALYSIS SECTION 1. Subchapter E, Chapter 21, Insurance Code, is amended by adding Article 21.49-2E to read as follows: PROHIBITION ON DENIAL OR EXCLUSION OF COVERAGE FOR PREEXISTING CONDITION Sec. 1: DEFINITIONS. In this article: (1) "Health insurance contract" means a health insurance policy, agreement, contract, or evidence of coverage that is delivered or issued for delivery by a health insurer. (2) "Health insurer" means an insurance company, group hospital service corporation, or health maintenance organization that delivers or issues for delivery an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an evidence of coverage that provides benefits for medical or surgical expenses incurred as a result of an accident or sickness. (3) "Preexisting condition" means a medical condition of an applicant for coverage under a health insurance contract that manifested itself before a determination on the application for coverage is made. Sec. 2: DENIAL PROHIBITED. A health insurer may not refuse to issue a health insurance contract to an applicant because of a preexisting condition. Sec. 3: EXCLUSION PROHIBITED. A health insurer may not issue a health insurance contract that excludes coverage for a preexisting condition. SECTION 2. Effective Date September 1, 1995, and applies only to a health insurance contract that is delivered, issued for delivery, or renewed on or after January 1, 1996. SECTION 3. Emergency Clause SUMMARY OF COMMITTEE ACTION In accordance with House rules, H.B. 491 was heard in a public hearing on April 26, 1995. The Chair laid out H.B. 491 and recognized Representative De La Garza to explain the bill. The Chair recognized the following persons to testify in support of H.B. 491: Ann T. Cloyd, Texas Association of Health Underwriters; David Pinkus, Small Business United of Texas; Jacqueline Shannon, Texas Alliance for the Mentally Ill; Robert Schneider, Consumers Union. The Chair recognized the following persons to testify in opposition to H.B. 491: Robert W. Blevins, Texas Life Insurance Association; Will D. Davis, Texas Legal Reserve Officials Association; James L. Young, Statesman National Life Insurance Company. The Chair left H.B. 491 as pending business before the Committee. Pursuant to an announcement filed with the Journal Clerk and read by the Reading Clerk, the House Committee on Insurance met in a formal meeting on May 8, 1995 at desk #24 on the House Floor and was called to order by the Chair, Representative John Smithee. The Chair laid out H.B. 491 as pending business and recognized Representative Shields who moved the Committee report H.B. 491 as filed to the full House with the recommendation that it do pass, be printed and be sent to the Committee on Local and Consent. Representative Averitt seconded the motion and the motion prevailed by the following vote: AYES: (6); NAYES (0); PNV (0); ABSENT (3).