Amendment H-8304 to HF 2643

Filed June 12, 2020 in the House by

What it changes

1. Page 13, after line 34 by inserting: “DIVISION ___ PREEXISTING CONDITIONS Sec. ___. NEW SECTION . 514M.1 Short title. This chapter shall be known and may be cited as “The Protect Coverage for Preexisting Conditions Act” . Sec. ___. NEW SECTION . 514M.2 Definitions. As used in this chapter, unless the context otherwise requires:
2. “Commissioner” means the commissioner of insurance.
3. “Health benefit plan” means any policy, contract, certificate, or agreement, including a short-term, limited-duration policy or a high deductible plan, offered or issued by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services.
4. “Health care services” means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease.
5. “Health carrier” means an entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the commissioner, including an insurance company offering sickness and accident plans, a health maintenance organization, a nonprofit health service corporation, a plan established pursuant to chapter 509A for public employees, a plan offered or maintained by a multiple employer welfare association, or any other entity providing a plan of health insurance, health benefits, or health care services. Notwithstanding section 505.20, subsection 1, “health carrier” also includes a nonprofit agricultural organization domiciled in the state that sponsors a health benefit plan pursuant to section 505.20.
6. “Preexisting condition exclusion” means a limitation or exclusion of benefits, or a denial of coverage, relating to a condition based on the fact that the condition was present -1- H8276.4456 (2) 88 ns/tm 1/ 10 before the date of enrollment for such coverage or the date of denial of coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received for the condition before the date of enrollment or the date of denial of coverage. Sec. ___. NEW SECTION . 514M.3 Preexisting conditions. Notwithstanding any other provision of law to the contrary, a health carrier that offers an individual health benefit plan or a group health benefit plan in this state shall not do either of the following:
7. Deny coverage to any employer or to any individual that is eligible to apply for the individual health benefit plan or the group health benefit plan.
8. Impose any preexisting condition exclusion on an employer or on an individual with respect to the individual health benefit plan or the group health benefit plan. Sec. ___. NEW SECTION . 514M.4 Premium rates.
9. a. Notwithstanding any other provision of law to the contrary, a health carrier that offers an individual health benefit plan or a group health benefit plan in this state shall develop premium rates for the individual health benefit plan or the group health benefit plan based only on the following factors: (1) Age, except that the rate shall not vary by more than three-to-one for like individuals of different ages who are age twenty-one and older. (2) Whether the health benefit plan covers an individual or family. (3) Tobacco use, except that the rate shall not vary by more than one and one-half times the rate charged to a nontobacco user. (4) Geographic rating area established in compliance with federal law. b. Notwithstanding any other provision of law to the contrary, with respect to premium rates for family coverage -2- H8276.4456 (2) 88 ns/tm 2/ 10 under an individual health benefit plan or a group health benefit plan offered in this state, a health carrier shall apply the factors permitted pursuant to paragraph “a” based on the premium that is attributable to each family member covered under the health benefit plan in accordance with rules adopted by the commissioner.
10. Notwithstanding any other provision of law to the contrary, a health carrier that offers an individual health benefit plan or a group health benefit plan in this state shall adjust the premium rates established pursuant to subsection 1 no more frequently than annually and based only on the factors in subsection 1, paragraph “a” , except that the health carrier may adjust the premium rates in the following circumstances: a. With respect to a small group health plan, if there are changes in enrollment. b. There is a change to the family composition of an individual enrolled in an individual health benefit plan or of an employee enrolled in a group health benefit plan. c. There is a change in the geographic rating area or in tobacco use for an individual enrolled in an individual health benefit plan. d. An individual enrolled in an individual health benefit plan requests changes to the health benefit plan or a small employer requests changes to a group health benefit plan. e. A change in federal law or federal regulations requiring a premium rate adjustment. Sec. ___. NEW SECTION . 514M.5 Rules. The commissioner shall adopt rules pursuant to chapter 17A as necessary to implement and administer this chapter. Sec. ___. NEW SECTION . 514M.6 Enforcement. The commissioner shall take any action within the commissioner’s authority to enforce compliance with this chapter. Sec. ___. APPLICABILITY. This division of this Act applies to health benefit plans that are delivered, issued -3- H8276.4456 (2) 88 ns/tm 3/ 10 for delivery, continued, or renewed in this state on or after January 1,
11. DIVISION ___ CHANGE EFFORTS PROHIBITED Sec. ___. NEW SECTION . 135.192 Sexual orientation and gender identity change efforts —— prohibitions —— penalties.
12. For the purposes of this section, unless the context otherwise requires: a. “Child” means an individual who is under the age of
13. b. “Practitioner” means a physician and surgeon or osteopathic physician and surgeon licensed under chapter 148 who specializes in the practice of psychiatry; a psychologist licensed under chapter 154B; a licensed marital and family therapist or mental health counselor or a temporary licensed marital and family therapist or mental health counselor as defined in section 154D.1; a social worker licensed pursuant to chapter 154C; a licensed school counselor, school psychologist, or school social worker; an advanced registered nurse practitioner; a practitioner as defined in section 272.1; a victim counselor as defined in section 915.20A; a psychiatric nurse; any other person who provides counseling or mental health or behavioral health services as a part of the person’s professional training or practice under Iowa law or rule; or any student, intern, volunteer, or other person assisting or acting under the direction or guidance of any of these professionals. c. (1) “Sexual orientation or gender identity change efforts” means any practice or treatment by a practitioner that seeks to change an individual’s sexual orientation or gender identity, including but not limited to efforts to change behaviors or gender expressions, or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender. (2) “Sexual orientation or gender identity change efforts” does not include any of the following practices, as long as the -4- H8276.4456 (2) 88 ns/tm 4/ 10 practice does not seek to change sexual orientation or gender identity: (a) Counseling or therapy that provides acceptance, support, and understanding of the individual or the facilitation of an individual’s coping, social support, and identity exploration and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices. (b) Counseling for an individual seeking to transition from one gender to another.
14. A practitioner shall not engage in sexual orientation or gender identity change efforts with a child.
15. A practitioner who engages in sexual orientation or gender identity change efforts with a child shall be subject to disciplinary action by the licensing entity or disciplinary authority with professional jurisdiction over the practitioner. Sec. ___. SEXUAL ORIENTATION AND GENDER IDENTITY CHANGE EFFORTS —— CHILD FOSTER CARE —— MANDATORY REPORTERS —— RULES.
16. For the purposes of this section: a. (1) “Child” means, as applicable, either a person less than eighteen years of age or a person eighteen or nineteen years of age who meets any of the following conditions: (a) Is in full-time attendance at an accredited school pursuing a course of study leading to a high school diploma. (b) Is attending an instructional program leading to a high school equivalency diploma. (c) Has been identified by the director of special education of the area education agency as a child requiring special education as defined in section 256B.2, subsection
17. (2) A person over eighteen years of age who has received a high school diploma or a high school equivalency diploma is not a “child” within the definition in this paragraph “a”. b. “Mental injury” means the same as defined in section 232.2. c. “Sexual orientation or gender identity change efforts” -5- H8276.4456 (2) 88 ns/tm 5/ 10 means the same as defined in section 135.192.
18. The department of human services shall adopt rules pursuant to chapter 17A relating to all of the following: a. To prohibit, as a condition of licensure, an agency or individual licensed pursuant to chapter 237 to provide child foster care from participating in sexual orientation or gender identity change efforts with a child for whom the licensed agency or individual is providing child foster care. b. To identify research-based instruction that supports lesbian, gay, bisexual, transgender, and questioning youth, including linguistic tools such as the correct use of pronouns and names, for incorporation into necessary training for department staff and for agencies or individuals licensed pursuant to chapter 237 to provide child foster care. c. To provide guidance to a mandatory reporter, as enumerated in section 232.69, subsection 1, in associating sexual orientation or gender identity change efforts with a child with mental injury constituting child abuse pursuant to section 232.68, subsection
19. DIVISION ___ STATE CONTRACTS —— IOWA PREFERENCE Sec. ___. Section 8A.311, Code 2020, is amended by adding the following new subsection: NEW SUBSECTION . 12A. If the lowest responsive bid received by the state for products or other purchases is from an out-of-state business, and an Iowa-based business submitted a bid which is within five percent or ten thousand dollars of the price of the lowest bid, whichever is less, the Iowa-based business which submitted the lowest responsive bid shall be notified and shall be allowed to match the lowest bid before a contract is awarded. Sec. ___. NEW SECTION . 8F.6 Preference. An oversight agency shall give preference in awarding a service contract to a recipient entity under this chapter to an Iowa-based business. -6- H8276.4456 (2) 88 ns/tm 6/ 10 DIVISION ___ PUBLIC RETIREMENT SYSTEMS GOALS Sec. ___. Section 97D.1, Code 2020, is amended by adding the following new subsection: NEW SUBSECTION .
20. It is the intent of the general assembly to maintain strong and stable public retirement systems that allow employees to retire with dignity. DIVISION ___ GROUNDWATER PROTECTION FUND Sec. ___. BULK TRANSPORT OF WATER. Of moneys available for use by the department of natural resources from the groundwater protection fund created in section 455E.11 for the fiscal year beginning July 1, 2020, and ending June 30, 2021, which are not allocated pursuant to that section, the department shall support the protection of the state’s groundwater, including by providing for administration; the prevention of the groundwater extracted for bulk transport to another state for any purpose; regulation and programs; salaries, support, maintenance, and equipment; and miscellaneous purposes. DIVISION ___ UNITED STATES CLIMATE ALLIANCE Sec. ___. NEW SECTION . 28O.1 United States Climate Alliance. The governor shall take all necessary actions for the state to become a member of, participate in, and maintain membership in the United States climate alliance. DIVISION ___ TELEHEALTH PARITY Sec. ___. Section 514C.34, subsection 1, Code 2020, is amended by adding the following new paragraphs: NEW PARAGRAPH . 0a. “Covered person” means the same as defined in section 514J.102. NEW PARAGRAPH . 0c. “Health carrier” means the same as defined in section 514J.102. Sec. ___. Section 514C.34, Code 2020, is amended by adding -7- H8276.4456 (2) 88 ns/tm 7/ 10 the following new subsection: NEW SUBSECTION . 3A. A health carrier shall reimburse a health care professional for health care services provided to a covered person by telehealth on the same basis and at the same rate as the health carrier would apply to the same health care services provided to a covered person by the health care professional in person. Sec. ___. APPLICABILITY. This division of this Act applies to health care services provided by a health care professional to a covered person by telehealth on or after January 1,
21. DIVISION ___ TAX CREDIT PROGRAM CAP Sec. ___. NEW SECTION . 422.120 Tax credit programs —— limitation.
22. Notwithstanding any other provision to the contrary, moneys awarded under a tax credit program shall not exceed the amount awarded during the fiscal year beginning July 1, 2019, and ending June 30, 2020, in subsequent fiscal years.
23. If necessary for the administration of a tax credit program, the tax credits may be awarded on a first-come, first-served basis until the maximum amount allowable under subsection 1 has been awarded.
24. This section does not apply to the tax programs subject to limitation in section 15.119 or to the earned income tax credit in section 422.12B. DIVISION ___ CORONAVIRUS RELIEF FUND —— MENTAL HEALTH AND DISABILITY SERVICES Sec. ___. CORONAVIRUS RELIEF FUND —— MENTAL HEALTH AND DISABILITY SERVICES. Of the funds received by the state from the federal coronavirus relief fund created pursuant to the federal Coronavirus Aid, Relief, and Economic Security Act, Pub. L. No. 116-136, $25,000,000 shall be deposited in the mental health and disability regional services fund created in section 225C.7A. Moneys deposited in the mental health -8- H8276.4456 (2) 88 ns/tm 8/ 10 and disability regional services fund under this section are appropriated to the department of human services for distribution to the mental health and disability services regions to fund mental health and disability services in accordance with section 225C.7A. DIVISION ___ RESOURCE ENHANCEMENT AND PROTECTION Sec. ___. Section 455A.18, subsection 3, paragraph a, Code 2020, is amended to read as follows: a. For each fiscal year of the fiscal period beginning July 1, 1997, and ending June 30, 2021 2031 , there is appropriated from the general fund, to the Iowa resources enhancement and protection fund, the amount of twenty million dollars, to be used as provided in this chapter . However, in any fiscal year of the fiscal period, if moneys from the lottery are appropriated by the state to the fund, the amount appropriated under this subsection shall be reduced by the amount appropriated from the lottery. DIVISION ___ CORONAVIRUS RELIEF —— ESSENTIAL EMPLOYEES Sec. ___. ESSENTIAL EMPLOYEES. Notwithstanding any provision of law to the contrary, for purposes of any moneys expended by the state from the federal coronavirus relief fund created pursuant to the federal Coronavirus Aid, Relief, and Economic Security Act, Pub. L. No. 116-136, persons employed for purposes of childcare shall be considered essential employees. DIVISION ___ CORONAVIRUS RELIEF —— SMALL BUSINESS GRANTS Sec. ___. SMALL BUSINESS GRANTS. Notwithstanding any provision of law to the contrary, for purposes of any moneys expended by the state from the federal coronavirus relief fund created pursuant to the federal Coronavirus Aid, Relief, and Economic Security Act, Pub. L. No. 116-136, for small business grants, nonprofit organizations are eligible to be awarded such -9- H8276.4456 (2) 88 ns/tm 9/ 10 grants. DIVISION ___ TESTING SHORTAGE Sec. ___. TESTING SHORTAGE. In the event a shortage of tests for the novel coronavirus occurs in this state, healthcare workers, members of vulnerable populations, and those persons working with members of vulnerable populations shall be given first preference to receive a test.”
25. By renumbering as necessary.

Official amendment (PDF) · In the Bill Book