Bill
Number: S.B. 1048
Alston
Floor Amendment
Reference
to: printed bill
Amendment
drafted by: Leg. Council
FLOOR
AMENDMENT EXPLANATION
Requires a Health Care Ministry to provide assistance for
the essential benefits required by the Affordable Care Act.
Prohibits a Health Care Ministry from:
1.
Refusing
to provide for the financial and medical needs of a participant based solely on
the participant's health status.
2.
Imposing
any preexisting condition exclusion or limitation.
3.
Using
a participant's health status to establish assistance.
4.
Refusing
to provide for the financial and medical needs of a participant that are based
on treating a preexisting condition.
5.
Imposing
annual or lifetime dollar limits on essential health care benefits.
6.
Reducing
the amount of assistance to a participant based solely on the participant's
preexisting condition.
7.
Unfairly
discriminating against a participant based on the participant's age or sex.
Defines Essential Benefits as the items and services
covered within the following 10 general categories:
1.
ambulatory
services.
2.
emergency
services.
3.
hospitalization.
4.
maternity
and newborn care.
5.
mental
health and substance abuse disorder services.
6.
prescription
drugs.
7.
rehabilitative
and habilitative services and devices.
8.
laboratory
services.
9.
preventive
and wellness services.
10.
pediatric
services, including oral and vision care.
Page 1, line
5, strike "definition" insert "definitions"
Line 6,
after "A." insert "Except as prescribed in
subsection B of this section,"
Between
lines 8 and 9, insert:
"B. A health care sharing ministry:
1. Shall
provide assistance that includes all essential health care benefits for all
participants.
2. May
not:
(a) Refuse
to provide for the financial and medical needs of a participant based solely on
the participant's health status.
(b) Impose
any preexisting condition exclusion or limitation.
(c) Use a
participant's health status to establish assistance.
(d) Refuse
to provide for the financial and medical needs of a participant that are based
on treating a preexisting condition.
(e) Impose
annual or lifetime dollar limits on essential health care benefits.
(f) Reduce
the amount of assistance to a participant based solely on the participant's
preexisting condition.
(g) Unfairly
discriminate against a participant based on the participant's age or sex."
Reletter to
conform
Line 9,
strike the comma insert ":
1. "Essential
health care benefits" means the items and services covered within the
following ten general categories:
(a) Ambulatory
services.
(b) Emergency
services.
(c) Hospitalization.
(d) Maternity
and newborn care.
(e) Mental
health and substance abuse disorder services.
(f) Prescription
drugs.
(g) Rehabilitative
and habilitative services and devices.
(h) Laboratory
services.
(i) Preventive
and wellness services.
(j) Pediatric
services, including oral and vision care.
2."
Page 1, line
12, strike "1." insert "(a)"
Line 14,
strike "2." insert "(b)"
Line 16,
strike "3." insert "(c)"
Line 21,
strike "4." insert "(d)"
Line 23,
strike "5." insert "(e)"
Line 27,
strike "6." insert "(f)"
Line 31,
strike "7." insert "(g)"
Line 37,
after the period insert "However, the organization must
cover all essential health care benefits, may not refuse to provide assistance
based solely on your health status and may not impose any preexisting condition
exclusion or limitation."
After line
45, insert:
"3. "Preexisting condition exclusion or
limitation" means an exclusion or limitation of assistance, including a
denial of assistance, based on the fact that the condition was present before
the date of the requested assistance, regardless of whether any medical advice,
diagnosis, care or treatment was recommended or received before that date."
Amend title to conform