text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Health Insurance Rate Review Act''.
  
  SEC. 2. PROTECTION OF CONSUMERS FROM EXCESSIVE, UNJUSTIFIED, OR 
                UNFAIRLY DISCRIMINATORY RATES.
  
      (a) Protection From Excessive, Unjustified, or Unfairly 
  Discriminatory Rates.--The first section 2794 of the Public Health 
  Service Act (42 U.S.C. 300gg-94), as added by section 1003 of the 
  Patient Protection and Affordable Care Act (Public Law 111-148), is 
  amended by adding at the end the following new subsection:
      ``(e) Protection From Excessive, Unjustified, or Unfairly 
  Discriminatory Rates.--
              ``(1) Authority of states.--Nothing in this section shall 
          be construed to prohibit a State from imposing requirements 
          (including requirements relating to rate review standards and 
          procedures and information reporting) on health insurance 
          issuers with respect to rates that are in addition to the 
          requirements of this section and are more protective of 
          consumers than such requirements.
              ``(2) Consultation in rate review process.--In carrying out 
          this section, the Secretary shall consult with the National 
          Association of Insurance Commissioners and consumer groups.
              ``(3) Determination of who conducts reviews for each 
          state.--The Secretary shall determine, after the date of 
          enactment of this section and periodically thereafter, the 
          following:
                      ``(A) In which States the State insurance 
                  commissioner or relevant State regulator shall 
                  undertake the corrective actions under paragraph (4), 
                  as a condition of the State receiving the grant in 
                  subsection (c), based on the Secretary's determination 
                  that the State is adequately prepared to undertake and 
                  is adequately undertaking such actions.
                      ``(B) In which States the Secretary shall undertake 
                  the corrective actions under paragraph (4), in 
                  cooperation with the relevant State insurance 
                  commissioner or State regulator, based on the 
                  Secretary's determination that the State is not 
                  adequately prepared to undertake or is not adequately 
                  undertaking such actions.
              ``(4) Corrective action for excessive, unjustified, or 
          unfairly discriminatory rates.--In accordance with the process 
          established under this section, the Secretary or the relevant 
          State insurance commissioner or State regulator shall take 
          corrective actions to ensure that any excessive, unjustified, 
          or unfairly discriminatory rates are corrected prior to 
          implementation, or as soon as possible thereafter, including 
          through mechanisms such as--
                      ``(A) denying rates;
                      ``(B) modifying rates; or
                      ``(C) requiring rebates to consumers.''.
      (b) Clarification of Regulatory Authority.--Such section is further 
  amended--
              (1) in subsection (a)--
                      (A) in the heading, by striking ``Premium'' and 
                  inserting ``Rate'';
                      (B) in paragraph (1), by striking ``unreasonable 
                  increases in premiums'' and inserting ``potentially 
                  excessive, unjustified, or unfairly discriminatory 
                  rates, including premiums,''; and
                      (C) in paragraph (2)--
                              (i) by striking ``an unreasonable premium 
                          increase'' and inserting ``a potentially 
                          excessive, unjustified, or unfairly 
                          discriminatory rate'';
                              (ii) by striking ``the increase'' and 
                          inserting ``the rate''; and
                              (iii) by striking ``such increases'' and 
                          inserting ``such rates'';
              (2) in subsection (b)--
                      (A) by striking ``premium increases'' each place it 
                  appears and inserting ``rates''; and
                      (B) in paragraph (2)(B), by striking ``premium'' 
                  and inserting ``rate''; and
              (3) in subsection (c)(1)--
                      (A) in the heading, by striking ``Premium'' and 
                  inserting ``Rate'';
                      (B) by inserting ``that satisfy the condition under 
                  subsection (e)(3)(A)'' after ``award grants to 
                  States''; and
                      (C) in subparagraph (A), by striking ``premium 
                  increases'' and inserting ``rates''.
      (c) Conforming Amendment.--Title XXVII of the Public Health Service 
  Act (42 U.S.C. 300gg et seq.) is amended--
              (1) in section 2723 (42 U.S.C. 300gg-22), as redesignated 
          by the Patient Protection and Affordable Care Act--
                      (A) in subsection (a)--
                              (i) in paragraph (1), by inserting ``and 
                          section 2794'' after ``this part''; and
                              (ii) in paragraph (2), by inserting ``or 
                          section 2794'' after ``this part''; and
                      (B) in subsection (b)--
                              (i) in paragraph (1), by inserting ``and 
                          section 2794'' after ``this part''; and
                              (ii) in paragraph (2)--
                                      (I) in subparagraph (A), by 
                                  inserting ``or section 2794 that is'' 
                                  after ``this part''; and
                                      (II) in subparagraph (C)(ii), by 
                                  inserting ``or section 2794'' after 
                                  ``this part''; and
              (2) in section 2761 (42 U.S.C. 300gg-61)--
                      (A) in subsection (a)--
                              (i) in paragraph (1), by inserting ``and 
                          section 2794'' after ``this part''; and
                              (ii) in paragraph (2)--
                                      (I) by inserting ``or section 
                                  2794'' after ``set forth in this 
                                  part''; and
                                      (II) by inserting ``and section 
                                  2794'' after ``the requirements of this 
                                  part''; and
                      (B) in subsection (b)--
                              (i) by inserting ``and section 2794'' after 
                          ``this part''; and
                              (ii) by inserting ``and section 2794'' 
                          after ``part A''.
      (d) Applicability to Grandfathered Plans.--Section 1251(a)(4)(A) of 
  the Patient Protection and Affordable Care Act (Public Law 111-148), as 
  added by section 2301 of the Health Care and Education Reconciliation 
  Act of 2010 (Public Law 111-152), is amended by adding at the end the 
  following:
                              ``(v) Section 2794 (relating to 
                          reasonableness of rates with respect to health 
                          insurance coverage).''.
      (e) Effective Date.--The amendments made by this section shall take 
  effect on the date of enactment of this Act.
target: Health Insurance Rate Review Act - Amends the Public Health Service Act to declare that federal provisions requiring the Secretary of Health and Human Services (HHS) to review unreasonable premium increases in health care coverage shall not be construed to prohibit a state from imposing additional rate requirements on health insurance issuers that are more protective of consumers. Expands such review to include all rate increases, not only premium increases.
  
  Directs the Secretary or the relevant state insurance commissioner (or state regulator) to take corrective actions to ensure that any excessive, unjustified, or unfairly discriminatory rates are corrected prior to, or as soon as possible after, implementation, including through mechanisms such as denying rates, modifying rates, or requiring rebates to consumers.
  
  Requires the Secretary to determine whether the state insurance commissioner or regulator or the Secretary will undertake such corrective actions based on whether the state can adequately undertake such actions. Applies these provisions to grandfathered health plans under the Patient Protection and Affordable Care Act.
feat_title: To amend the Public Health Service Act to provide protections for consumers against excessive, unjustified, or unfairly discriminatory increases in premium rates.