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H.R.4519 / 103rd Congress

Small Business Health Insurance Choice Act

See H.R.3600.

Official summary

Version 00 · Introduced in House · May 26, 1994

TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families Subtitle B: Preemption of Scope of State Regulation Subtitle C: Health Deduction Fairness Title II: Removing Anti-Trust Impediments Small Business Health Insurance Choice Act - Title I: Improved Access to Affordable Health Care - Subtitle A: Increased Availability And Continuity of Health Coverage of Health Coverage for Employees and their Families - Prohibits a group health plan limiting coverage or excluding from coverage based on a pre-existing condition if: (1) the condition was not diagnosed within three months before coverage; (2) the limitation or exclusion extends over more than six months after coverage; (3) the limitation or exclusion applies to an individual who, as of the date of birth, was covered; or (4) the limitation or exclusion relates to pregnancy. Sets forth continuity of coverage provisions. Prohibits a plan from cancelling coverage or denying renewal, except for such reasons as nonpayment of premiums, fraud, or because the plan no longer provides coverage in a geographic area. Provides for enforcement by the Department of Labor for employers and group health plans. Amends the Internal Revenue Code to impose an excise tax on the failure of an insurer to comply with the requirements of the preceding paragraph. Provides for an exception to the tax if a State has adequate sanctions. Subtitle B: Preemption of Scope of State Regulation - Prohibits a State or local law from: (1) requiring coverage of one or more specific benefits, services, or categories of health care, or services of any class or type of provider; and (2) prohibiting two or more employers from obtaining coverage under an insured multiple employer health plan. Preempts for five years provisions of State law concerning: (1) restrictions on reimbursement rates or selective contracting; and (2) restrictions on differential financial incentives. Subtitle C: Health Deduction Fairness - Extends permanently and increases to 100 percent the health insurance tax deduction for self-employed individuals. Permits the deduction of uncompensated health insurance costs without regard to the adjusted gross income threshold for individuals who are not eligible to participate in any subsidized health plan maintained by either an employer or spouse. Title II: Removing Antitrust Impediments - Provides for a program which permits a health care joint venture to apply for a limited exemption from the antitrust laws, Permits a health care joint venture to apply for a certificate of public advantage. Directs the Attorney General to issue the certificate if: (1) the benefits of issuance are likely to outweigh the reduction in competition; and (2) the reduction in competition is reasonably necessary to obtain the desired benefit. Establishes the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care to evaluate competition and antitrust policy with respect to the performance of health care markets and to report recommendations to the Congress.

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Who introduced it

Rep. Manzullo, Donald A. [R-IL-16] · R–IL

Committees

  • Energy and Commerce Committee
  • Education and Workforce Committee
  • Judiciary Committee
  • Ways and Means Committee
9 cosponsorship records, including any withdrawals

Actions

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  1. See H.R.3600.

  2. Referred to the Subcommittee on Commerce, Consumer Protection and Competitiveness.

  3. Referred to the Subcommittee on Labor-Management Relations.

  4. Referred to the Subcommittee on Economic and Commercial Law.

  5. Referred to the Subcommittee on Health.

  6. Referred to the House Committee on Ways and Means.

  7. Referred to the House Committee on Judiciary.

  8. Referred to the House Committee on Energy and Commerce.

  9. Referred to the House Committee on Education and Labor.

  10. Sponsor introductory remarks on measure. (CR E1103-1104)

  11. Introduced in House

  12. Introduced in House

Bill text & related measures

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Related bills identified by Congress.gov

Source last updated: Mar 23, 2026. Consult Congress.gov for the current record.

Explore the bill from different angles

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Neutral evidence review

Objective

Analyze H.R.4519 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.

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Fairness and public impact

Progressive lens

Examine H.R.4519 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.

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Institutions and government scope

Conservative lens

Examine H.R.4519 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.

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Individual rights and government power

Liberty lens

Examine H.R.4519 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.

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