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H.R. 4519 103rd Congress House

Small Business Health Insurance Choice Act

Official title: To increase access to health insurance for employees of small businesses, and for other purposes.

Introduced: May 26, 1994 See on congress.gov
Health Administrative procedureAntitrust actionsAntitrust lawCivil Rights and Liberties, Minority Issues
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CommerceCompetitionContinuum of careContractsCost effectivenessDamagesDepartment of JusticeDepartment of LaborDiscrimination in insuranceEmployee health benefitsEvidence (Law)Excise taxFederal advisory bodiesFederal preemptionFinance and Financial SectorGovernment Operations and PoliticsGovernment paperworkHealth care reformHealth insuranceIncomeIncome taxInsurance companiesInsurance premiumsJoint venturesJudicial review of administrative actsLabor and EmploymentLawManaged carePregnancyRestrictive trade practicesSelf-employedSelf-insuranceSmall businessStandardsState lawsTax deductionsTax penaltiesTaxation
This bill died when the 103rd Congress ended
It never became law before the 103rd Congress (1993–1994) adjourned, and bills don't carry over to the next Congress. It would have to be reintroduced. You can still save it for reference, but it won't receive updates.
 Everywhere this bill has been 11 steps
Introduced
In committee
Reported out
Passed House
Passed Senate
To President
Became law
Aug 2, 1994
See H.R.3600.
Jun 28, 1994
Referred to the Subcommittee on Commerce, Consumer Protection and Competitiveness.
Jun 22, 1994
Referred to the Subcommittee on Labor-Management Relations.
Jun 8, 1994
Referred to the Subcommittee on Economic and Commercial Law.
Jun 3, 1994
Referred to the Subcommittee on Health.
May 26, 1994
Referred to the House Committee on Ways and Means.
May 26, 1994
Referred to the House Committee on Judiciary.
May 26, 1994
Referred to the House Committee on Energy and Commerce.
May 26, 1994
Referred to the House Committee on Education and Labor.
May 26, 1994
Sponsor introductory remarks on measure. (CR E1103-1104)
May 26, 1994
Introduced in House
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 Latest action August 2, 1994

See H.R.3600.

 Plain-English summary Congressional Research Service

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.

 Related & companion bills 1
 Bill text 1 version

Source documents hosted by congress.gov.

 Committees of jurisdiction 8
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APA
U.S. Congress. (2026). H.R. 4519: Small Business Health Insurance Choice Act. 103rd Congress. Open America. https://openamerica.io/bill/103-HR-4519/
MLA
"H.R. 4519: Small Business Health Insurance Choice Act." 103rd Congress, 2026, Open America, https://openamerica.io/bill/103-HR-4519/.
Bluebook (legal)
H.R. 4519, 103rd Cong. (2026), https://openamerica.io/bill/103-HR-4519/.
Markdown link
[H.R. 4519: Small Business Health Insurance Choice Act](https://openamerica.io/bill/103-HR-4519/)
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