Title 42 — The Public Health and WelfareRelease 119-73

§18044 Level playing field

Title 42 › Chapter CHAPTER 157— - QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS › Subchapter SUBCHAPTER III— - AVAILABLE COVERAGE CHOICES FOR ALL AMERICANS › Part Part C— - State Flexibility Relating To Exchanges › § 18044

Last updated Apr 6, 2026|Official source

Summary

Private health plans from insurers do not have to follow certain federal or state rules when a qualified health plan under the Consumer Operated and Oriented Plan (CO‑OP) program or a multi‑State qualified health plan is not subject to those rules. The rules cover 13 areas, such as renewal and rating, preexisting condition rules, non‑discrimination, quality and fraud controls, solvency and market rules, prompt payment, appeals, privacy, licensure, and benefit plan materials.

Full Legal Text

Title 42, §18044

The Public Health and Welfare — Source: USLM XML via OLRC

(a)Notwithstanding any other provision of law, any health insurance coverage offered by a private health insurance issuer shall not be subject to any Federal or State law described in subsection (b) if a qualified health plan offered under the Consumer Operated and Oriented Plan program under section 18042 of this title, or a multi-State qualified health plan under section 18054 of this title, is not subject to such law.

(b)The Federal and State laws described in this subsection are those Federal and State laws relating to—

(1)guaranteed renewal;

(2)rating;

(3)preexisting conditions;

(4)non-discrimination;

(5)quality improvement and reporting;

(6)fraud and abuse;

(7)solvency and financial requirements;

(8)market conduct;

(9)prompt payment;

(10)appeals and grievances;

(11)privacy and confidentiality;

(12)licensure; and

(13)benefit plan material or information.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

Amendments

2010—Subsec. (a). Pub. L. 111–148, § 10104(n), substituted “, or a multi-State qualified health plan under section 18054 of this title” for “, a community health insurance option under section 18043 of this title, or a nationwide qualified health plan under section 18053(b) of this title”.

Reference

Citations & Metadata

Citation

42 U.S.C. § 18044

Title 42 — The Public Health and Welfare

Last Updated

Apr 6, 2026

Release point: 119-73