US Code

Public Law 119-102 (07/12/2026)

42 U.S.C. § 300gg–23

Preemption; State flexibility; construction

Section text and notes

(a)

Continued applicability of State law with respect to health insurance issuers

(1)

In general

Subject to paragraph (2) and except as provided in subsection (b), this part, part D, and part C insofar as it relates to this part or part D shall not be construed to supersede any provision of State law which establishes, implements, or continues in effect any standard or requirement solely relating to health insurance issuers in connection with individual or group health insurance coverage except to the extent that such standard or requirement prevents the application of a requirement of this part or part D.

(2)

Continued preemption with respect to group health plans

section 1144 of title 29Nothing in this part or part D shall be construed to affect or modify the provisions of with respect to group health plans.

(b)

Special rules in case of portability requirements

(1)

In general

1

1 See References in Text note below.
Subject to paragraph (2), the provisions of this part relating to health insurance coverage offered by a health insurance issuer supersede any provision of State law which establishes, implements, or continues in effect a standard or requirement applicable to imposition of a preexisting condition exclusion specifically governed by section 701  which differs from the standards or requirements specified in such section.

(2)

Exceptions

Only in relation to health insurance coverage offered by a health insurance issuer, the provisions of this part do not supersede any provision of State law to the extent that such provision—
(i)
1 substitutes for the reference to “6-month period” in section 2701(a)(1)  a reference to any shorter period of time;
(ii)
1 substitutes for the reference to “12 months” and “18 months” in section 2701(a)(2)  a reference to any shorter period of time;
(iii)
11 substitutes for the references to “63” days in sections 2701(c)(2)(A)  and 2701(d)(4)(A)  a reference to any greater number of days;
(iv)
11 substitutes for the reference to “30-day period” in sections 2701(b)(2)  and 2701(d)(1)  a reference to any greater period;
(v)
1 prohibits the imposition of any preexisting condition exclusion in cases not described in section 2701(d)  or expands the exceptions described in such section;
(vi)
1 requires special enrollment periods in addition to those required under section 2701(f) ; or
(vii)
1 reduces the maximum period permitted in an affiliation period under section 2701(g)(1)(B) .
(c)

Rules of construction

1Nothing in this part (other than section 2704)  or part D shall be construed as requiring a group health plan or health insurance coverage to provide specific benefits under the terms of such plan or coverage.

(d)

Definitions

For purposes of this section—
(1)

State law

The term “State law” includes all laws, decisions, rules, regulations, or other State action having the effect of law, of any State. A law of the United States applicable only to the District of Columbia shall be treated as a State law rather than a law of the United States.

(2)

State

The term “State” includes a State (including the Northern Mariana Islands), any political subdivisions of a State or such Islands, or any agency or instrumentality of either.

July 1, 1944, ch. 373 Pub. L. 104–191, title I, § 102(a)110 Stat. 1971 Pub. L. 104–204, title VI, § 604(b)(2)110 Stat. 2941 Pub. L. 111–148, title I124 Stat. 130 Pub. L. 116–260, div. BB, title I, § 102(a)(3)(D)134 Stat. 2772 (, title XXVII, § 2724, formerly § 2723, as added , , ; amended , , ; renumbered § 2737, renumbered § 2724, and amended , §§ 1001(4), 1563(c)(14), formerly § 1562(c)(14), title X, § 10107(b)(1), , , 269, 911; , , .)

Editorial Notes

References in Text

section 300gg of this titlePub. L. 111–148, title I124 Stat. 154 section 300gg–3 of this titlePub. L. 111–148, title I, § 1201(4)124 Stat. 155 section 300gg of this titleSection 2701, referred to in subsec. (b), is a reference to section 2701 of act . Section 2701, which was classified to , was renumbered section 2704, effective for plan years beginning on or after , with certain exceptions, and amended, by , §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(b)(1), , , 264, 911, and was transferred to . A new section 2701 of act , related to fair health insurance premiums, was added, effective for plan years beginning on or after , and amended, by , title X, § 10103(a), , , 892, and is classified to .

Section 701, referred to in subsec. (b)(1), probably means “section 2701” of act . See note above.

section 300gg–4 of this titlePub. L. 111–148, title I124 Stat. 130 section 300gg–25 of this titlePub. L. 111–148, title I124 Stat. 154 section 300gg–3 of this titleSection 2704, referred to in subsec. (c), is a reference to section 2704 of act . Section 2704, which was classified to , was renumbered section 2725, and amended by , §§ 1001(2), 1563(c)(3), formerly § 1562(c)(3), title X, § 10107(b)(1), , , 265, 911, and was transferred to . A new section 2704 of act , related to prohibition of preexisting condition exclusions or other discrimination based on health status, was added, effective for plan years beginning on or after , with certain exceptions, and amended, by , §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(b)(1), , , 264, 911, and is classified to .

Amendments

Pub. L. 116–260, § 102(a)(3)(D)(i)2020—Subsec. (a)(1). , substituted “this part, part D, and part C insofar as it relates to this part or part D” for “this part and part C insofar as it relates to this part” and inserted “or part D” before period at end.

Pub. L. 116–260, § 102(a)(3)(D)(ii)Subsec. (a)(2). , inserted “or part D” after “this part”.

Pub. L. 116–260, § 102(a)(3)(D)(iii)Subsec. (c). , inserted “or part D” after “this part (other than section 2704)”.

Pub. L. 111–148, § 1563(c)(14)(A)Pub. L. 111–148, § 10107(b)(1)2010—Subsec. (a)(1). , formerly § 1562(c)(14)(A), as renumbered by , inserted “individual or” before “group health insurance”.

Pub. L. 104–2041996—Subsec. (c). inserted “(other than section 2704)” after “part”.

Statutory Notes and Related Subsidiaries

Effective Date of 2020 Amendment

Pub. L. 116–260section 102(e) of div. BB of Pub. L. 116–260section 8902 of Title 5Amendment by applicable with respect to plan years beginning on or after , see , set out as a note under , Government Organization and Employees.

Effective Date of 1996 Amendment

Pub. L. 104–204section 604(c) of Pub. L. 104–204section 300gg–25 of this titleAmendment by applicable with respect to group health plans for plan years beginning on or after , see set out as an Effective Date note under .

Effective Date

section 102(c) of Pub. L. 104–191section 300gg of this titleSection applicable with respect to group health plans, and health insurance coverage offered in connection with group health plans, for plan years beginning after , except as otherwise provided, see , set out as a note under .