---
kind: "section"
citation: "42 U.S.C. § 18012"
title: "42"
title_heading: "The Public Health and Welfare"
number: "18012"
heading: "Rating reforms must apply uniformly to all health insurance issuers and group health plans"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/18012"
units:
  - "Chapter 157 — Quality, Affordable Health Care for All Americans"
  - "Subchapter II — Other Provisions"
---

# §18012. Rating reforms must apply uniformly to all health insurance issuers and group health plans


Any standard or requirement adopted by a [State](/usc/42/18024.md?p=d) pursuant to this title,[^1] or any amendment made by this title,[^1] shall be applied uniformly to all [health plans](/usc/42/18021.md?p=b-1-A) in each insurance market to which the standard and requirements apply. The preceding sentence shall also apply to a [State](/usc/42/18024.md?p=d) standard or requirement relating to the standard or requirement required by this title[^1] (or any such amendment) that is not the same as the standard or requirement but that is not preempted under [section 18041(d) of this title](/usc/42/18041.md?p=d).


## Footnotes

[^1]: See References in Text note below.

## Source credit

(Pub. L. 111–148, title I, § 1252, Mar. 23, 2010, 124 Stat. 162.)

## Notes

### Editorial Notes

### References in Text

This title, referred to in text, is title I of Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 130, which enacted this chapter and enacted, amended, and transferred numerous other sections and notes in the Code. For complete classification of title I to the Code, see Tables.

### Statutory Notes and Related Subsidiaries

### Effective Date

Section effective for plan years beginning on or after Jan. 1, 2014, see section 1255 of Pub. L. 111–148, set out as a note under section 300gg of this title.