---
kind: "section"
citation: "42 U.S.C. § 300gg–61"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300gg–61"
heading: "Enforcement"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300gg-61"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXV — Requirements Relating to Health Insurance Coverage"
  - "Part B — Individual Market Rules"
  - "Subpart 3 — general provisions"
---

# §300gg–61. Enforcement

- (a) **State enforcement—**
  - (1) **State authority—** Subject to [section 300gg–62 of this title](/usc/42/300gg–62.md), each [State](/usc/42/201.md?p=f) may require that [health insurance issuers](/usc/42/300gg–91.md?p=b-2) that issue, sell, renew, or offer [health insurance coverage](/usc/42/300gg–91.md?p=b-1) in the [State](/usc/42/201.md?p=f) in the [individual market](/usc/42/300gg–91.md?p=e-1-A) meet the requirements established under this part with respect to such issuers.
  - (2) **Failure to implement requirements—** In the case of a [State](/usc/42/201.md?p=f) that fails to substantially enforce the requirements set forth in this part with respect to [health insurance issuers](/usc/42/300gg–91.md?p=b-2) in the [State](/usc/42/201.md?p=f), the [Secretary](/usc/42/201.md?p=c) shall enforce the requirements of this part under [subsection (b)](#b) insofar as they relate to the issuance, sale, renewal, and offering of [health insurance coverage](/usc/42/300gg–91.md?p=b-1) in the [individual market](/usc/42/300gg–91.md?p=e-1-A) in such [State](/usc/42/201.md?p=f).
- (b) **Secretarial enforcement authority—** The [Secretary](/usc/42/201.md?p=c) shall have the same authority in relation to enforcement of the provisions of this part with respect to issuers of [health insurance coverage](/usc/42/300gg–91.md?p=b-1) in the [individual market](/usc/42/300gg–91.md?p=e-1-A) in a [State](/usc/42/201.md?p=f) as the [Secretary](/usc/42/201.md?p=c) has under [section 300gg–22(b)(2) of this title](/usc/42/300gg–22.md?p=b-2), and [section 300gg–22(b)(3) of this title](/usc/42/300gg–22.md?p=b-3)[^1] with respect to [violations](/usc/42/2000e–16a.md?p=c) of genetic nondiscrimination provisions, in relation to the enforcement of the provisions of part A with respect to issuers of [health insurance coverage](/usc/42/300gg–91.md?p=b-1) in the [small group market](/usc/42/300gg–91.md?p=e-5) in the [State](/usc/42/201.md?p=f).

## Footnotes

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

## Source credit

(July 1, 1944, ch. 373, title XXVII, § 2761, formerly § 2745, as added Pub. L. 104–191, title I, § 111(a), Aug. 21, 1996, 110 Stat. 1986; renumbered § 2761 and amended Pub. L. 104–204, title VI, § 605(a)(2), (b)(2), Sept. 26, 1996, 110 Stat. 2941, 2942; Pub. L. 110–233, title I, § 102(b)(2), May 21, 2008, 122 Stat. 895.)

## Notes

### Editorial Notes

### References in Text

Section 300gg–22(b)(2) of this title, and section 300gg–22(b)(3) of this title, referred to in subsec. (b), was in the original “section 2722(b)(2), and section 2722(b)(3)” and was translated as meaning section 2723(b)(2) and section 2723(b)(3) of act July 1, 1944, to reflect the probable intent of Congress and the renumbering of section 2722 as 2723 by Pub. L. 111–148, title I, §§ 1001(4), 1563(c)(13)(C), formerly § 1562(c)(13)(C), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 130, 269, 911.

### Amendments

2008—Subsec. (b). Pub. L. 110–233 amended subsec. (b) generally. Prior to amendment, text read as follows: “The Secretary shall have the same authority in relation to enforcement of the provisions of this part with respect to issuers of health insurance coverage in the individual market in a State as the Secretary has under section 300gg–22(b)(2) of this title in relation to the enforcement of the provisions of part A of this subchapter with respect to issuers of health insurance coverage in the small group market in the State.”

1996—Subsec. (a)(1). Pub. L. 104–204 made technical amendment to reference in original act which appears in text as reference to section 300gg–62 of this title.

### Statutory Notes and Related Subsidiaries

### Effective Date of 2008 Amendment

Amendment by Pub. L. 110–233 applicable, with respect to group health plans and health insurance coverage offered in connection with group health plans, for plan years beginning after the date that is one year after May 21, 2008, and, with respect to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market, after the date that is one year after May 21, 2008, see section 102(d)(2) of Pub. L. 110–233, set out as a note under section 300gg–21 of this title.

### Effective Date of 1996 Amendment

Amendment by Pub. L. 104–204 applicable to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market on or after Jan. 1, 1998, see section 605(c) of Pub. L. 104–204, set out as a note under section 300gg–44 of this title.

### Effective Date

Section applicable with respect to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market after June 30, 1997, regardless of when a period of creditable coverage occurs, see section 111(b) of Pub. L. 104–191, set out as a note under section 300gg–41 of this title.