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The conference report for H.R. 3103, the Health Insurance Portability and Accountability Act of 1996, provides for changes in the private heath insurance market. The bill guarantees the availability of private heath insurance coverage for certain groups and restricts the use of preexisting condition restrictions. Renewal of coverage will be guaranteed with limited exceptions. Although H.R. 3103 creates federal standards for insurers, health maintenance organizations (HMOs), and employers who self-insure, the bill permits substantial state flexibility for compliance. This report examines the major features of H.R. 3103 regarding heath insurance.