,i #aaeth ,,congress #ast ,session ,h4 ,r4 #dabh ,,in ,,the ,,house ,,of ,,representatives ,october #be1 #bjag,ms4 ,michelle ,lujan ,grisham of ,new ,mexico introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend title ,,xix of the ,social ,security ,act to allow ,states with ,exchanges with low-insurer participation to offer a ,medicaid buy-in plan1 and for other purposes4 #a4 ,short title ,this ,act may be cited at the ,health ,care ,choice and ,affordability ,act4 #b4 ,medicaid buy-in plans 7a7 ,in general 7#a7 ,offering on an ,exchange ,for a plan year beginning on or after ,january #a1 #bjah1 notwithstanding any other provision of law1 a ,medicaid buy-in ,state may offer to eligible individuals with respect to a plan year a ,medicaid buy-in plan in the individual market through an ,exchange established under title ,i of the ,patient ,protection and ,affordable ,care ,act for such plan year4 7#b7 ,premium rates 7,a7 ,in general ,a ,medicaid buy-in ,state that offers a ,medicaid buy-in plan under paragraph 7#a7 shall establish premium rates under such plan at a level calculated to produce revenue equal to the sum of-- 7i7 the costs of health benefits provided by the plan2 plus 7ii7 #aj percent of the administrative costs related to operating the plan4 7,b7 ,prohibiting discriminatory premiums ,in the case of a ,medicaid buy-in plan1 premiums may only vary to the extent permitted under section #bgja7;a77#a7 of the ,public ,health ,service ,act4 7#c7 ,enrollment ,the enrollment period for a ,medicaid buy-in plan offered under paragraph 7#a7 shall1 to the extent practicable1 conform with the enrollment period for qualified health plans offered through an ,exchange4 7#d7 ,federal payment for administrative expenses ,in the case of a ,medicaid buy-in ,state that offers a ,medicaid buy-in plan under paragraph 7#a71 the ,secretary of ,health and ,human ,services shall pay to such ,state for each calendar quarter beginning on or after ,january #a1 #bjah1 an amount equal to #ij percent of so much of the sums expended during such quarter as are attributable to administering the ,medicaid buy-in plan in such ,state4 7b7 ,premium tax credits 7#a7 ,in general ,section #cf;,b of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following new subsection3 7h7 ,application to individuals purchasing ,medicaid coverage ,in the case of any individual enrolled in a ,medicaid buy-in plan subsection 7a7 shall be applied by substituting for premium assistance credit amount of the taxpayer for the taxable year the following3 the lesser of-- 7#a7 the monthly premiums charged by a ,medicaid buy-in ,state for a ,medicaid buy-in plan that covers the taxpayer1 the taxpayer's spouse1 or any dependent 7as defined in section #aeb7 of the taxpayer1 or 7#b7 the excess 7if any7 of-- 7,a7 such monthly premium1 over 7,b7 an amount equal to #a_/ab of the product of the applicable percentage and the taxpayer's household income for the taxable year4 4 4 7#b7 ,exception for minimum essential coverage ,subparagraph 7,b7 of section #cf;,b7c77#b7 of the ,internal ,revenue ,code of #aihf is amended by inserting before the period at the end the following3 or eligibility for coverage under a ,medicaid buy-in plan 7as defined in section #b7;c7 of the ,health ,care ,choice and ,affordability ,act74 7#c7 ,individual mandate ,clause 7ii7 of section #ejjj;,a7f77#a77;,a7 of the ,internal ,revenue ,code of #aihf is amended by inserting before the comma the following3 including under a ,medicaid buy-in plan 7as defined in section #b7;c7 of the ,health ,care ,choice and ,affordability ,act74 7#d7 ,advance payment of credit 7,a7 ,in general ,advance determinations and payments of premium tax credits allowable under section #cf;,b of the ,internal ,revenue ,code of #aihf with respect to an individual enrolled in a ,medicaid buy-in plan shall be allowed1 subject to rules similar to the rules in section #adab of the ,patient ,protection and ,affordable ,care ,act 7applied without regard to whether such plan is a qualified health plan74 7,b7 ,coordination with credit ,section #cf;,b7f7 is amended by adding at the end the following new paragraph3 7#d7 ,medicaid buy-in plans ,for purposes of this subsection1 advance payments under section #b7;b77#d77;,a7 of the ,health ,care ,choice and ,affordability ,act shall be treated as advance payments under section #adab of the ,patient ,protection and ,affordable ,care ,act4 4 7#e7 ,conforming amendment relating to employer responsibility ,section #dihj;,h7c77#f7 of the ,internal ,revenue ,code of #aihf is amended by inserting 1 except that for purposes of subsections 7a77#b7 and 7b77#a77;,b71 the term qualified health plan shall include a ,medicaid buy-in plan 7as defined in section #b7;c7 of the ,health ,care ,choice and ,affordability ,act after such ,act4 7c7 ,definitions ,in this section3 7#a7 ,eligible individual ,the term eligible individual means an individual who will have access to only qualified health plans issued by one health insurance issuer 7as defined in section #bgia of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ia77 or will have access to no qualified health plans with respect to a plan year4 7#b7 ,medicaid buy-in ,state ,the term ,medicaid buy-in ,state means a ,state that has at least one political subdivision in which fewer than two health insurance issuers participate in the ,federal1 ,federally facilitated1 or ,state ,exchange established under title ,i of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh7 for such political subdivision4 7#c7 ,medicaid buy-in plan ,the term ,medicaid buy-in plan means a health insurance plan that-- 7,a7 is administered by the ,state agency administering the ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 7or a waiver of such plan72 and 7,b7 consists of benchmark coverage described in subsection 7b77#a7 of section #aicg of such ,act 7#db ,u4,s4,c4 #acifu-#g7;b77#a77 or benchmark-equivalent coverage described in subsection 7b77#b7 of such section4 7#d7 ,qualified health plan ,the term qualified health plan has the meaning given such term in section #acja of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjba74