,i #aafth ,,congress #ast ,session ,h4 ,r4 #adbe ,,in ,,the ,,house ,,of ,,representatives ,february #bh1 #bjai,mrs4 ,craig 7for herself and ,mr4 ,peters7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,patient ,protection and ,affordable ,care ,act to provide for a ,improve ,health ,insurance ,affordability ,fund to provide for certain reinsurance payments to lower premiums in the individual health insurance market4 #a4 ,short title ,this ,act may be cited as the ,state ,health ,care ,premium ,reduction ,act4 #b4 ,improve ,health ,insurance ,affordability ,fund ,subtitle ,d of title ,i of the ,patient ,protection and ,affordable ,care ,act is amended by inserting after part #e 7#db ,u4,s4,c4 #ahjfa et seq47 the following new part3 #f ,improve ,health ,insurance ,affordability ,fund #acea4 ,establishment of program ,there is hereby established the ,improve ,health ,insurance ,affordability ,fund to be administered by the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services 7in this section referred to as the ,administrator71 to provide funding1 in accordance with this title1 to the #ej ,states and the ,district of ,columbia 7each referred to in this section as a ,state7 beginning on ,january #a1 #bjbj1 for the purposes described in section #aceb4 #aceb4 ,use of funds 7a7 ,in general ,a ,state shall use the funds allocated to the ,state under this part for one of the following purposes3 7#a7 ,to provide reinsurance payments to health insurance issuers with respect to individuals enrolled under individual health insurance coverage 7other than through a plan described in subsection 7b77 offered by such issuers4 7#b7 ,to provide assistance 7other than through payments described in paragraph 7#a77 to reduce out-of-pocket costs1 such as copayments1 coinsurance1 premiums1 and deductibles1 of individuals enrolled under qualified health plans offered on the individual market through an ,exchange4 7b7 ,exclusion of certain grandfathered and transitional plans ,for purposes of subsection 7a71 a plan described in this subsection is the following3 7#a7 ,a grandfathered health plan 7as defined in section #abea74 7#b7 ,a plan 7commonly referred to as a transitional plan7 continued under the letter issued by the ,centers for ,medicare ,medicaid ,services on ,november #ad1 #bjac1 to the ,state ,insurance ,commissioners outlining a transitional policy for coverage in the individual and small group markets to which section #abea does not apply1 and under the extension of the transitional policy for such coverage set forth in the ,insurance ,standards ,bulletin ,series guidance issued by the ,centers for ,medicare ,medicaid ,services on ,march #e1 #bjad1 ,february #bi1 #bjaf1 ,february #ac1 #bjag1 and ,april #i1 #bjah1 or under any subsequent extensions thereof4 #acec4 ,state eligibility and approval2 ,default safeguard 7a7 ,encouraging ,state options for allocations 7#a7 ,in general ,to be eligible for an allocation of funds under this part for a year 7beginning with #bjbj71 a ,state shall submit to the ,administrator an application at such time 7but1 in the case of allocations for #bjbj1 not later than #ij days after the date of the enactment of this title and1 in the case of allocations for a subsequent year1 not later than ,march #ca of the previous year7 and in such form and manner as specified by the ,administrator containing-- 7,a7 a description of how the funds will be used2 and 7,b7 such other information as the ,administrator may require4 7#b7 ,automatic approval ,an application so submitted is approved unless the ,administrator notifies the ,state submitting the application1 not later than #fj days after the date of the submission of such application1 that the application has been denied for not being in compliance with any requirement of this part and of the reason for such denial4 7#c7 #e-year application approval ,if an application of a ,state is approved for a purpose described in section #aceb for a year1 such application shall be treated as approved for such purpose for each of the subsequent #d years4 7b7 ,default ,federal safeguard 7#a7 #bjbj ,for allocations made under this part for #bjbj1 in the case of a ,state that does not submit an application under subsection 7a7 by the #ij-;day submission date applicable to such year under subsection 7a77#a7 and in the case of a ,state that does submit such an application by such date that is not approved1 the ,administrator1 in consultation with the ,state insurance commissioner1 shall use1 in accordance with paragraph 7#c71 the allocation that would otherwise be provided to the ,state under this part for such year for such ,state4 7#b7 #bjba and subsequent years ,in the case of a ,state that does not have in effect an approved application under this section for #bjba or a subsequent year1 the ,administrator1 in consultation with the ,state insurance commissioner1 shall use1 in accordance with paragraph 7#c71 the allocation that would otherwise be provided to the ,state under this part for such year for such ,state4 7#c7 ,specified use ,an allocation for a ,state made pursuant to paragraph 7#a7 or 7#b7 for a year shall be used to carry out the purpose described in section #aceb7a7 in such ,state by providing reinsurance payments to health insurance issuers with respect to attachment range claims 7as defined in section #aced7;b77#b71 using the dollar amounts specified in subparagraph 7,b7 of such section for such year7 in an amount equal to the percentage 7specified for such year by the ,secretary under such subparagraph7 of the amount of such claims4 #aced4 ,allocations 7a7 ,appropriation ,for the purpose of providing allocations for ,states under this part there is appropriated1 out of any money in the ,treasury not otherwise appropriated #aj1jjj1jjj1jjj for #bjbj and each subsequent year4 7b7 ,allocations 7#a7 ,payment 7,a7 ,in general ,from amounts appropriated under subsection 7a7 for a year1 the ,secretary shall1 with respect to a ,state and not later than the date specified under subparagraph 7,b7 for such year1 allocate for such ,state the amount determined for such ,state and year under paragraph 7#b74 7,b7 ,specified date ,for purposes of subparagraph 7,a71 the date specified in this subparagraph is-- 7i7 for #bjbj1 the date that is #de days after the date of the enactment of this title2 and 7ii7 for #bjba or a subsequent year1 ,january #a of the respective year4 7,c7 ,notifications of allocation amounts ,for #bjba and each subsequent year1 the ,secretary shall notify each ,state of the amount determined for such ,state under paragraph 7#b7 for such year by not later than ,january #a of the previous year4 7#b7 ,allocation amount determinations 7,a7 ,in general ,for purposes of paragraph 7#a71 the amount determined under this paragraph for a year for a ,state is the amount that the ,secretary estimates would be expended under this part for such year on attachment range claims of individuals residing in such ,state if all ,states used such funds only for the purpose described in paragraph 7#a7 of section #aceb at the dollar amounts and percentage specified under subparagraph 7,b7 for such year4 ,for purposes of the previous sentence and section #acec7;b77#c71 the term attachment range claims means1 with respect to an individual1 the claims for such individual that exceed a dollar amount specified by the ,secretary for a year1 but do not exceed a ceiling dollar amount specified by the ,secretary for such year1 under subparagraph 7,b74 7,b7 ,specifications ,for purposes of subparagraph 7,a7 and section #acec7;b77#c71 the ,secretary shall determine the dollar amounts and the percentage to be specified under subparagraph 7,a7 for a year in a manner to ensure that the total amount of expenditures under this part for such year is estimated to equal the total amount appropriated for such year under subsection 7a7 if such expenditures were used solely for the purpose described in paragraph 7#a7 of section #aceb for attachment range claims at the dollar amounts and percentage so specified for such year4 7#c7 ,availability ,funds allocated to a ,state under this subsection for a year shall remain available through the end of the subsequent year4 7c7 ,annual distribution of previous year's remaining funds 7#a7 ,in general ,in carrying out subsection 7b71 the ,secretary shall1 with respect to a year 7beginning with #bjba71 not later than ,march #ca of such year-- 7,a7 determine the amount of funds1 if any1 from the amounts appropriated under subsection 7a7 for the previous year but not allocated for such previous year2 and 7,b7 if the ,secretary determines that any funds were not so allocated for such previous year1 allocate such remaining funds to ,states for such year1 in accordance with paragraph 7#b74 7#b7 ,allocation methodology ,for purposes of paragraph 7#a71 of the total remaining funds to be allocated for a year pursuant to such paragraph1 the ,secretary shall allocate to each ,state an amount that bears the same ratio to such total remaining funds as the amount allocated pursuant to subsection 7b7 to such ,state for such year bears to the total allocations made under such subsection for such year4 4