,,ii  #aafth ,,congress  #ast ,session  
,s4 #ifd  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,april #a1          
#bjai,mrs4 ,shaheen 7for herself1 ,ms4  
,stabenow1 ,mr4 ,casey1 ,mr4 ,reed1 ,mr4
 ,blumenthal1 ,ms4 ,hassan1 ,ms4        
,klobuchar1 ,mr4 ,tester1 ,mr4 ,kaine1  
,mr4 ,king1 ,ms4 ,harris1 ,mr4          
,whitehouse1 ,ms4 ,baldwin1 ,ms4        
,hirono1 and ,mr4 ,murphy7 introduced   
the following bill2 which was read twice
 and referred to the ,committee on      
,health1 ,education1 ,labor1 and        
,pensions  ,a ,,bill  ,to amend the     
,patient ,protection and ,affordable    
,care ,act to improve cost-sharing      
subsidies4  #a4 ,short title ,this ,act 
may be cited as the ,marketplace        
,certainty ,act4  #b4 ,enhancements for 
reduced cost-sharing  7a7 ,modification 
of amount  7#a7 ,in general ,section    
#adjb7;c77#b7 of the ,patient           
,protection and ,affordable ,care ,act  
is amended to read as follows3  7#b7    
,additional reduction ,the ,secretary   

shall establish procedures under which  
the issuer of a qualified health plan to
 which this section applies shall       
further reduce cost-sharing under the   
plan in a manner sufficient to--  7,a7  
in the case of an eligible insured whose
 household income is not less than #ajj 
percent but not more than #bjj percent  
of the poverty line for a family of the 
size involved1 increase the plan's share
 of the total allowed costs of benefits 
provided under the plan to #ie percent  
of such costs2  7,b7 in the case of an  
eligible insured whose household income 
is more than #bjj percent but not more  
than #cjj percent of the poverty line   
for a family of the size involved1      
increase the plan's share of the total  
allowed costs of benefits provided under
 the plan to #ij percent of such costs2 
and  7,c7 in the case of an eligible    
insured whose household income is more  
than #cjj percent but not more than #djj
 percent of the poverty line for a      
family of the size involved1 increase   

the plan's share of the total allowed   
costs of benefits provided under the    
plan to #he percent of such costs4  4   
7#b7 ,conforming amendment ,clause 7i7  
of section #adjb7;c77#a77;,b7 of such   
,act is amended to read as follows3  7i7
 ,in general ,the ,secretary shall      
ensure the reduction under this         
paragraph shall not result in an        
increase in the plan's share of the     
total allowed costs of benefits provided
 under the plan above--  7,i7 #ie       
percent in the case of an eligible      
insured described in paragraph          
7#b77;,a72  7,,ii7 #ij percent in the   
case of an eligible insured described in
 paragraph 7#b77;,b72 and  7,,iii7 #he  
percent in the case of an eligible      
insured described in paragraph          
7#b77;,c74  4  7#c7 ,effective date ,the
 amendments made by this subsection     
shall apply to plan years beginning     
after ,december #ca1 #bjai4  7b7        
,funding ,section #adjb of the ,patient 
,protection and ,affordable ,care ,act  

is amended by adding at the end the     
following new subsection3  7g7 ,funding 
,out of any funds in the ,treasury not  
otherwise appropriated1 there are       
appropriated to the ,secretary such sums
 as may be necessary for payments under 
this section4  4