,i #aahth ,,congress #ast ,session ,h4 ,r4 #aaac ,,in ,,the ,,house ,,of ,,representatives ,february #ba1 #bjbc,mr4 ,bera 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 streamline enrollment in health insurance affordability programs and minimum essential coverage1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,easy ,enrollment in ,health ,care ,act4 #b4 ,definitions ,in this ,act3 7#a7 ,,chip program ,the term ,,chip program means a ,state plan for child health assistance under title ,,xxi of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;aa et seq471 including any waiver of such a plan4 7#b7 ,exchange ,the term ,exchange means an ,american ,health ,benefit ,exchange established under subtitle ,d of title ,i of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjba et seq474 7#c7 ,family size ,the term family size has the meaning given such term in section #cf;,b7d7 of the ,internal ,revenue ,code of #aihf4 7#d7 ,group health plan ,the term group health plan has the meaning given such term in section #ejjj7;b77#a7 of the ,internal ,revenue ,code of #aihf4 7#e7 ,household income ,the term household income has the meaning given such term in section #cf;,b7d7 of the ,internal ,revenue ,code of #aihf4 7#f7 ,household member ,the term household member means the taxpayer1 the taxpayer's spouse1 and any dependent of the taxpayer4 7#g7 ,insurance affordability program ,the term insurance affordability program means any of the following3 7,a7 ,a ,medicaid program4 7,b7 ,a ,,chip program4 7,c7 ,the program under title ,i of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjja et seq47 for the enrollment in qualified health plans offered through an ,exchange1 including the premium tax credits under section #cf;,b of the ,internal ,revenue ,code of #aihf1 cost-sharing reductions under section #adjb of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjga71 and the advance payment of such credits and reductions under section #adab7;a77#c7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhb7;a77#c774 7,d7 ,a ,state basic health program under section #acca of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjea74 7,e7 ,any other ,federal1 ,state1 or local program that provides assistance for some or all of the cost of minimum essential coverage and requires eligibility for such program to be based in whole or in part on income1 including such a program carried out through a waiver under section #accb of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjeb7 or a ,state program supplementing the advanced payment of tax credits and cost-sharing reductions under section #adab7;a77#c7 of such ,act4 7#h7 ,medicaid program ,the term ,medicaid program means a ,state plan for medical assistance under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq471 including any waiver of such a plan4 7#i7 ,minimum essential coverage ,the term minimum essential coverage has the meaning given such term in section #ejjj;,a7f7 of the ,internal ,revenue ,code of #aihf4 7#aj7 ,modified adjusted gross income ,the term modified adjusted gross income has the meaning given such term in section #cf;,b7d77#b77;,b7 of the ,internal ,revenue ,code of #aihf4 7#aa7 ,net premium ,the term net premium1 with respect to a health plan or other form of minimum essential coverage-- 7,a7 except as provided in subparagraph 7,b71 means the payment from or on behalf of an individual required to enroll in such plan or coverage1 after application of the premium tax credit under section #cf;,b of the ,internal ,revenue ,code of #aihf1 the advance payment of such credit under section #adab7;a77#c7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhb7;a77#c771 and any other assistance provided by an insurance affordability program2 and 7,b7 does not include any amounts described in section #cf;,b7b77#c77;,d7 of the ,internal ,revenue ,code of #aihf or section #acjc7;b77#b7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjbc7;b77#b774 7#ab7 ,poverty line ,the term poverty line has the meaning given such term in section #cf;,b7d77#c7 of the ,internal ,revenue ,code of #aihf4 7#ac7 ,qualified health plan ,the term qualified health plan has the meaning given such term in section #acja7;a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjba7;a774 7#ad7 ,relevant return information ,the term relevant return information means1 with respect to a taxpayer1 any return information1 as defined in section #fajc7;b77#b7 of the ,internal ,revenue ,code of #aihf1 which may be relevant1 as determined by the ,secretary of the ,treasury in consultation with the ,secretary of ,health and ,human ,services1 with respect to-- 7,a7 determining1 or facilitating determination of1 the eligibility of any household member of the taxpayer for any insurance affordability program1 either directly or through enabling access to additional information potentially relevant to such eligibility2 or 7,b7 enrolling1 or facilitating the enrollment of1 such individual in minimum essential coverage4 7#ae7 ,single1 streamlined application ,the term single1 streamlined application means the form described in section #adac7;b77#a77;,a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhc7;b77#a77;,a774 7#af7 ,tax return preparer ,the term tax return preparer has the meaning given such term in section #ggja7;a77#cf7 of the ,internal ,revenue ,code of #aihf4 7#ag7 ,zero net premium ,the term zero net premium1 with respect to a health plan or other form of minimum essential coverage1 means a net premium of #j4jj for such plan or coverage4 #c4 ,federal income tax returns used to facilitate enrollment into insurance affordability programs 7a7 ,in general ,not later than ,january #a1 #bjbf1 the ,secretary shall establish a program which allows any taxpayer who is not covered under minimum essential coverage at the time their return of tax for the taxable year is filed1 as well as any other household member who is not covered under such coverage1 to1 in conjunction with the filing of their return of tax for any taxable year which begins after ,december #ca1 #bjbd1 elect to-- 7#a7 have a determination made as to whether the household member who is not covered under such coverage is eligible for an insurance affordability program2 and 7#b7 have such household member enrolled into minimum essential coverage1 provided that-- 7,a7 such coverage is provided through a zero-net-premium plan1 and 7,b7 the taxpayer does not-- 7i7 opt out of coverage through the zero-net-premium plan1 or 7ii7 select a different plan4 7b7 ,taxpayer requirements and consent 7#a7 ,in general ,pursuant to the program established under subsection 7a71 the taxpayer may1 in conjunction with the filing of their return of tax for the taxable year-- 7,a7 identify any household member who is not covered under minimum essential coverage at the time of such filing2 and 7,b7 with respect to each household member identified under subparagraph 7,a71 elect whether to-- 7i7 in accordance with section #fajc7l77#bc7 of the ,internal ,revenue ,code of #aihf 7as added by subsection 7f771 consent to the disclosure and transfer to the applicable ,exchange of any relevant return information for purposes of determining whether such household member may be eligible for any insurance affordability program and facilitating enrollment into such program and minimum essential coverage1 including any further disclosure and transfer by the ,exchange to any other entity as is deemed necessary to accomplish such purposes2 and 7ii7 in the case consent is provided under clause 7i7 with respect to such household member1 enroll such household member in any minimum essential coverage that is available with a zero net premium1 if-- 7,i7 the member is eligible for such coverage through an insurance affordability program2 and 7,,ii7 the member does not1 by the end of the special enrollment period described in section #d7;c77#a77;,a7-- 7aa7 select a different plan offering minimum essential coverage2 or 7bb7 opt out of such coverage that is available with a zero net premium4 7#b7 ,establishment of options for taxpayer consent and election ,for purposes of paragraph 7#a77;,b71 the ,secretary1 in consultation with the ,secretary of ,health and ,human ,services1 may provide the elections under such paragraph as a single election or as #b elections4 7#c7 ,supplemental form 7,a7 ,in general ,in the case of a taxpayer who has consented to disclosure and transfer of relevant return information pursuant to paragraph 7#a77;,b77i71 such taxpayer shall be enrolled in the insurance affordability program only if the taxpayer submits a supplemental form which is designed to collect additional information necessary 7as determined by the ,secretary of ,health and ,human ,services7 to establish eligibility for and enrollment in an insurance affordability program1 which may include 7except as provided in subparagraph 7,b771 with respect to each individual described in paragraph 7#a77;,a71 the following3 7i7 ,state of residence4 7ii7 ,date of birth4 7iii7 ,employment and the availability of benefits under a group health plan at the time the return of tax is filed4 7iv7 ,any changed circumstances described in section #adab7;b77#b7 of the ,patient ,protection and ,affordable ,care ,act2 7#db ,u4,s4,c4 #ahjhb7;b77#b774 7v7 ,solely for the purpose of facilitating automatic renewal of coverage and eligibility redeterminations under section #adac7;c77#c77;,a7 of such ,act 7#db ,u4,s4,c4 #ahjhc7;c77#c77;,a771 authorization for the ,secretary to disclose relevant return information for subsequent taxable years to insurance affordability programs4 7vi7 ,any methods preferred by the taxpayer or household member for the purpose of being contacted by the applicable ,exchange or insurance affordability program with respect to any eligibility determination for1 or enrollment in1 an insurance affordability program or minimum essential coverage1 such as an email address or a phone number for calls or text messages4 7vii7 ,information about household composition that-- 7,i7 may affect eligibility for an insurance affordability program2 and 7,,ii7 is not otherwise included on the return of tax4 7viii7 ,such other information as the ,secretary1 in consultation with the ,secretary of ,health and ,human ,services1 may require1 including information requested on the single1 streamlined application4 7,b7 ,limitations ,the information obtained through the form described in subparagraph 7,a7 may not include any request for information with respect to citizenship1 immigration status1 or health status of any household member4 7,c7 ,additional information ,the form described in subparagraph 7,a7 and the accompanying tax instructions may provide the taxpayer with additional information about insurance affordability programs1 including information provided to applicants on the single1 streamlined application4 7,d7 ,accessibility 7i7 ,in general ,the ,secretary shall ensure that the form described in subparagraph 7,a7 is made available to all taxpayers without discrimination based on language1 disability1 literacy1 or internet access4 7ii7 ,rule of construction ,nothing in clause 7i7 shall be construed as diminishing1 reducing1 or otherwise limiting any other legal obligation for the ,secretary to avoid or to prevent discrimination4 7#d7 ,return language ,the ,secretary1 in consultation with the ,secretary of ,health and ,human ,services1 shall1 with respect to any items described in this subsection which are to be included in a taxpayer's return of tax1 develop language for such items which is as simple and clear as possible 7such as referring to insurance affordability programs as free or low-cost health insurance74 7c7 ,tax return preparers 7#a7 ,in general ,with respect to any information submitted in conjunction with a tax return solely for purposes of the program described in subsection 7a71 any tax return preparer involved in preparing the return containing such information shall not be obligated to assess the accuracy of such information as provided by the taxpayer4 7#b7 ,submission of information ,as part of the program described in subsection 7a71 the ,secretary shall establish methods to allow for the immediate transfer of any relevant return information to the applicable ,exchange and insurance affordability programs in order to increase the potential for immediate determinations of eligibility for and enrollment in insurance affordability programs and minimum essential coverage4 7d7 ,transfer of information through secure interface 7#a7 ,in general ,as part of the program established under subsection 7a71 the ,secretary shall develop a secure1 electronic interface allowing an exchange of relevant return information with the applicable ,exchange in a manner similar to the interface described in section #adac7;c77#a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhc7;c77#a774 ,upon receipt of such information1 the applicable ,exchange may convey such information to any other entity as needed to facilitate determination of eligibility for an insurance affordability program or enrollment into minimum essential coverage4 7#b7 ,transfer by ,treasury or tax preparers 7,a7 ,in general ,the interface described in paragraph 7#a7 shall allow1 for any taxpayer who has provided consent pursuant to subsection 7b77#a77;,b77i71 for relevant return information1 along with confirmation that the ,secretary has accepted the return filing as meeting applicable processing criteria1 to be transferred to an applicable ,exchange by-- 7i7 the ,secretary2 or 7ii7 pursuant to such requirements and standards as are established by the ,secretary 7in consultation with the ,secretary of ,health and ,human ,services7-- 7,i7 if the ,secretary is not able to transfer such information to the applicable ,exchange1 the taxpayer2 or 7,,ii7 the tax return preparer who prepared the return containing such information4 7,b7 ,transfer requirements ,as soon as is practicable after the filing of a return described in subsection 7a7 in which the taxpayer has provided consent pursuant to subsection 7b77#a77;,b77i71 the ,secretary shall provide for all relevant return information to be transferred to the applicable ,exchange4 7,c7 ,data security ,any transfer of relevant return information described in this subsection shall be conducted-- 7i7 pursuant to interagency agreements that ensure data security and maintain privacy in a manner that satisfies the requirements under section #aidb7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifw-#b7;b772 and 7ii7 in the case of any taxpayer filing their tax return electronically1 in a manner that maximizes the opportunity for such taxpayer1 as part of the process of filing such return1 to immediately-- 7,i7 obtain a determination with respect to the eligibility of any household member for any insurance affordability program2 and 7,,ii7 enroll in minimum essential coverage4 7e7 ,errors that affect eligibility for insurance affordability programs ,the ,secretary of ,health and ,human ,services1 in consultation with the ,secretary1 shall establish procedures for addressing instances in which an error in relevant return information that was transferred to an ,exchange under subsection 7d7 may have resulted in a determination that an individual is eligible for more or less assistance under an insurance affordability program than the assistance for which the individual would otherwise have been eligible without the error4 ,such procedures shall include procedures for-- 7#a7 the reporting of such error to the individual1 the ,secretary of ,health and ,human ,services1 and the applicable ,exchange and insurance affordability program1 regardless of whether such error was included in an amendment to the tax return2 and 7#b7 correcting1 as soon as practicable1 the individual's eligibility status for insurance affordability programs1 subject to1 in the case of reduced eligibility for assistance1 any right of notice and appeal under laws governing the applicable insurance affordability program1 including section #adaa7;f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjha7;f774 7f7 ,disclosure of return information for determining eligibility for insurance affordability programs and enrollment into minimum essential health coverage 7#a7 ,in general ,section #fajc7l7 of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following3 7#bc7 ,disclosure of return information for determining eligibility for insurance affordability programs and enrollment into minimum essential health coverage 7,a7 ,in general ,in the case of any taxpayer who has consented to the disclosure and transfer of any relevant return information with respect to any household member pursuant to section #c7;b7 of the ,easy ,enrollment in ,health ,care ,act1 the ,secretary shall disclose such information to the applicable ,exchange4 7,b7 ,restriction on disclosure ,return information disclosed under subparagraph 7,a7 may be-- 7i7 used by an ,exchange only for the purposes of1 and to the extent necessary in-- 7,i7 determining eligibility for an insurance affordability program1 or 7,,ii7 facilitating enrollment into minimum essential coverage1 and 7ii7 further disclosed by an ,exchange to any other person only for the purposes of1 and to the extent necessary1 to carry out subclauses 7,i7 and 7,,ii7 of clause 7i74 7,c7 ,definitions ,for purposes of this paragraph1 the terms relevant return information1 ,exchange1 insurance affordability program1 and minimum essential coverage have the same meanings given such terms under section #b of the ,easy ,enrollment in ,health ,care ,act4 4 7#b7 ,safeguards ,section #fajc7p77#d7 of the ,internal ,revenue ,code of #aihf is amended by inserting or any ,exchange described in subsection 7l77#bc71 after or any entity described in subsection 7l77#ba71 each place it appears4 7g7 ,applications for insurance affordability programs without reliance on federal income tax returns 7#a7 ,rule of construction ,nothing in this ,act shall be construed as requiring any individual1 as a condition of applying for an insurance affordability program1 to-- 7,a7 file a return of tax for any taxable year for which filing a return of tax would not otherwise be required for such taxable year2 or 7,b7 consent to disclosure of relevant return information under subsection 7b77#a77;,b77i74 7#b7 ,methods and procedures ,any agency administering an insurance affordability program shall implement methods and procedures1 as prescribed by the ,secretary of ,health and ,human ,services1 in consultation with the ,secretary1 through which1 in the case of an individual applying for an insurance affordability program without filing a return of tax or consenting to disclosure of relevant return information under subsection 7b77#a77;,b77i71 the program determines household income and family size for-- 7,a7 a calendar year described in section #aijb7;e77#ad77;,d77vii77,i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a71 as added by section #e7;a72 and 7,b7 an applicable taxable year1 as defined in section #cf;,b7c77#e7 of the ,internal ,revenue ,code of #aihf 7as added by section #e7;b774 7h7 ,secretary ,in this section1 the term ,secretary means the ,secretary of the ,treasury1 or the ,secretary's delegate4 #d4 ,exchange use of relevant return information 7a7 ,in general ,an ,exchange that receives relevant return information under section #c7;d7 with respect to a taxpayer who has provided consent under section #c7;b77#a77;,b7 shall-- 7#a7 minimize additional information 7if any7 that is required to be provided by such taxpayer for a household member to qualify for any insurance affordability program by1 whenever feasible1 qualifying such household member for such program based on-- 7,a7 relevant information provided on the tax return filed by the taxpayer1 including information on the supplemental form described in section #c7;b77#c72 and 7,b7 information from other reliable third-party data sources that is relevant to eligibility for such program but not available from the return1 including information obtained through data matching based on social security numbers1 other identifying information1 and other items obtained from such return2 7#b7 determine the eligibility of any household member for the ,,chip program and1 where eligibility is determined based on modified adjusted gross income1 the ,medicaid program1 as required under section #adac of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhc7 and section #aidc of the ,social ,security ,act 7#db ,u4,s4,c4 #acifw-#c71 subject to any right of notice and appeal under laws governing such programs1 including section #adaa7;f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjha7;f772 7#c7 to the extent that any additional information is necessary for determining the eligibility of any household member for an insurance affordability program1 obtain such information in the manner that-- 7,a7 imposes the lowest feasible procedural burden to the taxpayer1 including-- 7i7 in the case of a taxpayer filing their tax return electronically1 online collection of such information at or near the time of such filing2 and 7ii7 prior to a denial of eligibility or enrollment due to failure to provide such information1 attempting to contact the taxpayer multiple times using the preferred contact methods described in section #c7;b77#c77;,a77vi72 and 7,b7 provides the individual with all procedural protections that would otherwise be available in applying for such program1 including the reasonable opportunity period described in section #aacg7;d77#d77;,a7 of the ,social ,security ,act 7#db,u4,s4,c4 #acbj;b-#g7;d77#d77;,a772 and 7#d7 when an individual is found eligible for an insurance affordability program other than the ,medicaid program-- 7,a7 enable such individual1 through procedures prescribed by the ,secretary of ,health and ,human ,services1 to seek coverage under the ,medicaid program or ,,chip program by providing additional information demonstrating potential eligibility for such program1 with any resulting determination subject to rights of notice and appeal under laws governing insurance affordability programs1 including section #adaa7;f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjha7;f772 and 7,b7 provide such individual with notice of such procedures4 7b7 ,medicaid and ,,chip 7#a7 ,state options 7,a7 ,in general ,in a ,state for which the ,secretary of ,health and ,human ,services is determining eligibility for individuals who apply for insurance affordability programs at the ,exchange serving residents of the individual's ,state1 the ,secretary of ,health and ,human ,services shall present the ,state with not less than #c sets of options for verification procedures and business rules that the ,exchange serving residents of such ,state shall use in determining eligibility for the ,state ,medicaid program and ,,chip program with respect to individuals who are household members described in section #c7;b77#a77;,b74 ,notwithstanding any other provision of law1 the ,secretary of ,health and ,human ,services may present each ,state with the same #c sets of options1 provided that each set can be customized to reflect each ,state's decisions about optional eligibility categories and criteria for the ,medicaid program and ,,chip program4 7,b7 ,business rules ,the business rules described in subparagraph 7,a7 shall specify detailed eligibility determination rules and procedures for processing initial applications and renewals1 including-- 7i7 the ,secretary's use of data from ,state agencies and other sources described in subsection 7c77#c77;,a77ii7 of section #adac of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhc72 and 7ii7 the circumstances for administrative renewal of eligibility for the ,medicaid program and the ,,chip program1 based on data showing probable continued eligibility4 7,c7 ,default ,in the case of a ,state described in subparagraph 7,a7 that does not select an option from the set presented under such subparagraph within a timeframe specified by the ,secretary of ,health and ,human ,services1 the ,secretary of ,health and ,human ,services shall determine the option that the ,exchange shall use for such ,state for the purposes described in such subparagraph4 7,d7 ,rule of construction ,nothing in this paragraph shall be construed as requiring a ,state to provide benefits under title ,,xix or ,,xxi of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq41 #acig;aa et seq47 to a category of individuals1 or to set an income eligibility threshold for benefits under such titles at a certain level1 if the ,state is not otherwise required to do so under such titles4 7#b7 ,enrollment 7,a7 ,in general ,if the ,exchange in a ,state determines that an individual described in paragraph 7#a77;,a7 is eligible for benefits under the ,state ,medicaid program or ,,chip program1 the ,exchange shall send the relevant information about the individual to the ,state and1 if consent has been given under section #c7;b77#a77;,b7 to enrollment in a health plan or other form of minimum essential coverage with a zero net premium1 the ,state shall enroll such individual in the ,state ,medicaid program or ,,chip program 7as applicable7 as soon as practicable1 except as provided in subparagraphs 7,b7 and 7,d74 7,b7 ,exception ,a ,state shall not enroll an individual in coverage under the ,state ,medicaid program or ,,chip program without the affirmative consent of the individual if the individual would be required to pay a premium for such coverage4 7,c7 ,managed care ,if the ,state ,medicaid program or ,,chip program requires an individual enrolled under subparagraph 7,a7 to receive coverage through a managed care organization or entity1 the ,state shall use a procedure for assigning the individual to such an organization or entity 7including auto-assignment procedures7 that is commonly used in the ,state when an individual who is found eligible for such program does not affirmatively select a particular organization or entity4 7,d7 ,opt-out procedures ,notwithstanding subparagraph 7,a71 an individual described in such subparagraph shall be given one or more opportunities to opt out of coverage under a ,state ,medicaid program or ,,chip program1 using procedures prescribed by the ,secretary of ,health and ,human ,services4 7c7 ,advance premium tax credits for qualified health plans 7#a7 ,in general ,in the case where a taxpayer has filed their return of tax for a taxable year on or before the date specified under section #fjgb7;a7 of the ,internal ,revenue ,code of #aihf with respect to such year and has provided consent described in section #c7;b77#a77;,b77i71 if the ,exchange has determined that an applicable household member has not qualified for the ,medicaid program or the ,,chip program1 such ,exchange shall-- 7,a7 in addition to any such period that may otherwise be available1 provide a special enrollment period that begins on the date the taxpayer has provided such consent2 and 7,b7 determine-- 7i7 whether the taxpayer would1 pursuant to section #adab of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhb71 be eligible for advance payment of the premium assistance tax credit under section #cf;,b of the ,internal ,revenue ,code of #aihf if such household member of the taxpayer were enrolled in a qualified health plan2 and 7ii7 if the taxpayer has made the election described in section #c7;b77#a77;,b77ii71 whether such household member has one or more options to enroll in a qualified health plan with a zero net premium4 7#b7 ,enrollment in a qualified health plan with a zero net premium 7,a7 ,in general ,in the case that a household member described in paragraph 7#a7 has one or more options to enroll in a qualified health plan with a zero net premium1 and consent has been given under section #c7;b77#a77;,b7 for enrollment of such household member in a qualified health plan with a zero net premium-- 7i7 the ,exchange shall identify a set of options 7as described in subparagraph 7,b77 for qualified health plans offering a zero net premium2 and 7ii7 from such set1 select a qualified health plan as the default enrollment choice for the household member in accordance with subparagraph 7,c74 7,b7 ,option sets 7i7 ,in general ,in the case that multiple qualified health plans with a zero net premium are available with more than #a actuarial value1 the ,exchange shall limit the set of options under subparagraph 7,a77i7 to such qualified health plans with the highest available actuarial value4 7ii7 ,further restrictions ,in the case described in clause 7i71 the ,exchange may further limit the set of options under subparagraph 7,a77i71 among the qualified health plans that have the highest available actuarial value as described in clause 7i71 based on the generosity of such plans' coverage of services not subject to a deductible4 7iii7 ,definition of highest actuarial value ,for purposes of this subparagraph1 the term highest actuarial value means the highest actuarial value among-- 7,i7 the levels of coverage described in paragraph 7#a7 of section #acjb7;d7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjbb7;d771 without regard to allowable variance under paragraph 7#c7 of such section2 and 7,,ii7 as applicable1 the levels of coverage that result from the application of cost-sharing reductions under section #adjb of such ,act 7#db ,u4,s4,c4 #ahjga74 7,c7 ,selecting a default option ,the ,secretary of ,health and ,human ,services shall establish procedures that ,exchanges may use in selecting1 from the set of options described in subparagraph 7,b71 the default enrollment choice under subparagraph 7,a77ii74 ,such procedures shall include-- 7i7 ,state options for randomization among health insurance issuers2 and 7ii7 factors that may be used to weight such randomization4 7,d7 ,notification of default enrollment ,as soon as possible after an ,exchange has identified a default enrollment choice for an individual under subparagraph 7,a77ii71 the ,exchange shall provide the individual with notice of such selection4 ,the notice shall include-- 7i7 a description of coverage provided by the selected qualified health plan2 7ii7 encouragement to learn about all available qualified health plan options before the end of the special enrollment period under paragraph 7#a77;,a7 and to select a plan that best meets the needs of the individual and the individual's family2 7iii7 an explanation that1 if the individual does not select a qualified health plan by the end of such special enrollment period or opt out of default enrollment in accordance with the process described in clause 7iv71 the ,exchange will enroll the individual in such selected qualified health plan in accordance with subparagraph 7,e72 7iv7 an explanation of the opt-out process preceding implementation of default enrollment1 which shall meet standards prescribed by the ,secretary of ,health and ,human ,services2 and 7v7 information on options for assistance with enrollment and plan choice1 including publicly funded navigators and private brokers and agents approved by the ,exchange4 7,e7 ,default enrollment 7i7 ,in general ,subject to subparagraph 7,f71 an ,exchange shall enroll in a default enrollment choice any individual who-- 7,i7 is sent a notice under subparagraph 7,d72 and 7,,ii7 fails to select a different qualified health plan1 or opt out of default enrollment under this paragraph1 by the end of the special enrollment period described in paragraph 7#a77;,a74 7ii7 ,updated notice ,at the time of the default enrollment described in clause 7i71 the ,exchange shall send a notice to the individual explaining that default enrollment has occurred1 describing the plan into which the individual has been enrolled1 and explaining the reconsideration procedures described in subparagraph 7,f74 7,f7 ,reconsideration 7i7 ,in general ,not later than #cj days after receiving a notice under subparagraph 7,e77ii71 the individual receiving such notice may use a method provided by the ,exchange to indicate-- 7,i7 the individual's decision to disenroll from the qualified health plan selected under subparagraph 7,a77ii72 or 7,,ii7 in the case of a household member for whom the selected qualified health plan under such subparagraph is a high cost-sharing qualified health plan1 the individual's decision to enroll in a specified lower cost-sharing qualified health plan1 identified by the ,exchange1 that is offered by the same health insurance issuer that sponsors the qualified health plan that was selected under such subparagraph4 7ii7 ,definitions ,for purposes of this subparagraph3 7,i7 ,high cost-sharing qualified health plan ,the term high cost-sharing qualified health plan means-- 7aa7 in the case of a household member with a household income at or below #bjj percent of the poverty line1 a qualified health plan that is not at the silver level2 or 7bb7 in the case of a household member with a household income above #bjj percent of the poverty line1 a qualified health plan that is not at the gold or platinum level4 7,,ii7 ,specified lower cost-sharing qualified health plan ,the term specified lower cost-sharing qualified health plan means-- 7aa7 in the case of a household member with a household income at or below #bjj percent of the poverty line1 the lowest-premium qualified health plan offered by the health insurance issuer that is at the silver level2 or 7bb7 in the case of a household member with a household income above #bjj percent of the poverty line1 the lowest-premium qualified health plan offered by the health insurance issuer that is at the gold level4 #e4 ,modernizing eligibility criteria for insurance affordability programs 7a7 ,income eligibility determinations for ,medicaid and ,,chip 7#a7 ,in general ,section #aijb7;e77#ad77;,d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e77#ad77;,d77 is amended by adding at the end the following new clauses3 7vi7 ,,snap and ,,tanf eligibility findings 7,i7 ,in general ,subject to subclause 7,,iii71 a ,state shall provide that an individual for whom a finding has been made as described in clause 7,,ii7 shall meet applicable eligibility for assistance under the ,state plan or a waiver of the plan involving financial eligibility1 citizenship or satisfactory immigration status1 and ,state residence4 ,a ,state shall rely on such a finding both for the initial determination of eligibility for medical assistance under the plan or waiver and any subsequent redetermination of eligibility4 7,,ii7 ,findings described ,a finding described in this subclause is a determination made within a reasonable period 7as determined by the ,secretary7 by a ,state agency responsible for administering the ,temporary ,assistance for ,needy ,families program under part ,a of title ,,iv or the ,supplemental ,nutrition ,assistance ,program established under the ,food and ,nutrition ,act of #bjjh that an individual is eligible for benefits under such program4 7,,iii7 ,limitation ,a ,state shall be required to rely on the findings of the ,state agency responsible for administering the supplemental nutrition assistance program established under the ,food and ,nutrition ,act of #bjjh only in the case of-- 7aa7 an individual who is under #ai years of age2 or 7bb7 an individual who is described in subsection 7a77#aj77;,a77i77,,viii74 7,,iv7 ,state option ,a ,state may rely on the findings of the ,state agency responsible for administering the supplemental nutrition assistance program established under the ,food and ,nutrition ,act of #bjjh in the case of an individual not described in subclause 7,,iii74 7vii7 ,recent annual income establishing eligibility 7,i7 ,in general ,for purposes of determining the income eligibility for medical assistance of an individual whose eligibility is determined based on the application of modified adjusted gross income under subparagraph 7,a71 a ,state shall provide that an individual whose eligibility date occurs in ,january1 ,february1 ,march1 or ,april of a calendar year shall be financially eligible if the individual's modified adjusted gross income for the preceding calendar year satisfies the income eligibility requirement applicable to the individual4 7,,ii7 ,definition ,for purposes of this clause1 an eligibility date means-- 7aa7 in the case of an individual who is not receiving medical assistance when the individual applies for an insurance affordability program 7as defined in section #b of the ,easy ,enrollment in ,health ,care ,act71 whether such application takes place through section #c7;b7 of such ,act or otherwise1 the date on which such individual applies for such program2 and 7bb7 in the case of an individual who is receiving medical assistance and whose continued eligibility for such assistance is being redetermined1 the date on which the individual is determined to satisfy all eligibility requirements applicable to the individual other than income eligibility4 7,,iii7 ,rules of construction 7aa7 ,eligibility determinations during ,may through ,december ,nothing in subclause 7,i7 shall be construed as diminishing1 reducing1 or otherwise limiting the ,state's obligation to grant eligibility1 under circumstances other than those described in such subclause1 based on data that include income shown on an individual's tax return1 including the obligation under section #adac7;c77#c77;,a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhc7;c77#c77;,a774 7bb7 ,alternative grounds for eligibility ,nothing in subclause 7,i7 shall be construed as diminishing1 reducing1 or otherwise limiting grounds for eligibility other than those described in such subclause1 including eligibility based on income as of the point in time at which an application for medical assistance under the ,state plan or a waiver of the plan is processed4 7cc7 ,qualifying for additional assistance ,notwithstanding subclause 7,i71 a ,state shall use an individual's modified adjusted gross income as determined as of the point in time at which the individual's application for medical assistance is processed or1 in the case of redetermination of eligibility1 projected annual income1 to determine the individual's eligibility for medical assistance if using the individual's modified adjusted gross income1 as so determined1 would result in the individual being eligible for greater benefits under the ,state plan 7or a waiver of such plan7 or in the imposition of lower premiums or cost-sharing on the individual under the plan 7or waiver7 than if the individual's eligibility was determined using the modified adjusted gross income of the individual as shown on the individual's tax return for the preceding calendar year4 4 7#b7 ,conforming amendment ,section #aijb7;e77#ad77;,h77i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e77#ad77;,h77i77 is amended by inserting except as provided in subparagraph 7,d77vii77,i71 before the requirement4 7#c7 ,effective date ,the amendments made by this subsection shall take effect on ,january #a1 #bjbe4 7b7 ,improving the stability and predictability of ,exchange coverage 7#a7 ,internal ,revenue ,code of #aihf ,section #cf;,b of the ,internal ,revenue ,code of #aihf is amended-- 7,a7 in subsection 7b7-- 7i7 in paragraph 7#b77;,b77ii71 by striking taxable year and inserting applicable tax year1 and 7ii7 in paragraph 7#c7-- 7,i7 in subparagraph 7,a7-- 7aa7 in clause 7i71 by striking taxable year and inserting applicable taxable year1 and 7bb7 in clause 7ii77,i71 by inserting 7or1 in the case of applicable taxable years beginning in any calendar year after #bjbe7 after #bjad1 and 7,,ii7 in subparagraph 7,b7-- 7aa7 in clause 7ii77,i77aa71 by striking the taxable year each place it appears and inserting the applicable taxable year1 and 7bb7 in the flush matter at the end-- 7,,aa7 striking files a joint return and no credit is allowed and inserting filed a joint return during the applicable taxable year and no credit was allowed1 and 7,,bb7 striking unless a deduction is allowed under section #aea for the taxable year and inserting unless a deduction was allowed under section #aea for the applicable taxable year1 7,b7 in subsection 7c7-- 7i7 in paragraph 7#a7-- 7,i7 in subparagraphs 7,a7 and 7,c71 by striking taxable year each place it appears and inserting applicable taxable year1 and 7,,ii7 in subparagraph 7,d71 by striking is allowable and all that follows through the period and inserting was allowable to another taxpayer for the applicable taxable year41 7ii7 in paragraph 7#b77;,c71 by adding at the end the following3 7v7 ,time period 7,i7 ,in general ,except as provided under subclause 7,,ii71 eligibility for minimum essential coverage under this subparagraph shall be based on the individual's eligibility for employer-sponsored minimum essential coverage during the open enrollment period 7or during a special enrollment period for an individual who enrolls or who changes their qualified health plan during a special enrollment period71 as determined by the applicable ,exchange4 7,,ii7 ,exception ,an individual shall be considered eligible for minimum essential coverage under clause 7iii7 for a month for which such ,exchange has determined1 subject to rights of notice and appeal under laws governing the applicable insurance affordability program 7including section #adaa7;f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjha7;f7771 that the individual is covered by an eligible employer-sponsored plan4 1 and 7iii7 by adding at the end the following3 7#e7 ,applicable taxable year ,the term applicable taxable year means-- 7,a7 with respect to a coverage month that is ,january1 ,february1 ,march1 ,april1 or ,may1 the most recent taxable year that ended at least #ab months before ,january #a of the plan year1 and 7,b7 with respect to any coverage month not described in subparagraph 7,a71 the most recent taxable year that ended before ,january #a of the plan year4 7#f7 ,exchange ,the term ,exchange means an ,american ,health ,benefit ,exchange established under subtitle ,d of title ,i of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjba et seq474 7#g7 ,open enrollment period ,the term open enrollment period means an open enrollment period described in subsection 7c77#f77;,b7 of section #acaa of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca74 1 7,c7 in subsection 7d7-- 7i7 in paragraph 7#a7-- 7,i7 by striking is allowed and inserting was allowed1 and 7,,ii7 by inserting applicable before taxable year1 and 7ii7 in paragraph 7#c77;,b71 by inserting applicable before taxable year1 7,d7 in subsection 7e77#a7-- 7i7 by striking is allowed and inserting was allowed1 and 7ii7 by inserting applicable before taxable year1 and 7,e7 in subsection 7f77#b7-- 7i7 in subparagraph 7,a71 by striking ,if and inserting ,except as provided in subparagraphs 7,b7 and 7,c71 if1 and 7ii7 by inserting at the end the following3 7,c7 ,safe harbor 7i7 ,income and family size ,no increase under subparagraph 7,a7 shall be imposed if the advance payments do not exceed amounts that are consistent with income and family size1 either-- 7,i7 as shown on the return of tax for the applicable plan year1 provided such return was accepted by the ,secretary as meeting applicable processing criteria1 or 7,,ii7 as determined by the applicable ,exchange under subsection 7b77#d7 of section #adab of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhb74 7ii7 ,employer-sponsored minimum essential coverage ,no increase under subparagraph 7,a7 shall be imposed based on eligibility for minimum essential coverage under subsection 7c77#b77;,c7 if the applicable ,exchange-- 7,i7 determined1 under clause 7v77,i7 of such subsection1 that the individual was ineligible for employer-sponsored minimum essential coverage1 and 7,,ii7 did not determine1 under clause 7v77,,ii7 of such subsection1 that the individual was covered through employer-sponsored minimum essential coverage4 7iii7 ,exception ,clauses 7i7 and 7ii7 shall not apply to the extent that any determination described in such clauses was based on a false statement by the taxpayer which-- 7,i7 was intentional or grossly negligent1 and 7,,ii7 was-- 7aa7 made on a return of tax1 or 7bb7 provided or caused to be provided to an ,exchange by the taxpayer4 4 7#b7 ,patient ,protection and ,affordable ,care ,act ,section #adab7;b7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhb7;b77 is amended-- 7,a7 in paragraph 7#a77;,b71 by striking the most recent and all that follows through the period at the end and inserting the applicable taxable year1 as defined in section #cf;,b7c77#e7 of the ,internal ,revenue ,code of #aihf42 7,b7 in paragraph 7#b77;,b71 by striking second preceding taxable year and inserting applicable taxable year1 as defined in such section #cf;,b7c77#e72 and 7,c7 by adding at the end the following3 7#c7 ,change form ,if1 after the submission of an individual's application form1 the individual experiences changes in circumstances as described in paragraph 7#b71 the individual may1 by submitting a change form as prescribed by the ,secretary1 apply for an increased amount of advance payments of the premium tax credit under section #cf;,b of the ,internal ,revenue ,code of #aihf1 increased cost-sharing reductions under section #adjb1 increased assistance under the basic health program under section #acca1 and coverage through a ,state ,medicaid program or ,,chip program4 7#d7 ,eligibility for additional assistance 7,a7 ,in general ,the ,secretary1 in consultation with the ,secretary of the ,treasury1 shall establish a process through which-- 7i7 an ,exchange determines1 through data sources and procedures described in sections #adaa and #adac 7#db ,u4,s4,c4 #ahjha2 #db ,u4,s4,c4 #ahjhc71 whether each individual who has submitted a change form under paragraph 7#c7 has experienced substantial changes in circumstances that warrant additional assistance through an insurance affordability program1 as defined in section #b of the ,easy ,enrollment in ,health ,care ,act2 7ii7 in the case the ,exchange determines an individual has experienced substantial changes in circumstances as described in clause 7i71 the ,exchange conveys such determination to the ,secretary of the ,treasury under section #cf;,b7f7 of the ,internal ,revenue ,code of #aihf and to the administrator of an insurance affordability program for which the individual may qualify under that determination2 and 7iii7 in the case the ,exchange determines an individual has experienced substantial changes in circumstances described in clause 7i71 the individual may qualify without delay for additional advance premium tax credits under section #cf;,b of the ,internal ,revenue ,code of #aihf1 increased cost-sharing reductions under section #adjb1 additional basic health program assistance under section #acca1 or coverage through a ,state ,medicaid program or ,,chip program4 7,b7 ,rights to notice and appeal ,a determination made by an ,exchange under this paragraph shall be subject to any applicable rights of notice and appeal1 including such rights under section #adaa7;f74 4 7#c7 ,effective dates ,the amendments made by this subsection shall take effect on ,january #a1 #bjbf1 and continue in effect through ,december #ca1 #bjcb4 #f4 ,strengthening data infrastructure for eligibility for insurance affordability programs 7a7 ,insurance ,affordability ,program access to ,national ,directory of ,new ,hires ,section #dec7;i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #fec7;i77 is amended by adding at the end the following new paragraph3 7#e7 ,administration of insurance affordability programs 7,a7 ,in general ,the ,secretary shall provide access to insurance affordability programs 7as such term is defined in section #b of the ,easy ,enrollment in ,health ,care ,act7 to information in the ,national ,directory of ,new ,hires that involves-- 7i7 identity1 employer1 quarterly wages1 and unemployment compensation1 to the extent such information is potentially relevant to determining the eligibility or scope of coverage of an individual for benefits provided by such a program2 and 7ii7 new hires1 to the extent such information is potentially relevant to determining whether an individual is offered minimum essential coverage through a group health plan1 as defined in section #ejjj7;b77#a7 of the ,internal ,revenue ,code of #aihf4 7,b7 ,reimbursement of ,,hhs costs ,insurance affordability programs shall reimburse the ,secretary1 in accordance with subsection 7k77#c71 for the additional costs incurred by the ,secretary in furnishing information under this paragraph4 4 7b7 ,use of information from the ,national ,directory of ,new ,hires ,notwithstanding any other provision of law-- 7#a7 in determining an individual's eligibility for advance payment of premium tax credits under section #adab7;a77#c7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhb7;a77#c771 and cost-sharing reductions under section #adjb of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjga71 and a basic health program under section #acca of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjea71 an ,exchange may use information about identity1 employer1 quarterly wages1 and unemployment compensation in the ,national ,directory of ,new ,hires1 and information about new hires to determine whether an individual is offered minimum essential coverage through a group health plan1 as defined in section #ejjj7;b77#a7 of the ,internal ,revenue ,code of #aihf1 subject to notice and appeal rights for any resulting eligibility determination1 including the rights described in section #adaa7;f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjha7;f772 and 7#b7 ,medicaid programs and ,,chip programs may use information in the ,national ,directory of ,new ,hires about identity1 employer1 quarterly wages1 and unemployment compensation to determine eligibility and to implement third-party liability procedures or premium assistance programs otherwise permitted or mandated under ,federal law1 and use information about new hires to implement such procedures and policies1 subject to notice and appeal rights for any resulting determination1 including those available under title ,,xix or title ,,xxi of the ,social ,security ,act or under section #adaa7;f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjha7;f774 7c7 ,use of information about eligibility for or receipt of group health coverage ,notwithstanding any other provision of ,federal or ,state law3 7#a7 ,in general ,subject to the requirements described in paragraph 7#b71 for purposes of determining eligibility and1 in the case of a ,medicaid program1 for purposes of determining the applicability of third-party liability procedures or premium assistance policies otherwise permitted or mandated under ,federal law1 an insurance affordability program shall have access to any source of information1 maintained by or accessible to a public entity1 about receipt or offers of coverage through a group health plan4 ,such sources shall include-- 7,a7 information maintained by or accessible to the ,secretary of ,health and ,human ,services for purposes of implementing section #ahfb7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciey7b772 7,b7 information maintained by or accessible to a ,state ,medicaid program for purposes of implementing subsections 7a77#be7 or 7a77#fj7 of section #aijb of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a72 and 7,c7 information reported under sections #fjee and #fjef of the ,internal ,revenue ,code of #aihf4 7#b7 ,requirements ,an insurance affordability program shall obtain the information described in paragraph 7#a7 pursuant to an interagency or other agreement1 consistent with standards prescribed by the ,secretary of ,health and ,human ,services1 in consultation with the ,secretary1 that prevents the unauthorized use1 disclosure1 or modification of such information and otherwise protects privacy and data security4 7d7 ,authorization ,to receive relevant information 7#a7 ,in general ,notwithstanding any other provision of law1 a ,federal or ,state agency or private entity in possession of the sources of data potentially relevant to eligibility for an insurance affordability program is authorized to convey such data or information to the insurance affordability program1 and such program is authorized to receive the data or information and to use it in determining eligibility4 7#b7 ,application of requirements and penalties ,a conveyance of data to an insurance affordability program under this subsection shall be subject to the same requirements that apply to a conveyance of data to a ,state ,medicaid plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 under section #aidb of such ,act 7#db ,u4,s4,c4 #acifw-#b71 and the penalties that apply to a violation of such requirements1 including penalties that apply to a private entity making a conveyance4 7e7 ,electronic transmission of information ,in determining an individual's eligibility for an insurance affordability program1 the program shall-- 7#a7 with respect to verifying an element of eligibility that is based on information from an ,express ,lane ,agency 7as defined in section #aijb7;e77#ac77;,f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e77#ac77;,f7771 from another public agency1 or from another reliable source of relevant data1 waive any otherwise applicable requirement that the individual must verify such information1 provide an attestation as to the subject of such information1 or provide a signature for attestations that include that subject1 before the individual is enrolled into minimum essential coverage2 and 7#b7 satisfy any otherwise applicable signature requirement with respect to an individual's enrollment in an insurance affordability program through an electronic signature 7as defined in section #agaj7a7 of the ,government ,paperwork ,elimination ,act 7#dd ,u4,s4,c4 #cejd note774 7f7 ,rule of construction ,nothing in this section shall be construed as diminishing1 reducing1 or otherwise limiting the legal authority for an insurance affordability program to grant eligibility1 in whole or in part1 based on an attestation alone1 without requiring verification through data matches or other sources4 #g4 ,funding for information technology development and operations 7a7 ,in general ,out of amounts in the ,treasury not otherwise appropriated1 there are appropriated to the ,secretary of ,health and ,human ,services such sums as may be necessary to establish information exchange and processing infrastructure and operate all information exchange and processing procedures described in this ,act1 including for the costs of staff and contractors4 7b7 ,agencies receiving funding ,the ,secretary of ,health and ,human ,services may1 as necessary and in accordance with the procedures described in subsection 7c71 transfer amounts appropriated under subsection 7a7 to entities that include the following for the purposes described in such subsection3 7#a7 ,the ,secretary of the ,treasury1 including the ,internal ,revenue ,service4 7#b7 ,the ,office of ,child ,support ,enforcement of the ,department of ,health and ,human ,services4 7#c7 ,a ,state-administered insurance affordability program1 including a ,medicaid or ,,chip program and a ,state basic health program under section #acca of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjea74 7#d7 ,an entity operating an ,exchange4 7#e7 ,a third-party data source1 which may be a public or private entity4 7c7 ,procedures ,the ,secretary of ,health and ,human ,services1 in consultation with the ,secretary of the ,treasury1 shall establish procedures for the entities described in subsection 7b7 to request a transfer of funding from the amounts appropriated under subsection 7a71 including procedures for reviewing such requests1 modifying and approving such requests1 appealing decisions about transfers1 and auditing such transfers4 #h4 ,conforming statutory changes 7a7 ,state income and eligibility verification systems ,section #aacg of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#g7 is amended-- 7#a7 in subsection 7a77#a71 by inserting 7in the case of an individual who has consented to the disclosure and transfer of relevant return information that includes the individual's social security account number pursuant to section #c7;b77#a77;,b7 of the ,easy ,enrollment in ,health ,care ,act1 the ,state shall deem such individual to have satisfied the requirement to furnish such account number to the ,state under this paragraph7 before the semicolon2 and 7#b7 in subsection 7d7-- 7,a7 in paragraph 7#a77;,a71 by striking ,the ,state shall require and inserting ,subject to paragraph 7#f71 the ,state shall require2 and 7,b7 by adding at the end the following new paragraph3 7#f7 ,satisfaction of requirement through reliable data matches ,in the case of an individual applying for the program described in paragraph 7#b7 or the ,children's ,health ,insurance ,program under title ,,xxi of this ,act1 the program shall not require an individual to make the declaration described in paragraph 7#a77;,a7 if the procedures established pursuant to section #c7;a77#a7 of the ,easy ,enrollment in ,health ,care ,act or section #adac7;c77#b77;,b77ii77,,ii7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhc7;c77#b77;,b77ii77,,ii77 were used to verify the individual's citizenship1 based on the individual's social security number as well as other identifying information1 which may include such facts as name and date of birth1 that increases the accuracy of matches with applicable sources of citizenship data4 4 7b7 ,eligibility determinations under ,,ppaca ,section #adaa7;b7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjha7;b77 is amended-- 7#a7 in paragraph 7#c71 by striking subparagraph 7,a7 and inserting the following3 7,a7 ,information regarding income and family size ,the information described in paragraphs 7#ba7 and 7#bc7 of section #fajc7l7 of the ,internal ,revenue ,code of #aihf for the applicable taxable year1 as defined in section #cf;,b7c77#e7 of such ,code4 2 and 7#b7 by adding at the end the following3 7#f7 ,receipt of information ,the requirements for providing information under this subsection may be satisfied through data submitted to the ,exchange through reliable data matches1 rather than by the applicant providing information4 ,in the case described in paragraph 7#b77;,a71 data matches shall not be used for this purpose unless they meet the requirements described in section #aacg7;d77#f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#g7;d77#f774 4 #i4 ,advisory committee 7a7 ,in general ,the ,secretary of the ,treasury1 in conjunction with the ,secretary of ,health and ,human ,services1 shall establish an advisory committee to provide guidance to both ,secretaries in carrying out this ,act4 ,the members of the committee shall include-- 7#a7 national experts in behavioral economics1 other behavioral science1 insurance affordability programs1 enrollment and retention in health programs and other benefit programs1 public benefits for immigrants1 public benefits for other historically marginalized or disadvantaged communities1 and ,federal income tax policy and operations2 and 7#b7 representatives of all relevant stakeholders1 including-- 7,a7 consumers2 7,b7 health insurance issuers2 7,c7 health care providers2 and 7,d7 tax return preparers4 7b7 ,purview ,the advisory committee established under subsection 7a7 shall be solicited for advice on any topic chosen by the ,secretary of the ,treasury or the ,secretary of ,health and ,human ,services1 including 7at a minimum7 all matters as to which a provision in this ,act1 other than subsection 7a71 requires a consultation between the ,secretary of the ,treasury and the ,secretary of ,health and ,human ,services4 #aj4 ,study 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall conduct a study analyzing the impact of this ,act and making recommendations for-- 7#a7 ,state pilot projects to test improvements to this ,act1 including an analysis of policies that automatically enroll eligible individuals into group health plans2 7#b7 modifying open enrollment periods for ,exchanges and plan years so that open enrollment coincides with filing of ,federal income tax returns2 and 7#c7 other steps to improve outcomes achieved by this ,act4 7b7 ,report ,not later than ,july #a1 #bjbh1 the ,secretary of ,health and ,human ,services shall deliver a report on the study and recommendations under subsection 7a7 to the ,committee on ,ways and ,means1 the ,committee on ,education and the ,workforce1 and the ,committee on ,energy and ,commerce of the ,house of ,representatives and to the ,committee on ,finance and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate4 #aa4 ,appropriations ,out of amounts in the ,treasury not otherwise appropriated1 there are appropriated1 in addition to the amounts described in section #g and any amounts otherwise made available1 to carry out the purposes of this ,act1 such sums as may be necessary to the ,secretary of the ,treasury1 and such sums as may be necessary to the ,secretary of ,health and ,human ,services1 to remain available until expended4