,,ii #aaith ,,congress #ast ,session ,s4 #ccfh ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #d1 #bjbe,ms4 ,blunt ,rochester 7for herself1 ,mr4 ,wyden1 ,mr4 ,booker1 ,mr4 ,merkley1 and ,ms4 ,smith7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to improve patient protections and affordability under the ,patient ,protection and ,affordable ,care ,act1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,restoring ,patient ,protections and ,affordability ,act of #bjbe4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,,title ,i--,consumer protections,sec4 #aja4 ,extension of temporary enhanced premium credits4,sec4 #ajb4 ,extending annual open enrollment period for plan year #bjbf4,sec4 #ajc4 ,restoring navigator program4,sec4 #ajd4 ,repeal of disallowance of premium tax credit in case of certain coverage enrolled in during special enrollment period4,,title ,,ii--,health plan accountability,sec4 #bja4 ,minimum notice requirements for plan year #bjbe enrollees4,sec4 #bjb4 ,minimum notice requirements for plan year #bjbf enrollees4,sec4 #bjc4 ,health insurance issuer reporting requirements4,sec4 #bjd4 ,enforcement4,,title ,,iii--,eliminating red tape,sec4 #cja4 ,applying commercial market policy to reenrollment process4,sec4 #cjb4 ,protection against bureaucratic coverage denials4,sec4 #cjc4 ,automatic enrollment from bronze to silver level qualified health plans offered on ,exchanges4,,title ,,iv--,market stabilization,sec4 #dja4 ,restoring marketplace flexibility4,sec4 #djb4 ,no health plan gouging4,sec4 #djc4 ,protecting continuity of coverage4,sec4 #djd4 ,protecting enrollees from surprise premium bills4,sec4 #dje4 ,no ,,aca and employer coverage premium spikes4 ,i ,consumer protections #aja4 ,extension of temporary enhanced premium credits 7a7 ,in general ,clause 7iii7 of section #cf;,b7b77#c77;,a7 of the ,internal ,revenue ,code of #aihf is amended-- 7#a7 by striking ,january #a1 #bjbf and inserting ,january #a1 #bjbi1 and 7#b7 by striking #bjbe in the heading and inserting #bjbh4 7b7 ,taxpayers whose household income exceeds #djj percent of the poverty line ,section #cf;,b7c77#a77;,e7 of the ,internal ,revenue ,code of #aihf is amended-- 7#a7 by striking ,january #a1 #bjbf and inserting ,january #a1 #bjbi1 and 7#b7 by striking #bjbe in the heading and inserting #bjbh4 7c7 ,effective date ,the amendments made by this section shall apply to taxable years beginning after ,december #ca1 #bjbe4 #ajb4 ,extending annual open enrollment period for plan year #bjbf ,with respect to plan year #bjbf1 the annual open enrollment period required to be provided by ,exchanges under section #acaa7;c77#f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca7;c77#f77 shall extend through ,may #a1 #bjbf4 #ajc4 ,restoring navigator program 7a7 ,funding ,section #acaa7;i77#f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca7;i77#f77 is amended-- 7#a7 by striking ,grants under and inserting the following3 7,a7 ,state ,exchanges ,in the case of an ,exchange established and operated by a ,state pursuant to subsection 7b71 grants under 2 and 7#b7 by adding at the end the following3 7,b7 ,federal ,exchanges ,for purposes of carrying out this subsection with respect to an ,exchange established and operated by the ,secretary pursuant to section #acba7;c71 the ,secretary shall obligate #ajj1jjj1jjj out of amounts collected through the user fees on participating health insurance issuers pursuant to section #aef4ej of title #de1 ,code of ,federal ,regulations 7or any successor regulations7 for fiscal year #bjbf4 ,such amount so obligated for a fiscal year shall remain available until expended4 4 7b7 ,standards ,section #acaa7;i77#d77;,a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca7;i77#d77;,a77 is amended-- 7#a7 in clause 7i71 by striking or at the end2 7#b7 in clause 7ii71 by striking the period and inserting a semicolon2 and 7#c7 by adding at the end the following3 7iii7 charge any fees to applicants or enrollees2 or 7iv7 request any form of remuneration from or on behalf of any applicant or enrollee4 4 #ajd4 ,repeal of disallowance of premium tax credit in case of certain coverage enrolled in during special enrollment period 7a7 ,in general ,section #cf;,b7c77#c77;,a7 of the ,internal ,revenue ,code of #aihf1 as amended by ,public ,law #aai-ba1 is amended by striking clause 7iii74 7b7 ,effective date ,the amendment made by this section shall apply with respect to plan years beginning after ,december #ca1 #bjbe4 ,,ii ,health plan accountability #bja4 ,minimum notice requirements for plan year #bjbe enrollees ,the ,secretary of ,health and ,human ,services shall require each health insurance issuer that offered a qualified health plan through a ,federal or ,state ,exchange for plan year #bjbe to notify1 not later than #ae days after the date of enactment of this ,act1 all individuals enrolled in such plan for any month during plan year #bjbe of-- 7#a7 changes to eligibility for premium assistance credits1 and to the premium assistance credit amounts1 under section #cf;,b of the ,internal ,revenue ,code of #aihf that first take effect with respect to plan year #bjbf2 7#b7 the extended open enrollment period for plan year #bjbf pursuant to section #aja2 and 7#c7 any additional information relating to such eligibility and enrollment1 as the ,secretary determines appropriate1 including the website and phone number for the applicable ,federal or ,state ,exchange4 #bjb4 ,minimum notice requirements for plan year #bjbf enrollees 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall require each health insurance issuer that offers a qualified health plan through a ,federal or ,state ,exchange for plan year #bjbf to notify all individuals enrolled in such plan for plan year #bjbf of-- 7#a7 changes to eligibility for premium assistance credits1 and to the premium assistance credit amounts1 under section #cf;,b of the ,internal ,revenue ,code of #aihf that first take effect with respect to plan year #bjbf2 7#b7 the extended open enrollment period for plan year #bjbf pursuant to section #aja2 and 7#c7 any additional information relating to such eligibility and enrollment1 as the ,secretary determines appropriate1 including the website and phone number for the applicable ,federal or ,state ,exchange4 7b7 ,timing ,the notification by a health insurance issuer under subsection 7a7 shall be made-- 7#a7 not later than #ae days after the date of enactment of this ,act1 with respect to individuals enrolled in such plan as of the date of enactment of this ,act2 and 7#b7 not later than #ae days after an individual's enrollment1 with respect to individuals enrolling1 after such date of enactment1 in the plan during the open enrollment period for plan year #bjbf4 #bjc4 ,health insurance issuer reporting requirements 7a7 ,report from issuer ,not later than #ij days after the date of enactment of this ,act1 each health insurance issuer that is subject to the reporting requirements under sections #bja and #bjb shall submit to the ,secretary of ,health and ,human ,services a report attesting to compliance with the requirements under sections #bja and #bjb4 7b7 ,consolidated report to ,congress ,not later than #abj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall submit to the ,committee on ,finance and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,ways and ,means1 the ,committee on ,energy and ,commerce1 and the ,committee on ,education and ,workforce of the ,house of ,representatives a report that consolidates the reports submitted by issuers under subsection 7a74 #bjd4 ,enforcement 7a7 ,in general ,consistent with the process set forth in subsections 7d7 and 7e7 of section #aef4hje of title #de1 ,code of ,federal ,regulations 7or successor regulations71 the ,secretary of ,health and ,human ,services may impose a civil monetary penalty upon any health insurance issuer who fails to comply with the notification requirements under section #bja or #bjb or the reporting requirements under section #bjc4 7b7 ,penalty amounts 7#a7 ,violations regarding notice to enrollees ,in the case of a violation of section #bja or #bjb1 such penalty shall be in the amount equal to #a1jjj for each individual enrolled in a plan for plan year #bjbe or #bjbf who did not receive a notice as required under section #bja or #bjb1 as applicable1 for each day between the date on which such notice was due and the date on which the notice is provided4 7#b7 ,reporting violations ,in the case of a violation of section #bjc1 such penalty shall be in the amount of #a1jjj per day for each individual enrolled in health insurance coverage with respect to which the report is required1 for each day between the date on which the report under section #cjb was due and the date on which the report is submitted4 ,,iii ,eliminating red tape #cja4 ,applying commercial market policy to reenrollment process 7a7 ,in general ,section #cf;,b7c77#e77;,a7 of the ,internal ,revenue ,code of #aihf1 as added by ,public ,law #aai-ba1 is amended by striking 1 using applicable enrollment information that shall be provided or verified by the applicant14 7b7 ,effective date ,the amendment made by this section shall apply to taxable years beginning after ,december #ca1 #bjbg4 #cjb4 ,protection against bureaucratic coverage denials 7a7 ,in general ,section #acaa7;c77#f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca7;c77#f77 is amended-- 7#a7 in subparagraph 7,c71 by striking 2 and and inserting a semicolon2 and 7#b7 by adding at the end the following3 7,e7 special enrollment periods for any individual denied the advance payment for which the individual applies for one or more months pending the verification prescribed by section #cf;,b7c77#e77;,a7 of the ,internal ,revenue ,code of #aihf1 to permit enrollment of any such individual following such verification2 and 4 7b7 ,effective date ,the amendment made by this section shall apply with respect to plan years beginning on or after ,january #a1 #bjbh4 #cjc4 ,automatic enrollment from bronze to silver level qualified health plans offered on ,exchanges ,the ,secretary of ,health and ,human ,services shall revise section #aee4cce7;j7 of title #de1 ,code of ,federal ,regulations 7or any successor regulation7 to ensure that1 with respect to reenrollments for plan years beginning on or after ,january #a1 #bjbf1 a ,federal or ,state ,exchange established under subtitle ,d of title ,i of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjba et seq47 may reenroll an individual who was enrolled in a bronze level qualified health plan in a silver level qualified health plan 7as such terms are defined in section #acja7;a7 and described in #acjb7;d7 of such ,act 7#db ,u4,s4,c4 #ahjba7;a72 #ahjbb7;d7774 ,,iv ,market stabilization #dja4 ,restoring marketplace flexibility 7a7 ,in general ,section #acaa7;c77#f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca7;c77#f771 as amended by section #cjb7;a71 is further amended by adding at the end the following3 7,f7 a special enrollment period once per month for any individual who is eligible for the advance payment of premium tax credits under section #adab and whose household income is not expected to exceed #aej percent of the poverty line for a family of the size involved4 4 7b7 ,effective date ,the amendment made by subsection 7a7 shall apply with respect to plan years beginning on or after ,january #a1 #bjbf4 #djb4 ,no health plan gouging ,the ,secretary of ,health and ,human ,services shall-- 7#a7 revise section #aef4adj7;c7 of title #de1 ,code of ,federal ,regulations 7or a successor regulation71 to provide that1 for plan years beginning on or after ,january #a1 #bjbf1 the allowable variation in the actuarial value of a health plan applicable under such section shall be the allowable variation for such plan applicable under such section for plan year #bjbe2 and 7#b7 revise section #aef4djj of title #de1 ,code of ,federal ,regulations 7or a successor regulation71 to provide that1 for plan years beginning on or after ,january #a1 #bjbf1 the term de minimis variation for a silver plan variation means a minus #j percentage point and plus #b percentage point allowable actuarial value variation4 #djc4 ,protecting continuity of coverage 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall revise section #aee4cje7;f77#d7 of title #de1 ,code of ,federal ,regulations 7or a successor regulation7 to provide that an ,exchange may determine an enrollee ineligible for an advance premium tax credit under section #cf;,b of the ,internal ,revenue ,code of #aihf as described in such section #aee4cje7;f77#d7 only after a taxpayer 7or a taxpayer's spouse1 if married7 has failed to file a ,federal income tax return and reconcile their past advance premium tax credit for #b consecutive years for which tax data will be utilized for verification of household income and family size4 7b7 ,effective date ,the requirement described in subsection 7a7 shall apply with respect to plan years beginning on or after ,january #a1 #bjbf4 #djd4 ,protecting enrollees from surprise premium bills 7a7 ,in general ,section #cf;,b7f77#b7 of the ,internal ,revenue ,code of #aihf1 as amended by ,public ,law #aai-ba1 is amended-- 7#a7 by striking ,if the advanced payments and inserting the following3 7,a7 ,in general ,if the advanced payments 1 and 7#b7 by adding at the end the following new subparagraph3 7,b7 ,limitation on increase 7i7 ,in general ,in the case of a taxpayer whose household income is less than #djj percent of the poverty line for the size of the family involved for the taxable year1 the amount of the increase under subparagraph 7,a7 shall in no event exceed the applicable dollar amount determined in accordance with the following table 7one-half of such amount in the case of a taxpayer whose tax is determined under section #a7;c7 for the taxable year73 ,if the household income 7expressed as a percentage of the poverty line7 is3,the applicable dollar amount is3,less than #bjjfjj;,at least #bjj but less than #cjja1ejj;,at least #cjj but less than #djjb1ejj4 7ii7 ,indexing of amount ,in the case of any calendar year beginning after #bjad1 each of the dollar amounts in the table contained under clause 7i7 shall be increased by an amount equal to-- 7,i7 such dollar amount1 multiplied by 7,,ii7 the cost-of-living adjustment determined under section #a7;f77#c7 for the calendar year1 determined by substituting calendar year #bjac for calendar year #bjaf in subparagraph 7,a77ii7 thereof4 ,if the amount of any increase under clause 7i7 is not a multiple of #ej1 such increase shall be rounded to the next lowest multiple of #ej4 4 7b7 ,conforming amendment ,section #ce7;g77#ab77;,b77ii7 of such ,code is amended by striking the amount determined under clause 7i7 shall be substituted for the amount determined under section #cf;,b7f77#b7 and inserting then section #cf;,b7f77#b77;,b7 shall be applied by substituting the amount determined under clause 7i7 for the amount determined under section #cf7;f77#b77;,a74 7c7 ,effective date ,the amendment made by this section shall apply to taxable years beginning after ,december #ca1 #bjbe4 #dje4 ,no ,,aca and employer coverage premium spikes ,section #acjb7;c77#d7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjbb7;c77#d77 is amended by adding at the end the following3 ,for calendar year #bjbf and each subsequent calendar year1 the lower bound of the allowable premium adjustment percentage for purposes of paragraph 7#a77;,b77i7 is the lower bound of the premium adjustment percentage that applied under this paragraph for plan year #bjbb using ,national ,health ,expenditure ,accounts projections of average per enrollee employer-sponsored insurance premiums44