This bill modifies the requirements for the premium assistance tax credit and allows all individuals to purchase catastrophic health plans in the individual market.
(Under current law, the premium assistance tax credit is provided to eligible individuals and families to subsidize the purchase of health insurance plans on an exchange established under the Patient Protection and Affordable Care Act.) The bill modifies the credit to:
The bill also modifies the requirements for minimum essential health benefits to allow all individuals purchasing health insurance in the individual market to purchase a lower premium catastrophic plan. (The plans are currently limited to individuals who are under 30 or qualify for a hardship or affordability exemption.)
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6311 Introduced in House (IH)]
<DOC>
115th CONGRESS
2d Session
H. R. 6311
To amend the Internal Revenue Code of 1986 and the Patient Protection
and Affordable Care Act to modify the definition of qualified health
plan for purposes of the health insurance premium tax credit and to
allow individuals purchasing health insurance in the individual market
to purchase a lower premium copper plan.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 6, 2018
Mr. Roskam (for himself and Mr. Burgess) introduced the following bill;
which was referred to the Committee on Energy and Commerce, and in
addition to the Committee on Ways and Means, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend the Internal Revenue Code of 1986 and the Patient Protection
and Affordable Care Act to modify the definition of qualified health
plan for purposes of the health insurance premium tax credit and to
allow individuals purchasing health insurance in the individual market
to purchase a lower premium copper plan.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. MODIFICATION OF DEFINITION OF QUALIFIED HEALTH PLAN.
(a) In General.--Section 36B(c)(3)(A) of the Internal Revenue Code
of 1986 is amended--
(1) by inserting ``(determined without regard to
subparagraphs (A), (C)(ii), and (C)(iv) of paragraph (1)
thereof and without regard to whether the plan is offered on an
Exchange)'' after ``1301(a) of the Patient Protection and
Affordable Care Act'', and
(2) by striking ``shall not include'' and all that follows
and inserting ``shall not include any health plan that--
``(i) is a grandfathered health plan or a
grandmothered health plan, or
``(ii) includes coverage for abortions
(other than any abortion necessary to save the
life of the mother or any abortion with respect
to a pregnancy that is the result of an act of
rape or incest).''.
(b) Definition of Grandmothered Health Plan.--Section 36B(c)(3) of
such Code is amended by adding at the end the following new
subparagraph:
``(C) Grandmothered health plan.--
``(i) In general.--The term `grandmothered
health plan' means health insurance coverage
which is offered in the individual health
insurance market as of October 1, 2013, and is
permitted to be offered in such market after
January 1, 2014, as a result of CCIIO guidance.
``(ii) CCIIO guidance defined.--The term
`CCIIO guidance' means the letter issued by the
Centers for Medicare & Medicaid Services on
November 14, 2013, to the State Insurance
Commissioners outlining a transitional policy
for non-grandfathered coverage in the
individual health insurance market, as
subsequently extended and modified (including
by a communication entitled `Insurance
Standards Bulletin Series--INFORMATION--
Extension of Transitional Policy through 2019'
issued on April 9, 2018, by the Director of the
Center for Consumer Information and Insurance
Oversight of such Centers).
``(iii) Individual health insurance
market.--The term `individual health insurance
market' means the market for health insurance
coverage (as defined in section 9832(b))
offered to individuals other than in connection
with a group health plan (within the meaning of
section 5000(b)(1)).''.
(c) Conforming Amendment Related to Abortion Coverage.--Section
36B(c)(3) of such Code, as amended by paragraph (2), is amended by
adding at the end the following new subparagraph:
``(D) Certain rules related to abortion.--
``(i) Option to purchase separate coverage
or plan.--Nothing in subparagraph (A) shall be
construed as prohibiting any individual from
purchasing separate coverage for abortions
described in such subparagraph, or a health
plan that includes such abortions, so long as
no credit is allowed under this section with
respect to the premiums for such coverage or
plan.
``(ii) Option to offer coverage or plan.--
Nothing in subparagraph (A) shall restrict any
health insurance issuer offering a health plan
from offering separate coverage for abortions
described in such subparagraph, or a plan that
includes such abortions, so long as premiums
for such separate coverage or plan are not paid
for with any amount attributable to the credit
allowed under this section (or the amount of
any advance payment of the credit under section
1412 of the Patient Protection and Affordable
Care Act).
``(iii) Other treatments.--The treatment of
any infection, injury, disease, or disorder
that has been caused by or exacerbated by the
performance of an abortion shall not be treated
as an abortion for purposes of subparagraph
(A).''.
(d) Conforming Amendments Related to Off-Exchange Coverage.--
(1) Advance payment not applicable.--Section 1412 of the
Patient Protection and Affordable Care Act is amended by adding
at the end the following new subsection:
``(f) Exclusion of Off-Exchange Coverage.--Advance payments under
this section, and advance determinations under section 1411, with
respect to any credit allowed under section 36B shall not be made with
respect to any health plan which is not enrolled in through an
Exchange.''.
(2) Reporting.--Section 6055(b) of the Internal Revenue
Code of 1986 is amended by adding at the end the following new
paragraph:
``(3) Information relating to off-exchange premium credit
eligible coverage.--If minimum essential coverage provided to
an individual under subsection (a) consists of a qualified
health plan (as defined in section 36B(c)(3)) which is not
enrolled in through an Exchange established under title I of
the Patient Protection and Affordable Care Act, a return
described in this subsection shall include--
``(A) a statement that such plan is a qualified
health plan (as defined in section 36B(c)(3)),
``(B) the premiums paid with respect to such
coverage,
``(C) the months during which such coverage is
provided to the individual,
``(D) the adjusted monthly premium for the
applicable second lowest cost silver plan (as defined
in section 36B(b)(3)) for each such month with respect
to such individual, and
``(E) such other information as the Secretary may
prescribe.''.
(3) Other conforming amendments.--
(A) Section 36B(b)(2)(A) of such Code is amended by
striking ``and which were enrolled'' and all that
follows and inserting ``, or''.
(B) Section 36B(b)(3)(B)(i) of such Code is amended
by striking ``the same Exchange'' and all that follows
and inserting ``the Exchange through which such
taxpayer is permitted to obtain coverage, and''.
(C) Section 36B(c)(2)(A)(i) of such Code is amended
by striking ``that was enrolled in through an Exchange
established by the State under section 1311 of the
Patient Protection and Affordable Care Act''.
(e) Effective Date.--
(1) In general.--Except as otherwise provided in this
subsection, the amendments made by this subsection shall apply
to taxable years beginning after December 31, 2018.
(2) Advance payment not applicable to off-exchange
coverage.--The amendment made by subsection (d)(1) shall take
effect on January 1, 2019.
(3) Reporting.--The amendment made by subsection (d)(2)
shall apply to coverage provided for months beginning after
December 31, 2018.
SEC. 2. ALLOWING ALL INDIVIDUALS PURCHASING HEALTH INSURANCE IN THE
INDIVIDUAL MARKET THE OPTION TO PURCHASE A LOWER PREMIUM
COPPER PLAN.
(a) In General.--Section 1302(e) of the Patient Protection and
Affordable Care Act (42 U.S.C. 18022(e)) is amended--
(1) in paragraph (1)--
(A) by redesignating clauses (i) and (ii) of
subparagraph (B) as subparagraphs (A) and (B),
respectively, and adjusting the margins accordingly;
(B) by striking ``plan year if--'' and all that
follows through ``the plan provides--'' and inserting
``plan year if the plan provides--''; and
(C) in subparagraph (A), as redesignated by
paragraph (1), by striking ``clause (ii)'' and
inserting ``subparagraph (B)'';
(2) by striking paragraph (2); and
(3) by redesignating paragraph (3) as paragraph (2).
(b) Risk Pools.--Section 1312(c)(1) of the Patient Protection and
Affordable Care Act (42 U.S.C. 18032(c)(1)) is amended by inserting
``and enrollees in catastrophic plans described in section 1302(e)''
after ``Exchange''.
(c) Conforming Amendment.--Section 1312(d)(3)(C) of the Patient
Protection and Affordable Care Act (42 U.S.C. 18032(d)(3)(C)) is
amended by striking ``, except that in the case of a catastrophic plan
described in section 1302(e), a qualified individual may enroll in the
plan only if the individual is eligible to enroll in the plan under
section 1302(e)(2)''.
(d) Effective Date.--The amendments made by this section shall
apply to plan years beginning after December 31, 2018.
<all>
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Committee Consideration and Mark-up Session Held.
Ordered to be Reported (Amended) by the Yeas and Nays: 23 - 16.
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-849, Part I.
Reported (Amended) by the Committee on Ways and Means. H. Rept. 115-849, Part I.
Rules Committee Resolution H. Res. 1011 Reported to House. Rule provides for consideration of H.R. 184 and H.R. 6311. Rule provides for consideration of H.R. 184 and H.R. 6311 both under closed rules. The rule provides for one motion to recommit with or without instructions on each measure.
Rule H. Res. 1011 passed House.
Considered under the provisions of rule H. Res. 1011. (consideration: CR H7658-7667)
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Rule provides for consideration of H.R. 184 and H.R. 6311. Rule provides for consideration of H.R. 184 and H.R. 6311 both under closed rules. The rule provides for one motion to recommit with or without instructions on each measure.
DEBATE - The House proceeded with one hour of debate on H.R. 6311.
The previous question was ordered pursuant to the rule.
Ms. Frankel (FL) moved to recommit with instructions to the Committee on Ways and Means.
DEBATE - The House proceeded with 10 minutes of debate on the Frankel (FL) motion to recommit with instructions. The instructions contained in the motion seek to require the bill to be reported back to the House with an amendment stating no amendment made by this Act shall take effect until the annual reports of the Board of the Trustees of the Federal Hospital Insurance Trust Fund established under section 1817 of the Social Security Act and the Federal Supplementary Medical Insurance Trust Fund indicate the reduction of solvency of such trust funds by reason of Public Law 115-97 have been reversed.
The previous question on the motion to recommit with instructions was ordered without objection.
On motion to recommit with instructions Failed by the Yeas and Nays: 187 - 229 (Roll no. 375).
Roll Call #375 (House)Passed/agreed to in House: On passage Passed by recorded vote: 242 - 176 (Roll no. 376).(text: CR H7658-7659)
Roll Call #376 (House)On passage Passed by recorded vote: 242 - 176 (Roll no. 376). (text: CR H7658-7659)
Roll Call #376 (House)Motion to reconsider laid on the table Agreed to without objection.
Received in the Senate.