SAVE Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 1896 To amend title I of the Patient Protection and Affordable Care Act to provide for additional grants for States to conduct activities related to establishing American Health Benefit Exchanges. IN THE HOUSE OF REPRESENTATIVES MARCH 16, 2021 Mr. KIM of New Jersey (for himself and Mr. FITZPATRICK) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title I of the Patient Protection and Affordable Care Act to provide for additional grants for States to conduct activities related to establishing American Health Benefit Exchanges. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘State Allowance for 4 a Variety of Exchanges Act of 2021’’ or the ‘‘SAVE Act 5 of 2021’’. 6 VerDate Sep 11 2014 22:16 May 15, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1896.IH H1896 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 1896 IH SEC. 2. PRESERVING STATE OPTION TO IMPLEMENT 1 HEALTH CARE MARKETPLACES. 2 (a) IN GENERAL.—Section 1311 of the Patient Pro- 3 tection and Affordable Care Act (42 U.S.C. 18031) is 4 amended— 5 (1) in subsection (a)— 6 (A) in paragraph (4)(B), by striking 7 ‘‘under this subsection’’ and inserting ‘‘under 8 this paragraph or paragraph (1)’’; and 9 (B) by adding at the end the following new 10 paragraph: 11 ‘‘(6) ADDITIONAL PLANNING AND ESTABLISH- 12 MENT GRANTS.— 13 ‘‘(A) IN GENERAL.—There shall be appro- 14 priated to the Secretary, out of any moneys in 15 the Treasury not otherwise appropriated, $200 16 million to award grants to eligible States for 17 the uses described in paragraph (3). 18 ‘‘(B) DURATION AND RENEWABILITY.—A 19 grant awarded under subparagraph (A) shall be 20 for a period of 2 years and may not be renewed. 21 ‘‘(C) LIMITATION.—A grant may not be 22 awarded under subparagraph (A) after Decem- 23 ber 31, 2024. 24 ‘‘(D) ELIGIBLE STATE DEFINED.—For 25 purposes of this paragraph, the term ‘eligible 26 VerDate Sep 11 2014 22:16 May 15, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1896.IH H1896 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 1896 IH State’ means a State that, as of January 1, 1 2019, was not operating an Exchange (other 2 than an Exchange described in section 3 155.200(f) of title 45, Code of Federal Regula- 4 tions).’’; and 5 (2) in subsection (d)(5)(A)— 6 (A) by striking ‘‘OPERATIONS.—In estab- 7 lishing an Exchange under this section’’ and in- 8 serting ‘‘OPERATIONS.— 9 ‘‘(i) IN GENERAL.—In establishing an 10 Exchange under this section (other than in 11 establishing an Exchange with respect to 12 which a grant is awarded under subsection 13 (a)(6))’’; and 14 (B) by adding at the end the following: 15 ‘‘(ii) ADDITIONAL PLANNING AND ES- 16 TABLISHMENT GRANTS.—In establishing 17 an Exchange with respect to which a grant 18 is awarded under subsection (a)(6), the 19 State shall ensure that such Exchange is 20 self-sustaining beginning on January 1, 21 2026, including allowing the Exchange to 22 charge assessments or user fees to partici- 23 pating health insurance issuers, or to oth- 24 VerDate Sep 11 2014 22:16 May 15, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1896.IH H1896 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 1896 IH erwise generate funding, to support its op- 1 erations.’’. 2 (b) CLARIFICATION REGARDING FAILURE TO ESTAB- 3 LISH EXCHANGE OR IMPLEMENT REQUIREMENTS.—Sec- 4 tion 1321(c) of the Patient Protection and Affordable 5 Care Act (42 U.S.C. 18041(c)) is amended— 6 (1) in paragraph (1), by striking ‘‘If’’ and in- 7 serting ‘‘Subject to paragraph (3), if’’; and 8 (2) by adding at the end the following new 9 paragraph: 10 ‘‘(3) CLARIFICATION.—This subsection shall 11 not apply in the case of a State that elects to apply 12 the requirements described in subsection (a) and 13 satisfies the requirement described in subsection (b) 14 on or after January 1, 2014.’’. 15 Æ VerDate Sep 11 2014 22:16 May 15, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\H1896.IH H1896 pbinns on DSKJLVW7X2PROD with BILLS