SAVE Act

IB Union Calendar No. 27 116TH CONGRESS 1ST SESSION H. R. 1385 [Report No. 116–49] To amend the Patient Protection and Affordable Care Act to preserve the option of States to implement health care marketplaces, and for other purposes. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 27, 2019 Mr. KIM (for himself and Mr. FITZPATRICK) introduced the following bill; which was referred to the Committee on Energy and Commerce MAY 3, 2019 Additional sponsors: Ms. SCHAKOWSKY, Mrs. WATSON COLEMAN, Ms. BLUNT ROCHESTER, Mr. PALLONE, Mr. RUSH, Mrs. DINGELL, Mr. RUIZ, Ms. ESHOO, Mr. KENNEDY, Ms. MATSUI, Mr. VAN DREW, Ms. CLARKE of New York, Ms. HOULAHAN, Ms. SCANLON, Ms. MCCOLLUM, and Ms. MUCARSEL-POWELL MAY 3, 2019 Reported with an amendment, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed [Strike out all after the enacting clause and insert the part printed in italic] [For text of introduced bill, see copy of bill as introduced on February 27, 2019] VerDate Sep 11 2014 20:32 May 03, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H1385.RH H1385 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 1385 RH A BILL To amend the Patient Protection and Affordable Care Act to preserve the option of States to implement health care marketplaces, and for other purposes. VerDate Sep 11 2014 20:32 May 03, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6652 E:\BILLS\H1385.RH H1385 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 1385 RH 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 a 4 Variety of Exchanges Act’’ or the ‘‘SAVE Act’’. 5 SEC. 2. PRESERVING STATE OPTION TO IMPLEMENT 6 HEALTH CARE MARKETPLACES. 7 (a) IN GENERAL.—Section 1311 of the Patient Protec- 8 tion and Affordable Care Act (42 U.S.C. 18031) is amend- 9 ed— 10 (1) in subsection (a)— 11 (A) in paragraph (4)(B), by striking 12 ‘‘under this subsection’’ and inserting ‘‘under 13 this paragraph or paragraph (1)’’; and 14 (B) by adding at the end the following new 15 paragraph: 16 ‘‘(6) ADDITIONAL PLANNING AND ESTABLISH- 17 MENT GRANTS.— 18 ‘‘(A) IN GENERAL.—There shall be appro- 19 priated to the Secretary, out of any moneys in 20 the Treasury not otherwise appropriated, 21 $200,000,000 to award grants to eligible States 22 for the uses described in paragraph (3). 23 ‘‘(B) DURATION AND RENEWABILITY.—A 24 grant awarded under subparagraph (A) shall be 25 VerDate Sep 11 2014 20:32 May 03, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6203 E:\BILLS\H1385.RH H1385 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 1385 RH for a period of two years and may not be re- 1 newed. 2 ‘‘(C) LIMITATION.—A grant may not be 3 awarded under subparagraph (A) after December 4 31, 2022. 5 ‘‘(D) ELIGIBLE STATE DEFINED.—For pur- 6 poses of this paragraph, the term ‘eligible State’ 7 means a State that, as of the date of the enact- 8 ment of this paragraph, is not operating an Ex- 9 change (other than an Exchange described in sec- 10 tion 155.200(f) of title 45, Code of Federal Regu- 11 lations).’’; and 12 (2) in subsection (d)(5)(A)— 13 (A) by striking ‘‘OPERATIONS.—In estab- 14 lishing an Exchange under this section’’ and in- 15 serting ‘‘OPERATIONS.— 16 ‘‘(i) IN GENERAL.—In establishing an 17 Exchange under this section (other than in 18 establishing an Exchange pursuant to a 19 grant awarded under subsection (a)(6))’’; 20 and 21 (B) by adding at the end the following: 22 ‘‘(ii) ADDITIONAL PLANNING AND ES- 23 TABLISHMENT GRANTS.—In establishing an 24 Exchange pursuant to a grant awarded 25 VerDate Sep 11 2014 20:32 May 03, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6203 E:\BILLS\H1385.RH H1385 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 1385 RH under subsection (a)(6), the State shall en- 1 sure that such Exchange is self-sustaining 2 beginning on January 1, 2024, including 3 allowing the Exchange to charge assessments 4 or user fees to participating health insur- 5 ance issuers, or to otherwise generate fund- 6 ing, to support its operations.’’. 7 (b) CLARIFICATION REGARDING FAILURE TO ESTAB- 8 LISH EXCHANGE OR IMPLEMENT REQUIREMENTS.—Section 9 1321(c) of the Patient Protection and Affordable Care Act 10 (42 U.S.C. 18041(c)) is amended— 11 (1) in paragraph (1), by striking ‘‘If’’ and in- 12 serting ‘‘Subject to paragraph (3), if’’; and 13 (2) by adding at the end the following new para- 14 graph: 15 ‘‘(3) CLARIFICATION.—This subsection shall not 16 apply in the case of a State that elects to apply the 17 requirements described in subsection (a) and satisfies 18 the requirement described in subsection (b) on or after 19 January 1, 2014.’’. 20 VerDate Sep 11 2014 20:32 May 03, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6203 E:\BILLS\H1385.RH H1385 pamtmann on DSKBFK8HB2PROD with BILLS Union Calendar No. 27 116TH CONGRESS 1ST SESSION H. R. 1385 [Report No. 116–49] A BILL To amend the Patient Protection and Affordable Care Act to preserve the option of States to im- plement health care marketplaces, and for other purposes. MAY 3, 2019 Reported with an amendment, committed to the Com- mittee of the Whole House on the State of the Union, and ordered to be printed VerDate Sep 11 2014 20:32 May 03, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6651 Sfmt 6651 E:\BILLS\H1385.RH H1385 pamtmann on DSKBFK8HB2PROD with BILLS