Marketplace Certainty Act

II 116TH CONGRESS 1ST SESSION S. 964 To amend the Patient Protection and Affordable Care Act to improve cost- sharing subsidies. IN THE SENATE OF THE UNITED STATES APRIL 1, 2019 Mrs. SHAHEEN (for herself, Ms. STABENOW, Mr. CASEY, Mr. REED, Mr. BLUMENTHAL, Ms. HASSAN, Ms. KLOBUCHAR, Mr. TESTER, Mr. KAINE, Mr. KING, Ms. HARRIS, Mr. WHITEHOUSE, Ms. BALDWIN, Ms. HIRONO, and Mr. MURPHY) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Patient Protection and Affordable Care Act to improve cost-sharing subsidies. 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 ‘‘Marketplace Certainty 4 Act’’. 5 SEC. 2. ENHANCEMENTS FOR REDUCED COST-SHARING. 6 (a) MODIFICATION OF AMOUNT.— 7 VerDate Sep 11 2014 01:02 Apr 06, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S964.IS S964 kjohnson on DSK79L0C42 with BILLS 2 •S 964 IS (1) IN GENERAL.—Section 1402(c)(2) of the 1 Patient Protection and Affordable Care Act is 2 amended to read as follows: 3 ‘‘(2) ADDITIONAL REDUCTION.—The Secretary 4 shall establish procedures under which the issuer of 5 a qualified health plan to which this section applies 6 shall further reduce cost-sharing under the plan in 7 a manner sufficient to— 8 ‘‘(A) in the case of an eligible insured 9 whose household income is not less than 100 10 percent but not more than 200 percent of the 11 poverty line for a family of the size involved, in- 12 crease the plan’s share of the total allowed 13 costs of benefits provided under the plan to 95 14 percent of such costs; 15 ‘‘(B) in the case of an eligible insured 16 whose household income is more than 200 per- 17 cent but not more than 300 percent of the pov- 18 erty line for a family of the size involved, in- 19 crease the plan’s share of the total allowed 20 costs of benefits provided under the plan to 90 21 percent of such costs; and 22 ‘‘(C) in the case of an eligible insured 23 whose household income is more than 300 per- 24 cent but not more than 400 percent of the pov- 25 VerDate Sep 11 2014 01:02 Apr 06, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S964.IS S964 kjohnson on DSK79L0C42 with BILLS 3 •S 964 IS erty line for a family of the size involved, in- 1 crease the plan’s share of the total allowed 2 costs of benefits provided under the plan to 85 3 percent of such costs.’’. 4 (2) CONFORMING AMENDMENT.—Clause (i) of 5 section 1402(c)(1)(B) of such Act is amended to 6 read as follows: 7 ‘‘(i) IN GENERAL.—The Secretary 8 shall ensure the reduction under this para- 9 graph shall not result in an increase in the 10 plan’s share of the total allowed costs of 11 benefits provided under the plan above— 12 ‘‘(I) 95 percent in the case of an 13 eligible insured described in para- 14 graph (2)(A); 15 ‘‘(II) 90 percent in the case of an 16 eligible insured described in para- 17 graph (2)(B); and 18 ‘‘(III) 85 percent in the case of 19 an eligible insured described in para- 20 graph (2)(C).’’. 21 (3) EFFECTIVE DATE.—The amendments made 22 by this subsection shall apply to plan years begin- 23 ning after December 31, 2019. 24 VerDate Sep 11 2014 01:02 Apr 06, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S964.IS S964 kjohnson on DSK79L0C42 with BILLS 4 •S 964 IS (b) FUNDING.—Section 1402 of the Patient Protec- 1 tion and Affordable Care Act is amended by adding at 2 the end the following new subsection: 3 ‘‘(g) FUNDING.—Out of any funds in the Treasury 4 not otherwise appropriated, there are appropriated to the 5 Secretary such sums as may be necessary for payments 6 under this section.’’. 7 Æ VerDate Sep 11 2014 01:02 Apr 06, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\S964.IS S964 kjohnson on DSK79L0C42 with BILLS