SAVE Act

II 116TH CONGRESS 1ST SESSION S. 1400 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 SENATE OF THE UNITED STATES MAY 9, 2019 Mr. MENENDEZ (for himself, Mr. CASEY, and Mr. BOOKER) 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 preserve the option of States to implement health care marketplaces, and for other purposes. 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’’ or the ‘‘SAVE Act’’. 5 VerDate Sep 11 2014 04:19 May 17, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1400.IS S1400 kjohnson on DSK79L0C42 with BILLS 2 •S 1400 IS 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, 16 $200,000,000 to award grants to eligible States 17 for 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, 2022. 24 ‘‘(D) ELIGIBLE STATE DEFINED.—For 25 purposes of this paragraph, the term ‘eligible 26 VerDate Sep 11 2014 04:19 May 17, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1400.IS S1400 kjohnson on DSK79L0C42 with BILLS 3 •S 1400 IS State’ means a State that, as of the date of the 1 enactment of this paragraph, is not operating 2 an Exchange.’’; and 3 (2) in subsection (d)(5)(A)— 4 (A) by striking ‘‘In establishing an Ex- 5 change under this section’’ and inserting the 6 following: 7 ‘‘(i) IN GENERAL.—In establishing an 8 Exchange under this section (other than in 9 establishing an Exchange pursuant to sub- 10 section (a)(6))’’; and 11 (B) by adding at the end the following: 12 ‘‘(ii) ADDITIONAL PLANNING AND ES- 13 TABLISHMENT GRANTS.—In establishing 14 an Exchange pursuant to subsection 15 (a)(6), the State shall ensure that such 16 Exchange is self-sustaining beginning on 17 January 1, 2024, including allowing the 18 Exchange to charge assessments or user 19 fees to participating health insurance 20 issuers, or to otherwise generate funding, 21 to support its operations.’’. 22 (b) CLARIFICATION REGARDING FAILURE TO ESTAB- 23 LISH EXCHANGE OR IMPLEMENT REQUIREMENTS.—Sec- 24 VerDate Sep 11 2014 04:19 May 17, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1400.IS S1400 kjohnson on DSK79L0C42 with BILLS 4 •S 1400 IS tion 1321(c) of the Patient Protection and Affordable 1 Care Act (42 U.S.C. 18041(c)) is amended— 2 (1) in paragraph (1), by striking ‘‘If’’ and in- 3 serting ‘‘Subject to paragraph (3), if’’; and 4 (2) by adding at the end the following new 5 paragraph: 6 ‘‘(3) CLARIFICATION.—This subsection shall 7 not apply in the case of a State that elects to apply 8 the requirements described in subsection (a) and 9 satisfies the requirement described in subsection (b) 10 on or after January 1, 2014.’’. 11 Æ VerDate Sep 11 2014 04:19 May 17, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\S1400.IS S1400 kjohnson on DSK79L0C42 with BILLS