ENROLL Act of 2019

II 116TH CONGRESS 1ST SESSION S. 1905 To amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes. IN THE SENATE OF THE UNITED STATES JUNE 19, 2019 Ms. BALDWIN (for herself, Mr. CASEY, Mrs. SHAHEEN, Mr. BOOKER, Mr. KAINE, Ms. STABENOW, Ms. HIRONO, Ms. DUCKWORTH, Mr. MERKLEY, Mr. VAN HOLLEN, Ms. HASSAN, Mr. KING, Mr. COONS, Mr. MENENDEZ, Mr. PETERS, Mr. TESTER, Ms. HARRIS, Ms. SMITH, Mr. MURPHY, Ms. ROSEN, Mr. BLUMENTHAL, and Ms. KLOBUCHAR) introduced the fol- lowing 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 provide for additional requirements with respect to the navigator program, 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 ‘‘Expand Navigators’ 4 Resources for Outreach, Learning, and Longevity Act of 5 2019’’ or the ‘‘ENROLL Act of 2019’’. 6 VerDate Sep 11 2014 00:25 Jun 25, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1905.IS S1905 SSpencer on DSKBBXCHB2PROD with BILLS 2 •S 1905 IS SEC. 2. PROVIDING FOR ADDITIONAL REQUIREMENTS 1 WITH RESPECT TO THE NAVIGATOR PRO- 2 GRAM. 3 (a) IN GENERAL.—Section 1311(i) of the Patient 4 Protection and Affordable Care Act (42 U.S.C. 18031(i)) 5 is amended— 6 (1) in paragraph (2), by adding at the end the 7 following new subparagraph: 8 ‘‘(C) SELECTION OF RECIPIENTS.—In the 9 case of an Exchange established and operated 10 by the Secretary within a State pursuant to sec- 11 tion 1321(c), in awarding grants under para- 12 graph (1), the Exchange shall— 13 ‘‘(i) select entities to receive such 14 grants based on an entity’s demonstrated 15 capacity to carry out each of the duties 16 specified in paragraph (3); 17 ‘‘(ii) not take into account whether or 18 not the entity has demonstrated how the 19 entity will provide information to individ- 20 uals relating to group health plans offered 21 by a group or association of employers de- 22 scribed in section 2510.3–5(b) of title 29, 23 Code of Federal Regulations (or any suc- 24 cessor regulation), or short-term limited 25 duration insurance (as defined by the Sec- 26 VerDate Sep 11 2014 00:19 Jun 25, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1905.IS S1905 SSpencer on DSKBBXCHB2PROD with BILLS 3 •S 1905 IS retary for purposes of section 2791(b)(5) 1 of the Public Health Service Act); and 2 ‘‘(iii) ensure that, each year, the Ex- 3 change awards such a grant to— 4 ‘‘(I) at least one entity described 5 in this paragraph that is a community 6 and consumer-focused nonprofit 7 group; and 8 ‘‘(II) at least one entity described 9 in subparagraph (B), which may in- 10 clude another community and con- 11 sumer-focused nonprofit group in ad- 12 dition to any such group awarded a 13 grant pursuant to subclause (I). 14 In awarding such grants, an Exchange 15 may consider an entity’s record with re- 16 spect to waste, fraud, and abuse for pur- 17 poses of maintaining the integrity of such 18 Exchange.’’; 19 (2) in paragraph (3)— 20 (A) in subparagraph (C), by inserting after 21 ‘‘qualified health plans’’ the following: ‘‘ , State 22 medicaid plans under title XIX of the Social 23 Security Act, and State children’s health insur- 24 VerDate Sep 11 2014 23:17 Jun 24, 2019 Jkt 034408 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1905.IS S1905 SSpencer on DSKBBXCHB2PROD with BILLS 4 •S 1905 IS ance programs under title XXI of such Act’’; 1 and 2 (B) by adding at the end the following 3 flush left sentence: 4 ‘‘The duties specified in the preceding sentence may 5 be carried out by such a navigator at any time dur- 6 ing a year.’’; 7 (3) in paragraph (4)(A)— 8 (A) in the matter preceding clause (i), by 9 striking ‘‘not’’; 10 (B) in clause (i)— 11 (i) by inserting ‘‘not’’ before ‘‘be’’; 12 and 13 (ii) by striking ‘‘; or’’ and inserting a 14 semicolon; 15 (C) in clause (ii)— 16 (i) by inserting ‘‘not’’ before ‘‘re- 17 ceive’’; and 18 (ii) by striking the period and insert- 19 ing a semicolon; and 20 (D) by adding at the end the following new 21 clause: 22 ‘‘(iii) maintain physical presence in 23 the State of the Exchange so as to allow 24 in-person assistance to consumers.’’; and 25 VerDate Sep 11 2014 23:17 Jun 24, 2019 Jkt 034408 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1905.IS S1905 SSpencer on DSKBBXCHB2PROD with BILLS 5 •S 1905 IS (4) in paragraph (6)— 1 (A) by striking ‘‘FUNDING.—Grants 2 under’’ and inserting ‘‘FUNDING.— 3 ‘‘(A) STATE EXCHANGES.—Grants under’’; 4 and 5 (B) by adding at the end the following new 6 subparagraph: 7 ‘‘(B) FEDERAL EXCHANGES.—For pur- 8 poses of carrying out this subsection, with re- 9 spect to an Exchange established and operated 10 by the Secretary within a State pursuant to sec- 11 tion 1321(c), the Secretary shall obligate 12 $100,000,000 out of amounts collected through 13 the user fees on participating health insurance 14 issuers pursuant to section 156.50 of title 45, 15 Code of Federal Regulations (or any successor 16 regulations) for fiscal year 2020 and each sub- 17 sequent fiscal year. Such amount for a fiscal 18 year shall remain available until expended.’’. 19 (b) EFFECTIVE DATE.—The amendments made by 20 subsection (a) shall apply with respect to plan years begin- 21 ning on or after January 1, 2020. 22 Æ VerDate Sep 11 2014 23:17 Jun 24, 2019 Jkt 034408 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S1905.IS S1905 SSpencer on DSKBBXCHB2PROD with BILLS