Amends the Patient Protection and Affordable Care Act to eliminate the funding mechanism for the three-year transitional reinsurance program, under which group health plans are required to pay a fee to reinsurance entities for plan years beginning January 1, 2014. (The fees are distributed to individual health plans that cover high-risk individuals.) Authorizes appropriations for such reinsurance program instead.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3489 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 3489
To amend section 1341 of the Patient Protection and Affordable Care Act
to repeal the funding mechanism for the transitional reinsurance
program in the individual market, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 14, 2013
Mr. Tiberi (for himself, Mr. Lipinski, Mr. Boustany, Mr. Schock, Mr.
Brady of Texas, Ms. Jenkins, Mr. Sam Johnson of Texas, Mr. Reichert,
Mr. Griffin of Arkansas, Mr. McIntyre, Mr. Turner, Mrs. Black, and Mr.
Murphy of Florida) introduced the following bill; which was referred to
the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend section 1341 of the Patient Protection and Affordable Care Act
to repeal the funding mechanism for the transitional reinsurance
program in the individual market, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. FINDINGS; PURPOSE.
(a) Findings.--Congress makes the following findings:
(1) According to the most recent United States Census,
employer-based health insurance is the largest source of health
insurance coverage in the United States. Of those employed, 70
percent receive employment-based health insurance. Of
unemployed Americans, 30 percent receive employer-sponsored
health insurance.
(2) Despite the large percentages of coverage, as health
care costs climb, the percentage of Americans who receive
health insurance through employers has fallen significantly
over the last decade--from 70 percent nationwide in 2000 to 60
percent in 2011, according to a report by the Robert Wood
Johnson Foundation.
(3) According to recent surveys done by the National
Business Group on Health and the Kaiser Family Foundation, most
companies continue to provide health insurance for employees
and wish to continue doing so into the future.
(4) Employers who offer insurance will not contribute
additional risk to the health insurance exchanges established
in the Patient Protection and Affordable Care Act (in this Act
referred to as ``PPACA'').
(5) The transitional reinsurance program, established in
section 1341 of PPACA, is intended to stabilize risk in the
individual health insurance market during the first three years
of the health insurance exchanges, as established by that Act.
(6) PPACA also requires that the Treasury collect a fee for
each employer-sponsored covered life in order to pay for the
transitional reinsurance program.
(7) This fee is a disincentive for employers to continue
offering coverage to all employees, and does not give employers
any benefits of the transitional reinsurance program.
(b) Purpose.--It is the purpose of this Act to remove the current
funding mechanism for the transitional reinsurance program. Employer-
sponsored insurance should be supported so that Americans can sustain
quality health coverage.
SEC. 2. CHANGES IN FUNDING FOR TRANSITIONAL REINSURANCE PROGRAM IN THE
INDIVIDUAL MARKET.
(a) In General.--Section 1341(b) of the Patient Protection and
Affordable Care Act (Public Law 111-148; 42 U.S.C. 18061(b)) is
amended--
(1) in paragraph (1), by striking ``under which--'' and all
that follows and inserting the following: ``under which the
applicable reinsurance entity uses amounts appropriated under
paragraph (2)(B) to make reinsurance payments to health
insurance issuers that cover high risk individuals in the
individual market (excluding grandfathered health plans) for
any plan year beginning in the 3-year period beginning January
1, 2014.'';
(2) in paragraph (2)(B), by striking ``Payment amount'' and
all that follows through the end of the first sentence and
inserting the following: ``Authorization of appropriations;
payment formula.--There are hereby authorized to be
appropriated, based on the best estimates of the NAIC,
$10,000,000,000 for plan years beginning in 2014,
$6,000,000,000 for plan years beginning in 2015, and
$4,000,000,000 for plan years beginning in 2016 to make
reinsurance payments to health insurance issuers described in
paragraph (1) that insure high-risk individuals consistent with
paragraph (3).''; and
(3) by striking paragraphs (3) and (4) and inserting the
following:
``(3) Extension of fund availability and treatment of
unexpended amounts.--
``(A) Extension of fund availability.--The amounts
appropriated for a plan year under paragraph (2)(B)
shall be allocated among States and used in any of the
plan years referred to in such paragraph based on the
reinsurance needs of the States and periods involved,
as determined by the Secretary.
``(B) Treatment of unexpended amounts.--Amounts
appropriated under paragraph (2)(B) that remain
unexpended as of December 31, 2016, and that are
otherwise allocated to a State may be used to make
payments under any reinsurance program of the State in
the individual market in effect in the 2-year period
beginning on January 1, 2017.''.
(b) Effective Date.--The amendments made by subsection (a) shall
take effect as if included in the enactment of section 1341 of Public
Law 111-148.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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