Streamlining Verification for Americans Act - Requires the Secretary of the Treasury to allow large employers to prospectively report information regarding health care coverage available to employees eligible for premium subsidies on a health care exchange.
Amends the Patient Protection and Affordable Care Act to require the Secretary of Health and Human Services (HHS), upon an individual's request, to make an advance determination of the individual's eligibility for premium subsidies based on information other than the individual's most recent taxable year income.
Requires the Government Accountability Office (GAO) to evaluate the notification of employers by health care exchanges regarding employees determined to be eligible for premium subsidies and the appeals process for eligibility determinations.
Amends the Internal Revenue Code of 1986 to allow a person reporting an individual's health coverage to the Treasury to identify the individual using their birth date in place of their taxpayer identification number (TIN) in certain circumstances.
Allows large employers or persons reporting an employee's or individual's health coverage to the Treasury to provide the required statement to the employee or individual electronically.
Prohibits provision of premium subsidies and assessment of the penalty for not maintaining minimum essential coverage between December 31, 2014, and the date a process is established to verify eligibility for premium subsidies.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5557 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 5557
To reform the verification and reporting processes for the health care
premium and cost-sharing subsidies.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 18, 2014
Mrs. Black introduced the following bill; which was referred to the
Committee on Ways and Means, and in addition to the Committee on Energy
and Commerce, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To reform the verification and reporting processes for the health care
premium and cost-sharing subsidies.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Streamlining Verification for
Americans Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Employer reporting requirements under the Patient
Protection and Affordable Care Act (Public Law 111-148) should
strike the appropriate balance between sufficient reporting to
enforce the law and protecting the privacy of individuals.
(2) Protection of the privacy of the primary insured
individual and each other individual covered under the policy,
which should include minimizing the transmittal of social
security numbers, should be a priority when implementing
reporting requirements.
SEC. 3. IMPROVING THE ACCURACY OF EXCHANGE DETERMINATIONS OF
ELIGIBILITY FOR PREMIUM ASSISTANCE TAX CREDITS.
(a) In General.--If an employer provides prospective reporting for
any calendar year under subsection (b), such employer shall be treated
as making the return described in section 6056(b) of the Internal
Revenue Code of 1986 for such year if such return contains, consistent
with the requirements of subsection (c)(2), only information with
respect to employees with respect to whom the employer has received a
notification under section 1411(e)(4)(B)(iii) of the Patient Protection
and Affordable Care Act (42 U.S.C. 18081(e)(4)(B)(iii)). If the
preceding sentence applies to any employer for any calendar year, such
employer shall be treated as furnishing the statements required under
section 6056(c) of such Code, if the employer furnishes such statements
to such employees with respect to the information included in the
return made under the preceding sentence.
(b) Prospective Reporting.--Not later than 60 days after the date
of the enactment of this Act, the Secretary of the Treasury, in
consultation with the Secretary of Health and Human Services, the
Secretary of Labor, and the Administrator of the Small Business
Administration, shall implement a reporting system under which an
employer may elect to provide the following information with respect to
a calendar year before the beginning of such year:
(1) The name, date, and employer identification number of
the employer.
(2) A certification as to whether the employer offers to
its full-time employees the opportunity to enroll in minimum
essential coverage under an eligible employer-sponsored plan
(as defined in section 5000A(f)(2) of the Internal Revenue Code
of 1986) and whether the employer offers the spouses of such
full-time employees the opportunity to enroll in such coverage.
(3) The months during the year for which coverage is
generally available to full-time employees.
(4) A certification as to whether the coverage described in
paragraph (2) satisfies the requirements to qualify for one of
the affordability safe harbors promulgated by the Secretary of
the Treasury for purposes of section 4980H of the Internal
Revenue Code of 1986.
(5) A certification as to whether an employee's effective
date of coverage is generally affected by a waiting period.
(c) Requirements.--The reporting system established under
subsection (b) shall provide for--
(1) the processes necessary to ensure that Exchanges can
access the information described in subsection (b) to assist in
verifying eligibility determinations for advance payment of the
premium tax credits under section 36B of the Internal Revenue
Code of 1986 and the cost-sharing subsidies under section 1402
of the Patient Protection and Affordable Care Act (42 U.S.C.
18071); and
(2) guidance on how employers who voluntarily report in
advance under this section could satisfy the report and
statement requirements under subsections (b) and (c) of section
6056 of the Internal Revenue Code of 1986 by reporting only
with respect to employees with respect to whom the employer has
received a notification under section 1411(e)(4)(B)(iii) of the
Patient Protection and Affordable Care Act (42 U.S.C.
18081(e)(4)(B)(iii)).
SEC. 4. USE OF CURRENT YEAR INFORMATION IN DETERMINING SUBSIDY
ELIGIBILITY OF APPLICANTS .
(a) In General.--Section 1412(b)(2) of the Patient Protection and
Affordable Care Act (42 U.S.C. 18082(b)(2)) is amended to read as
follows:
``(2) Changes in circumstances.--The Secretary shall
provide procedures for making advance determinations on the
basis of information other than that described in paragraph
(1)(B) upon the request of the individual. Such procedures
shall include allowing an individual to have eligibility
determined on the basis of household income for a later period
or on the basis of the individual's estimate of such income for
the taxable year.''.
(b) Conforming Amendment.--Section 1411(b)(3)(B) of the Patient
Protection and Affordable Care Act (42 U.S.C. 18081(b)(3)(B)) is
amended to read as follows:
``(B) Changes in circumstance.--In the case of an
individual with respect to whom section 1412(b)(2)
applies, the information described in such section.''.
SEC. 5. EVALUATING THE DEVELOPMENT AND UTILIZATION OF SYSTEMS FOR
EXCHANGES TO NOTIFY EMPLOYERS OF POTENTIAL EXCISE TAX
LIABILITY UNDER THE EMPLOYER MANDATE.
Not later than 90 days after the date of the enactment of this Act,
the Comptroller General of the United States shall conduct a study
evaluating, with respect to the period beginning on October 1, 2013,
and ending on the date of the enactment of this Act--
(1) the notification of employers by Exchanges established
under title I of the Patient Protection and Affordable Care Act
that a full-time employee has been determined eligible for an
advanced premium assistance tax credit, as required by
subsection (e)(4)(B)(iii) of section 1411 of such Act (42
U.S.C. 18081); and
(2) the extent to which the Secretary of Health and Human
Services has established a separate appeals process for
employers who have been notified that an employee has been
determined eligible for an advanced premium assistance tax
credit to challenge that eligibility determination, as required
by subsection (f)(2) of such section.
SEC. 6. PROTECTING DEPENDENT PRIVACY.
(a) In General.--Paragraph (1) of section 6055(b) of the Internal
Revenue Code of 1986 is amended by adding at the end the following
flush sentence:
``For purposes of subparagraph (B)(i), in the case of an
individual other than the primary insured, if the person
required to make the return does not collect or maintain
information on the TINs of such individuals (other than for
purposes of this section), the individual's name and date of
birth may be substituted for the individual's name and TIN.''.
(b) Effective Date.--The amendment made by this section shall apply
to returns the due date for which is after December 31, 2013.
SEC. 7. ELECTRONIC STATEMENTS.
(a) Statements From Employers.--Subsection (c) of section 6056 of
the Internal Revenue Code of 1986 is amended by adding at the end the
following new paragraph:
``(3) Electronic delivery.--The statement required to be
furnished to any employee under paragraph (1) may be furnished
to such employee electronically if such employee has consented
to receive such statement electronically. For purposes of the
preceding sentence, if an employee has consented, before the
date of the enactment of this paragraph, to electronically
receive, from the person furnishing such statement, other
documents used in filing the employee's return of tax, such
employee shall be treated as having consented to receive such
statement electronically unless such employee requests that
such consent not apply to such statement.''.
(b) Statements From Insurance Providers.--Subsection (c) of section
6055 of the Internal Revenue Code of 1986 is amended by adding at the
end the following new paragraph:
``(3) Electronic delivery.--The statement required to be
furnished to any individual under paragraph (1) may be
furnished to such individual electronically if such individual
has consented to receive such statement electronically. For
purposes of the preceding sentence, if an individual has
consented, before the date of the enactment of this paragraph,
to electronically receive, from the person furnishing such
statement, other documents containing private health
information, such individual shall be treated as having
consented to receive such statement electronically unless such
individual requests that such consent not apply to such
statement.''.
(c) Effective Date.--The amendments made by this section shall
apply to statements the due date for which is after December 31, 2013.
SEC. 8. DELAYING PROVISION OF ACA PREMIUM AND COST-SHARING SUBSIDIES
UNTIL ELIGIBILITY VERIFICATION PROCESS FOR SUCH SUBSIDIES
IS COMPLETE.
(a) In General.--Notwithstanding any other provision of law, no
premium tax credit under section 36B of the Internal Revenue Code of
1986 or reduced cost-sharing under section 1402 of the Patient
Protection and Affordable Care Act (42 U.S.C. 18071) shall be allowed
with respect to any individual for any coverage month which begins
after December 31, 2014, and before the date on which the process to
verify, in accordance with section 1411 of the Patient Protection and
Affordable Care Act (42 U.S.C. 18081), the estimated household income
and coverage requirements of such individual for purposes of
determining eligibility for, and the accurate amount of, such credit or
reduction, respectively, has been completed. For purposes of the
previous sentence, the verification process described in such sentence
with respect to an individual shall not be treated as complete unless a
manual or electronic review has been completed of applicable
information required to be submitted by such individual under section
1411(b) of such Act (42 U.S.C. 18081(b)) and any inconsistency of such
information with records of the Secretary of the Treasury, the
Secretary of Homeland Security, or the Commissioner of Social Security
has been resolved.
(b) Treatment of Individual Mandate.--Notwithstanding any other
provision of law, no penalty shall be imposed under section 5000A of
the Internal Revenue Code of 1986 with respect to an individual for any
month--
(1) with respect to which such individual would (but for
subsection (a)) be allowed a premium tax credit under section
36B of the Internal Revenue Code of 1986; and
(2) which begins after December 31, 2014, and before the
date on which the verification process described in subsection
(a) has been completed, in accordance with such subsection,
with respect to the eligibility of such individual for such
credit.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
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