Coverage Protection Act

Summary: Coverage Protection Act - Directs the Secretary of Health and Human Services (HHS), in the case of an individual who enrolls in a qualified health plan offered through a health care exchange established under the Patient Protection and Affordable Care Act (PPACA) before February 1, 2014, to require the issuer of the plan to treat such individual as enrolled as of December 23, 2013, if the individual:  attests, not later than January 31, 2014, to making reasonable, good-faith attempts to successfully enroll in such a plan through an exchange before December 23, 2013, or was initially determined through healthcare.gov to be eligible to enroll in a Medicaid plan but is not eligible to so enroll in such a plan and, because of the incorrect eligibility determination, was subsequently unable to enroll in a qualified plan before December 23, 2013; and pays to the issuer of the plan in which the individual is enrolled any premiums owed for enrollment in the plan, taking into account the amount of any premium assistance made available under the Internal Revenue Code.   Counts coverage provided under a qualified plan for January and February 2014 under this Act as coverage under such a plan by or through an exchange for such months for all purposes, including premium assistance, PPACA cost-sharing reductions, and the requirement to maintain minimum essential coverage. Amends PPACA to allow a state to make coverage under a qualified plan retroactive to January 1, 2014, with respect to an individual who enrolls through the state exchange (or the federal exchange in the case of a state that does not have one) during the period established by the state that begins on December 23, 2013, and ends on a date determined by the state, but not later than January 31, 2014. Allows a state that has an enrollment deadline that is prior to December 23, 2013, to modify the period to encompass such deadline. Applies retroactively to January 1, 2014, any premium assistance tax credit or cost-sharing assistance for which the individual is determined to be eligible, but where the determination has not been verified by the date on which the individual enrolls in the qualified plan. Directs the Secretary to require a health insurance issuer that offers a qualified plan through an exchange to:  allow in-network providers in the plan to treat a receipt of payment of premiums by an individual enrolled for January or February 2014 who has not received a health insurance card from the issuer in the same manner as if such receipt were such a health insurance card issued for services furnished during such month; and notify such in-network providers of that policy.  

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Coverage Protection Act''.

SEC. 2. AUTHORITY TO PROVIDE TIMELY COVERAGE FOR INDIVIDUALS WHO WERE 
              UNABLE TO ENROLL IN A QUALIFIED HEALTH PLAN.

    (a) In General.--In the case of an individual who enrolls in a 
qualified health plan offered through an Exchange established under 
title I of the Patient Protection and Affordable Care Act (Public Law 
111-148) before February 1, 2014, the Secretary of Health and Human 
Services shall require that the issuer of the plan treat such 
individual as enrolled in such plan as of December 23, 2013, if the 
following conditions are met:
            (1) Attempted timely enrollment.--The individual submits, 
        not later than January 31, 2014, an attestation (in such form 
        and manner as the Secretary may require) that the individual--
                    (A) made reasonable, good-faith attempts, but was 
                unable, to successfully enroll in such a plan through 
                an Exchange before December 23, 2013; or
                    (B) was initially determined through healthcare.gov 
                to be eligible to enroll in a Medicaid plan under title 
                XIX of the Social Security Act but is not eligible to 
                so enroll in such a Medicaid plan and, because of such 
                incorrect eligibility determination, was subsequently 
                unable to enroll in a qualified health plan before 
                December 23, 2013.
            (2) Payment of premiums.--The individual pays to the health 
        insurance issuer issuing the qualified health plan in which 
        such individual is enrolled (either directly or through the 
        Exchange) any applicable premiums owed by such individual for 
        enrollment in the plan taking into account the amount of any 
        premium assistance made available under section 36B of the 
        Internal Revenue Code of 1986.
    (b) Application for Purposes of Premium Assistance, Reduced Cost-
Sharing, and Individual Responsibility.--Coverage provided under a 
qualified health plan for January and February of 2014 under subsection 
(a) shall be counted as coverage under such a plan by or through an 
Exchange for such months for all purposes, including the following:
            (1) Premium assistance.--Section 36B of the Internal 
        Revenue Code of 1986.
            (2) Cost-sharing reductions.--Section 1402 of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18071).
            (3) Individual responsibility requirement.--Section 5000A 
        of the Internal Revenue Code of 1986.

SEC. 3. RETROACTIVE COVERAGE AND PREMIUM ASSISTANCE.

    Section 1311(c) of the Patient Protection and Affordable Care Act 
(42 U.S.C. 18031(c)) is amended by adding at the end the following:
            ``(7) State option to make initial coverage retroactive.--
                    ``(A) In general.--Notwithstanding any other 
                provision of law, the Secretary shall permit a State, 
                at the option of the State, to make coverage under a 
                qualified health plan retroactive to January 1, 2014, 
                with respect to an individual who enrolls in such plan 
                through the State Exchange (or the Federal Exchange in 
                the case of a State that has not established a State 
                Exchange) during the period established by the State 
                under subparagraph (B). Any health care items or 
                services provided to such enrollee in January of 2014 
                shall be covered retroactively under the plan as if the 
                enrollee had been enrolled on January 1 of such year.
                    ``(B) Period.--The period established under this 
                subparagraph shall be the period beginning on December 
                23, 2013, and ending on a date determined by the State, 
                but in no event later than January 31, 2014, except 
                that a State that has an enrollment deadline that is 
                prior to December 23, 2013, may modify the period under 
                this subparagraph to encompass such deadline.
                    ``(C) Tax credits and cost sharing assistance.--If 
                an individual is determined to be eligible for a tax 
                credit under section 36B of the Internal Revenue Code 
                of 1986 or cost-sharing assistance under section 1402, 
                but such determination has not been verified by the 
                date on which the individual enrolls in the qualified 
                health plan involved, the credit and assistance shall 
                be applied on a retroactive basis to January 1, 2014, 
                and the initial premium payment amount shall be offset 
                to include such credit and assistance amounts for such 
                month.''.

SEC. 4. TRANSITIONAL USE OF RECEIPT OF INSURANCE PAYMENT AS ALTERNATIVE 
              TO HEALTH INSURANCE CARD FOR EXCHANGE PLANS.

    (a) In General.--The Secretary of Health and Human Services shall 
require a health insurance issuer that offers a qualified health plan 
through an Exchange under title I of the Patient Protection and 
Affordable Care Act (Public Law 111-148)--
            (1) to allow in-network providers in such plan to treat, 
        for purposes of coverage under the plan, a receipt of payment 
        of premiums by an individual enrolled under the plan for 
        January or February 2014 who has not received a health 
        insurance card from the issuer in the same manner as if such 
        receipt were such a health insurance card issued to such 
        individual by the issuer for services furnished during such 
        month; and
            (2) to notify such in-network providers of the policy under 
        paragraph (1).
    (b) Rule of Construction.--Nothing in this section shall be 
construed as precluding a health care provider from directly seeking to 
verify the status of the enrollment of an individual in a qualified 
health plan offered through an Exchange by contacting the Exchange or 
the issuer of such plan.