II 

116TH CONGRESS 

1ST SESSION S. 964 

To amend the Patient Protection and Affordable Care Act to improve costsharing subsidies. 

IN THE SENATE OF THE UNITED STATES 

APRIL 1, 2019 

Mrs. SHAHEEN (for herself, Ms. STABENOW, Mr. CASEY, Mr. REED, Mr. 

BLUMENTHAL, Ms. HASSAN, Ms. KLOBUCHAR, Mr. TESTER, Mr. KAINE, 

Mr. KING, Ms. HARRIS, Mr. WHITEHOUSE, Ms. BALDWIN, Ms. HIRONO, 

and Mr. MURPHY) 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 improve cost-sharing subsidies. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Marketplace Certainty 

5 Act’’. 

6 SEC. 2. ENHANCEMENTS FOR REDUCED COST-SHARING. 

7 (a) MODIFICATION OF AMOUNT.— 


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1 (1) IN GENERAL.—Section 1402(c)(2) of the 

2 Patient Protection and Affordable Care Act is 

3 amended to read as follows: 

4 ‘‘(2) ADDITIONAL REDUCTION.—The Secretary 

5 shall establish procedures under which the issuer of 

6 a qualified health plan to which this section applies 

7 shall further reduce cost-sharing under the plan in 

8 a manner sufficient to— 

9 ‘‘(A) in the case of an eligible insured 

10 whose household income is not less than 100 

11 percent but not more than 200 percent of the 

12 poverty line for a family of the size involved, in13 crease the plan’s share of the total allowed 

14 costs of benefits provided under the plan to 95 

15 percent of such costs; 

16 ‘‘(B) in the case of an eligible insured 

17 whose household income is more than 200 per18 cent but not more than 300 percent of the pov19 erty line for a family of the size involved, in20 crease the plan’s share of the total allowed 

21 costs of benefits provided under the plan to 90 

22 percent of such costs; and 

23 ‘‘(C) in the case of an eligible insured 

24 whose household income is more than 300 per25 cent but not more than 400 percent of the povVerDate Sep 11 2014 01:02 Apr 06, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S964.IS S964

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1 erty line for a family of the size involved, in2 crease the plan’s share of the total allowed 

3 costs of benefits provided under the plan to 85 

4 percent of such costs.’’. 

5 (2) CONFORMING AMENDMENT.—Clause (i) of 

6 section 1402(c)(1)(B) of such Act is amended to 

7 read as follows: 

8 ‘‘(i) IN GENERAL.—The Secretary 

9 shall ensure the reduction under this para10 graph shall not result in an increase in the 

11 plan’s share of the total allowed costs of 

12 benefits provided under the plan above— 

13 ‘‘(I) 95 percent in the case of an 

14 eligible insured described in para15 graph (2)(A); 

16 ‘‘(II) 90 percent in the case of an 

17 eligible insured described in para18 graph (2)(B); and 

19 ‘‘(III) 85 percent in the case of 

20 an eligible insured described in para21 graph (2)(C).’’. 

22 (3) EFFECTIVE DATE.—The amendments made 

23 by this subsection shall apply to plan years begin24 ning after December 31, 2019. 


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1 (b) FUNDING.—Section 1402 of the Patient Protec2 tion and Affordable Care Act is amended by adding at 

3 the end the following new subsection: 

4 ‘‘(g) FUNDING.—Out of any funds in the Treasury 

5 not otherwise appropriated, there are appropriated to the 

6 Secretary such sums as may be necessary for payments 

7 under this section.’’. 

Æ 


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