I 

115TH CONGRESS 

2D SESSION H. R. 7102 

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 HOUSE OF REPRESENTATIVES 

OCTOBER 30, 2018 

Ms. CASTOR of Florida (for herself and Ms. BLUNT ROCHESTER) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce 

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. 

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 ‘‘Expand Navigators’ 

5 Resources for Outreach, Learning, and Longevity Act of 

6 2018’’ or the ‘‘ENROLL Act of 2018’’. 


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1 SEC. 2. PROVIDING FOR ADDITIONAL REQUIREMENTS 

2 WITH RESPECT TO THE NAVIGATOR PRO3 GRAM. 

4 (a) IN GENERAL.—Section 1311(i) of the Patient 

5 Protection and Affordable Care Act (42 U.S.C. 18031(i)) 

6 is amended— 

7 (1) in paragraph (2), by adding at the end the 

8 following new subparagraph: 

9 ‘‘(C) SELECTION OF RECIPIENTS.—In 

10 awarding grants under paragraph (1), the Ex11 change shall— 

12 ‘‘(i) select entities to receive such 

13 grants based solely on an entity’s dem14 onstrated capacity to carry out each of the 

15 duties specified in paragraph (3); 

16 ‘‘(ii) not take into account whether or 

17 not the entity— 

18 ‘‘(I) has demonstrated how the 

19 entity will provide information to indi20 viduals relating to group health plans 

21 offered by a group or association of 

22 employers described in section 

23 2510.3–5(b) of title 29, Code of Fed24 eral Regulations (or any successor 

25 regulation), or short-term limited du26 ration insurance (as defined by the 


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1 Secretary for purposes of section 

2 2791(b)(5) of the Public Health Serv3 ice Act); or 

4 ‘‘(II) has developed a plan— 

5 ‘‘(aa) to inform individuals 

6 of the option not to purchase 

7 health insurance coverage that 

8 covers abortion services or how 

9 individuals may receive a hard10 ship exemption if all qualified 

11 health plans offered through such 

12 Exchange provide coverage of 

13 such services; or 

14 ‘‘(bb) to provide information 

15 and assistance to individuals with 

16 respect to prohibitions on the use 

17 of premium assistance tax credits 

18 described in section 36B of the 

19 Internal Revenue Code of 1986 

20 and cost-sharing reductions de21 scribed in section 1402 from 

22 being used to cover abortion serv23 ices, the process by which health 

24 insurance issuers must develop 

25 premiums for qualified health 


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1 plans that cover such services, 

2 and segregation of funds require3 ments for such issuers; and 

4 ‘‘(iii) ensure that, each year, the Ex5 change awards such a grant to— 

6 ‘‘(I) at least one entity described 

7 in this paragraph that is a community 

8 and consumer-focused nonprofit 

9 group; and 

10 ‘‘(II) at least one entity described 

11 in subparagraph (B), which may in12 clude another community and con13 sumer-focused nonprofit group in ad14 dition to any such group awarded a 

15 grant pursuant to subclause (I).’’; 

16 (2) in paragraph (3)(C), by inserting after 

17 ‘‘qualified health plans’’ the following: ‘‘, State med18 icaid plans under title XIX of the Social Security 

19 Act, and State children’s health insurance programs 

20 under title XXI of such Act’’; and 

21 (3) in paragraph (4)(A)— 

22 (A) in the matter preceding clause (i), by 

23 striking ‘‘not’’; 

24 (B) in clause (i)— 


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1 (i) by inserting ‘‘not’’ before ‘‘be’’; 

2 and 

3 (ii) by striking ‘‘; or’’ and inserting 

4 ‘‘;’’; 

5 (C) in clause (ii)— 

6 (i) by inserting ‘‘not’’ before ‘‘re7 ceive’’; and 

8 (ii) by striking the period and insert9 ing ‘‘;’’; and 

10 (D) by adding at the end the following new 

11 clause: 

12 ‘‘(iii) maintain physical presence in 

13 the State of the Exchange so as to allow 

14 in-person assistance to consumers.’’. 

15 (b) EXCHANGES OPERATED BY THE SECRETARY.— 

16 Section 1321(c) of the Patient Protection and Affordable 

17 Care Act (42 U.S.C. 18041(c)) is amended by adding at 

18 the end the following new paragraph: 

19 ‘‘(3) NAVIGATOR PROGRAM AND OUTREACH

20 AND ENROLLMENT ACTIVITIES.— 

21 ‘‘(A) NAVIGATOR PROGRAM.— 

22 ‘‘(i) IN GENERAL.—In the case of an 

23 Exchange established or operated by the 

24 Secretary within a State pursuant to this 

25 subsection, the Secretary shall establish a 


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1 program under which such Exchange 

2 awards grants, with respect to such State, 

3 to entities that would be described in para4 graph (2) of section 1311(i) to carry out 

5 the duties that would be described in para6 graph (3) of such section if the references 

7 in such section 1311(i) to ‘this subsection’ 

8 and ‘paragraph (1)’ were each instead a 

9 reference to ‘paragraph (3)(A) of section 

10 1321(c)’. 

11 ‘‘(ii) APPLICATION OF STATE EX12 CHANGE NAVIGATOR PROVISIONS.—For 

13 purposes of carrying out this subpara14 graph, the provisions of paragraphs (2) 

15 through (5) of section 1311(i) shall apply 

16 to the Secretary with respect to an Ex17 change described in clause (i) established 

18 or operated within a State and the pro19 gram under this subparagraph, with re20 spect to such State, in the same manner as 

21 such provisions apply to a State with re22 spect to an Exchange described in section 

23 1311(i) established by the State and the 

24 program established under such section. 


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1 ‘‘(iii) FUNDING.—For purposes of 

2 carrying out this subparagraph, the Sec3 retary shall obligate $100,000,000 out of 

4 amounts collected through the user fees on 

5 participating health insurance issuers pur6 suant to section 156.50 of title 45, Code of 

7 Federal Regulations (or any successor reg8 ulations) for each of fiscal year 2019 and 

9 each subsequent fiscal year. Such amount 

10 for a fiscal year shall remain available 

11 until expended. 

12 ‘‘(B) OUTREACH AND EDUCATIONAL AC13 TIVITIES.— 

14 ‘‘(i) IN GENERAL.—In the case of an 

15 Exchange established or operated by the 

16 Secretary within a State pursuant to this 

17 subsection, the Secretary shall carry out 

18 outreach and educational activities for pur19 poses of informing potential enrollees in 

20 qualified health plans offered through the 

21 Exchange of the availability of coverage 

22 under such plans and financial assistance 

23 for coverage under such plans. Such out24 reach and educational activities shall be 

25 provided in a manner that is culturally and 


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1 linguistically appropriate to the needs of 

2 the populations being served by the Ex3 change (including hard-to-reach popu4 lations, such as racial and sexual minori5 ties, limited English proficient populations, 

6 and young adults). 

7 ‘‘(ii) FUNDING.—For purposes of car8 rying out this subparagraph, the Secretary 

9 shall obligate $100,000,000 out of the 

10 amounts collected through the user fees on 

11 participating health insurance issuers pur12 suant to section 156.50 of title 45, Code of 

13 Federal Regulations (or any successor reg14 ulations) for each of fiscal years 2019 

15 through 2021. Such amount shall remain 

16 available without fiscal year limitation 

17 until expended.’’. 

18 (c) EFFECTIVE DATE.—The amendments made by 

19 this section shall apply with respect to plan years begin20 ning on or after January 1, 2020. 

Æ 


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