69–006 

115TH CONGRESS REPT. 115–161 " ! HOUSE OF REPRESENTATIVES 1st Session Part 1 

VERIFY FIRST ACT 

JUNE 2, 2017.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. BRADY of Texas, from the Committee on Ways and Means, 

submitted the following 

R E P O R T 

together with 

DISSENTING VIEWS 

[To accompany H.R. 2581] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Ways and Means, to whom was referred the 

bill (H.R. 2581) to amend the Internal Revenue Code of 1986 to require the provision of Social Security numbers as a condition of receiving the health insurance premium tax credit, having considered 

the same, report favorably thereon with an amendment and recommend that the bill as amended do pass. 

CONTENTS 

Page 

I. SUMMARY AND BACKGROUND ............................................................... 3 

A. Purpose and Summary ..................................................................... 3 

B. Background and Need for Legislation ............................................. 3 

C. Legislative History ............................................................................ 4 

II. EXPLANATION OF THE BILL ................................................................... 5 

A. Verification of Status in United States as Condition of Receiving 

Advance Payment of Health Insurance Premium Tax Credit .... 5 

III. VOTES OF THE COMMITTEE .................................................................... 8 

IV. BUDGET EFFECTS OF THE BILL ............................................................ 10 

A. Committee Estimate of Budgetary Effects ...................................... 10 

B. Statement Regarding New Budget Authority and Tax Expenditures Budget Authority .................................................................. 10 

C. Cost Estimate Prepared by the Congressional Budget Office ....... 10 

V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF 

THE HOUSE .............................................................................................. 12 

A. Committee Oversight Findings and Recommendations ................. 12 

B. Statement of General Performance Goals and Objectives ............. 12 

2 

C. Information Relating to Unfunded Mandates ................................ 12 

D. Applicability of House Rule XXI 5(b) .............................................. 12 

E. Tax Complexity Analysis .................................................................. 12 

F. Congressional Earmarks, Limited Tax Benefits, and Limited 

Tariff Benefits ................................................................................. 13 

G. Duplication of Federal Programs ..................................................... 13 

H. Disclosure of Directed Rule Makings .............................................. 13 

VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED 13 

VII. DISSENTING VIEWS ................................................................................... 38 

The amendment is as follows: 

Strike all after the enacting clause and insert the following: 

SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Verify First Act’’. 

SEC. 2. VERIFICATION OF STATUS IN UNITED STATES AS CONDITION OF RECEIVING ADVANCE 

PAYMENT OF HEALTH INSURANCE PREMIUM TAX CREDIT. 

(a) APPLICATION TO CURRENT HEALTH INSURANCE PREMIUM TAX CREDIT.—Section 

36B of the Internal Revenue Code of 1986, as in effect for months beginning before 

January 1, 2020, is amended by redesignating subsection (g) as subsection (h) and 

by inserting after subsection (f) the following new subsection: 

‘‘(g) VERIFICATION OF STATUS IN UNITED STATES FOR ADVANCE PAYMENT.—No advance payment of the credit allowed under this section with respect to any premium 

under subsection (b)(2)(A) with respect to any individual shall be made under section 1412 of the Patient Protection and Affordable Care Act unless the Secretary has 

received confirmation from the Secretary of Health and Human Services that the 

Commissioner of Social Security or the Secretary of Homeland Security has verified 

under section 1411(c)(2) of such Act the individual’s status as a citizen or national 

of the United States or an alien lawfully present in the United States using a process that includes the appropriate use of information related to citizenship or immigration status, such as social security account numbers (but not individual taxpayer 

identification numbers).’’. 

(b) APPLICATION TO NEW HEALTH INSURANCE PREMIUM TAX CREDIT.—Section 36B 

of the Internal Revenue Code of 1986, as amended by the American Health Care 

Act of 2017 and in effect for months beginning after December 31, 2019, is amended 

by adding at the end the following new subsection: 

‘‘(h) VERIFICATION OF STATUS IN UNITED STATES FOR ADVANCE PAYMENT.—No advance payment of the credit allowed under this section with respect to any amount 

under subparagraph (A) or (B) of subsection (b)(1) with respect to any individual 

shall be made under section 1412 of the Patient Protection and Affordable Care Act 

unless the Secretary has received confirmation from the Secretary of Health and 

Human Services that the Commissioner of Social Security or the Secretary of Homeland Security has verified under section 1411(c)(2) of such Act the individual’s status as a citizen or national of the United States or a qualified alien (within the 

meaning of section 431 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1641)) using a process that includes the appropriate 

use of information related to citizenship or immigration status, such as social security account numbers (but not individual taxpayer identification numbers).’’. 

(c) CONFORMING AMENDMENT ON CONTINUOUS HEALTH INSURANCE COVERAGE

PROVISION.—Section 2710A(b)(1) of the Public Health Service Act, as added by section 133 of the American Health Care Act of 2017, is amended by adding after subparagraph (C) the following: 

‘‘In the case of an individual who applies for advance payment of a credit under 

section 1412 of the Patient Protection and Affordable Care Act and for whom 

a determination of eligibility for such advance payment is delayed by reason of 

the requirement for verification of the individual’s status in the United States 

under section 1411(c)(2) of such Act, the period of days beginning with the date 

of application for advance payment and ending with the date of such 

verification shall not be taken into account in applying subparagraph (B). The 

Secretary shall establish a procedure by which information relating to this period is provided to the individual.’’. 

(d) DELAY PERMITTED IN COVERAGE DATE IN CASE OF DELAY IN VERIFICATION OF

STATUS FOR INDIVIDUALS APPLYING FOR ADVANCE PAYMENT OF CREDIT.—Section 

1411(e) of the Patient Protection and Affordable Care Act (42 U.S.C. 18081(e)) is 

amended— 

(1) in paragraph (3), by inserting after ‘‘applicant’s eligibility’’ the following: 

‘‘(other than eligibility for advance payment of a credit under section 1412)’’; 

and 

3 

1 All section references herein are to the Internal Revenue Code of 1986, as amended, unless 

otherwise stated. 

(2) by adding at the end the following new paragraph: 

‘‘(5) DELAY PERMITTED IN COVERAGE DATE IN CASE OF DELAY IN VERIFICATION

OF STATUS FOR INDIVIDUALS APPLYING FOR ADVANCE PAYMENT OF CREDIT.—In 

the case of an individual whose eligibility for advance payments is delayed by 

reason of the requirement for verification under subsection (c)(2), if, for coverage 

to be effective as of the date requested in the individual’s application for enrollment, the individual would (but for this paragraph) be required to pay 2 or 

more months of retroactive premiums, the individual shall be provided the option to elect to postpone the effective date of coverage to the date that is not 

more than 1 month later than the date requested in the individual’s application 

for enrollment.’’. 

(e) EFFECTIVE DATES.— (1) APPLICATION TO CURRENT HEALTH INSURANCE PREMIUM TAX CREDIT.—The 

amendment made by subsection (a) is contingent upon the enactment of the 

American Health Care Act of 2017 and shall apply (if at all) to months beginning after December 31, 2017. 

(2) APPLICATION TO NEW HEALTH INSURANCE PREMIUM TAX CREDIT.—The 

amendment made by subsection (b) is contingent upon the enactment of the 

American Health Care Act of 2017 and shall apply (if at all) to months beginning after December 31, 2019, in taxable years ending after such date. 

(3) CONFORMING AMENDMENT ON CONTINUOUS HEALTH INSURANCE COVERAGE

PROVISION.—The amendment made by subsection (c) is contingent upon the enactment of the American Health Care Act of 2017 and shall take effect (if at 

all) as if included in such Act. 

(4) FLEXIBILITY IN COVERAGE DATE IN CASE OF DELAY IN VERIFICATION OF STA- TUS.—The amendment made by subsection (d) is contingent upon the enactment 

of the American Health Care Act of 2017 and shall apply (if at all) to applications for advance payments for months beginning after December 31, 2017. 

I. SUMMARY AND BACKGROUND 

A. PURPOSE AND SUMMARY

The bill, H.R. 2581, as reported by the Committee on Ways and 

Means, amends the premium tax credit under section 36B of the 

Internal Revenue Code (‘‘Code’’),1 to specify that advance payments 

of the credit are not to be made with respect to an individual unless the Secretary of the Treasury has confirmed with the Secretary of Health and Human Services that the individual’s status 

as a citizen or national of the United States, or as lawfully present 

in the United States, has been verified. In addition, H.R. 2581, as 

reported by the Committee on Ways and Means, amends H.R. 

1628, the American Health Care Act of 2017, as passed by the 

House of Representatives on May 4, 2017, to provide a similar rule 

with respect to advance payments of a new credit for the purchase 

of health insurance (effective for months beginning after December 

31, 2019, in taxable years ending after that date). 

B. BACKGROUND AND NEED FOR LEGISLATION

Under present law and the American Health Care Act of 2017, 

an individual is not eligible for the premium assistance credit unless the individual is a citizen or national of the United States, or, 

in the case of the present†law credit, lawfully present in the United 

States, or, in the case of the new credit under the American Health 

Care Act of 2017, a qualified alien. The procedures applicable with 

respect to advance payment of either credit require verification of 

the individual’s status by the Secretary of Health and Human 

Services before advance payments of the credit are made by the 

Department of the Treasury. However, existing procedures may not 

4 

be sufficient to ensure that proper verification has occurred. The 

bill therefore requires the Secretary of the Treasury to confirm 

such verification before making an advanced payment. 

On March 8, 2017, in fulfillment of the reconciliation instructions 

included in section 2002 of the Concurrent Resolution on the Budget for Fiscal Year 2017 (S. Con. Res. 3), the Committee marked up 

Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of Health-Related Tax Policy. This submission included provisions modifying the determination and advanced payment of the refundable tax credit. However, that language was 

later changed at the Committee on Rules in order to comply with 

Senate guidance regarding the Reconciliation process. 

C. LEGISLATIVE HISTORY

Background 

H.R. 2581 was introduced on May 22, 2017, and was referred to 

the Committee on Ways and Means and the Committee on Energy 

and Commerce. 

Committee action 

The Committee on Ways and Means marked up H.R. 2581, the 

Verify First Act, on May 24, 2017, and ordered the bill, as amended, favorably reported (with a quorum being present). 

Committee hearings 

Since the 112th Congress, the Committee on Ways and Means 

and its subcommittees have held a number of hearings on health 

reform that explored various parts of the health system and informed policy contained in the American Health Care Act. These 

hearings include: 

• March 2, 2011—Hearing on Improving Efforts to Combat 

Health Care Fraud 

• September 11, 2012—Hearing on Internal Revenue Service’s Implementation and Administration of the Democrats’ 

Health Care Law 

• September 12, 2012—Hearing on Implementation of 

Health Insurance Exchanges and Related Provisions 

• December 4, 2013—Hearing on the Challenges of the Affordable Care Act 

• June 10, 2014—Verification of Income and Insurance Information under the Affordable Care Act 

• March 14, 2016—Hearing on the Tax Treatment of Health 

Care 

• May 17, 2016—Member Day Hearing on Tax-Related Proposals to Improve Health Care 

5 

2Sec. 36B, effective for taxable years ending after December 31, 2013. Under the Affordable 

Care Act, an American Health Benefit Exchange is a source through which individuals can purchase health insurance coverage. As used herein, the Affordable Care Act (or ‘‘ACA’’) refers to 

the combination of the Patient Protection and Affordable Care Act (‘‘PPACA’’), Pub. L. No. 111– 

148, and the Healthcare and Education Reconciliation Act of 2010 (‘‘HCERA’’), Pub. L. No. 111– 

152. Qualified health plan is defined in PPACA section 1301. 3Federal poverty level refers to the most recently published poverty guidelines determined by 

the Secretary of Health and Human Services. Levels for 2017 and previous years are available 

at https://aspe.hhs.gov/prior-hhs-poverty-guidelines-and-federal-register-references. 4Sec. 911. 

5 Under section 86, only a portion of an individual’s social security benefits are included in 

gross income. 6PPACA sec. 1312(f)(3) and sec. 36B(e)(2). 

II. EXPLANATION OF THE BILL 

A. VERIFICATION OF STATUS IN UNITED STATES AS CONDITION OF

RECEIVING ADVANCE PAYMENT OF HEALTH INSURANCE PREMIUM

TAX CREDIT

PRESENT LAW

Premium assistance credit 

In general 

A refundable tax credit (‘‘premium assistance credit’’) is provided 

for eligible individuals and families to subsidize the purchase of 

health insurance plans through an American Health Benefit Exchange (‘‘Exchange’’), referred to as ‘‘qualified health plans.’’ 2 In 

general, as discussed below, advance payments with respect to the 

premium assistance credit are made during the year directly to the 

insurer. However, eligible individuals may choose to pay their total 

health insurance premiums without advance payments and claim 

the credit at the end of the taxable year. 

The premium assistance credit is generally available for individuals (single or joint filers) with household incomes between 100 

and 400 percent of the Federal poverty level (‘‘FPL’’) for the family 

size involved.3 Household income is defined as the sum of: (1) the 

individual’s modified adjusted gross income, plus (2) the aggregate 

modified adjusted gross incomes of all other individuals taken into 

account in determining the individual’s family size (but only if the 

other individuals are required to file a tax return for the taxable 

year). Modified adjusted gross income is defined as adjusted gross 

income increased by: (1) any amount excluded from gross income 

for citizens or residents living abroad,4 (2) any tax-exempt interest 

received or accrued during the tax year, and (3) the portion of the 

individual’s social security benefits not included in gross income.5

To be eligible for the premium assistance credit, individuals who 

are married must file a joint return. Individuals who are listed as 

dependents on a return are not eligible for the premium assistance 

credit. 

In order to enroll in a qualified health plan through an Exchange 

and receive the premium assistance credit, an individual must be 

a citizen or national of the United States or an alien lawfully 

present in the United States.6

Advance payments and reconciliation on tax return 

As part of the process of enrollment in a qualified health plan 

through an Exchange, an individual may apply and be approved for 

advance payments with respect to a premium assistance credit 

6 

7PPACA secs. 1411–1412. The Department of Health and Human Services is responsible for 

rules relating to Exchanges and the eligibility determination process. 8PPACA sec. 1411(c)(2). 

9 Rev. Proc. 2016–55, 2015–45 I.R.B. 707. The applicable dollar amounts are indexed to reflect 

cost-of-living increases, with the amount of any increase rounded down to the next lowest multiple of $50. 10Sec. 6109(a). 

(‘‘advance payments’’).7 The individual must provide information on 

income, family size, changes in marital or family status or income, 

and U.S. citizen, national or lawfully present status. The Exchange 

process includes a system through which the Secretary of Health 

and Human Services (‘‘HHS’’) verifies information provided by the 

individual using information from certain Federal agencies and 

other sources. U.S. citizen, national or lawfully present status is 

verified by obtaining information from the Commissioner of Social 

Security and the Secretary of Homeland Security.8 If an individual 

is approved for advance payments, the Department of the Treasury 

pays the advance amount directly to the issuer of the health plan 

in which the individual is enrolled. The individual then pays to the 

issuer of the plan the difference, if any, between the advance payment amount and the total premium charged for the plan. 

An individual on whose behalf advance payments of the premium 

assistance credit for a taxable year are made is required to file an 

income tax return to reconcile the advance payments with the credit to which the individual is entitled for the taxable year. 

If the advance payments of the premium assistance credit exceed 

the amount of credit to which the individual is entitled, the excess 

(‘‘excess advance payments’’) is treated as an additional tax liability 

on the individual’s income tax return for the taxable year (referred 

to as ‘‘recapture’’), subject to a limit on the amount of additional 

liability in some cases. For an individual with household income 

below 400 percent of FPL, liability for the excess advance payments 

for a taxable year is limited to a specific dollar amount (the ‘‘applicable dollar amount’’) as shown in the table below. One-half of the 

applicable dollar amount shown in the table below applies to an 

unmarried individual who is not a surviving spouse or filing as a 

head of household. 

RECONCILIATION LIMIT ON ADDITIONAL TAX LIABILITY (FOR 2017) 9

Household income (expressed as a percent of FPL) Applicable 

dollar amount 

Less than 200% ...................................................................................................................................................... $600 

At least 200% but less than 300% ....................................................................................................................... 1,500 

At least 300% but less than 400% ....................................................................................................................... 2,550 

If the advance payments of the premium assistance credit for a 

taxable year are less than the amount of the credit to which the 

individual is entitled, the additional credit amount is also reflected 

on the individual’s income tax return for the year. 

SSNs and ITINs 

An individual filing a U.S. tax return is required to state his or 

her taxpayer identification number on the return. Generally, a taxpayer identification number is the individual’s Social Security number (‘‘SSN’’).10 However, in the case of an individual who is not eligible to be issued an SSN, but who has a tax filing obligation, the 

7 

11Treas. Reg. Sec. 301.6109–1(d)(3)(i). 12Treas. Reg. Sec. 301.6109–1(d)(3)(ii). 13 H.R. 1628, as passed by the House of Representatives on May 4, 2017. The AHCA also 

amends certain provisions of the Public Health Service Act (the ‘‘PHSA’’). Under present-law 

PHSA section 2701, premiums charged for health insurance purchased in the individual market 

are permitted to vary only by certain factors, such as the number of individuals covered by the 

insurance and, within limits, the age of the insured. This limit on premium variation is referred 

to as community rating. AHCA section 133 amends the PHSA to require an increase of 30 percent in the otherwise applicable premium in certain cases where an individual enrolling in 

health insurance coverage did not have health insurance for 63 or more consecutive days during 

the preceding 12-month period (sometimes referred to as the ‘‘continuous coverage’’ requirement). Under AHCA section 136, in certain cases where the continuous coverage requirement 

is not met, premiums may be based on the health status of the individual in lieu of the 30 percent premium increase. 14 AHCA section 214. AHCA section 201 amends the present-law premium assistance credit 

to repeal the limits on recapture of excess advance payments, effective for taxable years beginning after December 31, 2017. AHCA section 202 makes other changes to the present-law premium assistance credit for periods before the new credit becomes effective. 15Qualified alien is defined in section 431 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. sec. 1641). 16 AHCA section 214(b), adding a new PPACA section 1412(f). 

Internal Revenue Service issues an individual taxpayer identification number (‘‘ITIN’’) for use in connection with the individual’s tax 

filing requirements.11 An individual who is eligible to receive an 

SSN may not obtain an ITIN for purposes of his or her tax filing 

obligations.12 An ITIN does not provide eligibility to work in the 

United States or to claim Social Security benefits. 

THE AMERICAN HEALTH CARE ACT OF 2017

The American Health Care Act of 2017, as passed by the House 

of Representatives on May 4, 2017 (the ‘‘AHCA’’), amends various 

health-related provisions of the Code.13 Effective for months beginning after December 31, 2019, in taxable years ending after that 

date, the AHCA replaces the present-law premium assistance credit with a new credit.14 Under the AHCA, an individual is eligible 

for the new premium assistance credit only if the individual is a 

citizen or national of the United States or a qualified alien.15 In 

connection with the new premium assistance credit, the AHCA 

amends the provisions relating to advance payment of the credit to 

direct the Secretary of the Treasury and the Secretary of HHS to 

prescribe such regulations as each Secretary may deem necessary 

to establish and operate the advance payment program in a manner that protects taxpayer information, provides robust verification 

of all information necessary to establish eligibility for advance payments, ensures proper and timely payments to appropriate health 

providers, and protects program integrity to the maximum extent 

feasible.16

REASONS FOR CHANGE

The Committee is concerned that the existing verification procedures that apply with respect to citizen, national or immigration 

status before advance payments may be made do not adequately 

ensure that only eligible individuals are approved for advance payments. Erroneous advance payments represent a misuse of taxpayer funds and contribute to Federal deficits, particularly when 

erroneous amounts cannot be fully recovered. The Committee 

therefore wishes to strengthen the procedures that must be followed before advance payments can be made. 

8 

17 An SSN is not the sole means by which citizenship or immigration status can be verified. 

However, under the provision, an ITIN cannot be used to verify citizenship or immigration status. 18The bill also contains a provision that amends the continuus coverage requirement under 

AHCA section 133 so that, in the case of an individual for whom a determination of eligibility 

for advance payments is delayed by reason of the requirement to verify the individual’s status 

under PPACA section 1411(c)(2), the period from the date of application for advance payments 

to the date of verification is disregarded in determining whether the individual meets the continuous coverage requirement (including for purposes of whether, under AHCA section 136, premiums can be based on the individual’s health status). The bill further contains a provision that 

amends PPACA section 1411 to require with respect to such an individual that, if, in order for 

the individual’s health coverage to be effective as of the date requested in the individual’s application for enrollment, the individual would be required to pay retroactive premiums for two or 

more months, the individual must be provided the option of postponing the effective date of coverage for up to one month. 19The provision amending the continuous coverage requirement under AHCA section 133 is 

contingent on enactment of the AHCA and will take effect (if at all) as if included in the AHCA. 

The provision relating to the postponement of health coverage by an individual, for whom a determination of eligibility for advance payments is delayed by reason of the requirement to verify 

the individual’s status under PPACA section 1411(c)(2), is contingent on enactment of the AHCA 

and will apply (if at all) to applications for advance payments for months beginning after December 31, 2017. 

EXPLANATION OF PROVISION

The provision amends the present-law premium assistance credit 

to specify that no advance payments are to be made with respect 

to an individual unless the Secretary of the Treasury has received 

confirmation from the Secretary of HHS that the Commissioner of 

Social Security or the Secretary of Homeland Security has verified 

the individual’s status as a citizen or national of the United States 

or an alien lawfully present in the United States using a process 

that includes the appropriate use of information related to citizenship or immigration status, such as SSNs.17 The provision also 

amends the provision of the AHCA relating to the new premium 

assistance credit to add a similar requirement of confirmation that 

an individual’s status as a citizen or national of the United States 

or a qualified alien has been verified.18

EFFECTIVE DATE

The provision relating to the present-law premium assistance 

credit is contingent on the enactment of the AHCA and will apply 

(if at all) to months beginning after December 31, 2017. The provision relating to the new premium assistance credit under the 

AHCA is contingent on the enactment of the AHCA and will apply 

(if at all) to months beginning after December 31, 2019, in taxable 

years ending after that date.19

III. VOTES OF THE COMMITTEE 

In compliance with clause 3(b) of rule XIII of the Rules of the 

House of Representatives, the following statement is made concerning the vote of the Committee on Ways and Means in its consideration of H.R. 2581, the ‘‘Verify First Act,’’ on May 24, 2017. 

The vote on the amendment by Ms. Sanchez to the amendment 

in the nature of a substitute to H.R. 2581, which would limit the 

applicability of the underlying provision, was not agreed to by a 

roll call vote of 21 nays to 16 yeas (with a quorum being present). 

The vote was as follows: 

9 

Representative Yea Nay Present Representative Yea Nay Present 

Mr. Brady ................................ ........... X ........... Mr. Neal ................................. X ........... ...........

Mr. Johnson ............................. ........... ........... ........... Mr. Levin ................................ X ........... ...........

Mr. Nunes ............................... ........... X ........... Mr. Lewis ................................ X ........... ...........

Mr. Tiberi ................................ ........... X ........... Mr. Doggett ............................ X ........... ...........

Mr. Reichert ............................ ........... X ........... Mr. Thompson ........................ X ........... ...........

Mr. Roskam ............................. ........... ........... ........... Mr. Larson .............................. X ........... ...........

Mr. Buchanan ......................... ........... X ........... Mr. Blumenauer ..................... X ........... ...........

Mr. Smith (NE) ........................ ........... X ........... Mr. Kind ................................. X ........... ...........

Ms. Jenkins ............................. ........... X ........... Mr. Pascrell ............................ X ........... ...........

Mr. Paulsen ............................. ........... X ........... Mr. Crowley ............................ X ........... ...........

Mr. Marchant .......................... ........... X ........... Mr. Davis ................................ X ........... ...........

Ms. Black ................................ ........... ........... ........... Ms. Sanchez ........................... X ........... ...........

Mr. Reed ................................. ........... X ........... Mr. Higgins ............................ X ........... ...........

Mr. Kelly .................................. ........... X ........... Ms. Sewell .............................. X ........... ...........

Mr. Renacci ............................. ........... X ........... Ms. DelBene ........................... X ........... ...........

Mr. Meehan ............................. ........... X ........... Ms. Chu .................................. X ........... ...........

Ms. Noem ................................ ........... X ...........

Mr. Holding ............................. ........... X ...........

Mr. Smith (MO) ....................... ........... X ...........

Mr. Rice .................................. ........... X ...........

Mr. Schweikert ........................ ........... X ...........

Ms. Walorski ........................... ........... X ...........

Mr. Curbelo ............................. ........... X ...........

Mr. Bishop .............................. ........... X ...........

Mr. Nunes’s motion to table Mr. Doggett’s appeal of the ruling 

of the Chair was agreed to by a roll call vote of 22 yeas and 16 

nays (with a quorum being present). The vote was as follows: 

Representative Yea Nay Present Representative Yea Nay Present 

Mr. Brady ................................ X ........... ........... Mr. Neal ................................. ........... X ...........

Mr. Johnson ............................. ........... ........... ........... Mr. Levin ................................ ........... X ...........

Mr. Nunes ............................... X ........... ........... Mr. Lewis ................................ ........... X ...........

Mr. Tiberi ................................ X ........... ........... Mr. Doggett ............................ ........... X ...........

Mr. Reichert ............................ X ........... ........... Mr. Thompson ........................ ........... X ...........

Mr. Roskam ............................. X ........... ........... Mr. Larson .............................. ........... X ...........

Mr. Buchanan ......................... X ........... ........... Mr. Blumenauer ..................... ........... X ...........

Mr. Smith (NE) ........................ X ........... ........... Mr. Kind ................................. ........... X ...........

Ms. Jenkins ............................. X ........... ........... Mr. Pascrell ............................ ........... X ...........

Mr. Paulsen ............................. X ........... ........... Mr. Crowley ............................ ........... X ...........

Mr. Marchant .......................... X ........... ........... Mr. Davis ................................ ........... X ...........

Ms. Black ................................ ........... ........... ........... Ms. Sanchez ........................... ........... X ...........

Mr. Reed ................................. X ........... ........... Mr. Higgins ............................ ........... X ...........

Mr. Kelly .................................. X ........... ........... Ms. Sewell .............................. ........... X ...........

Mr. Renacci ............................. X ........... ........... Ms. DelBene ........................... ........... X ...........

Mr. Meehan ............................. X ........... ........... Ms. Chu .................................. ........... X ...........

Ms. Noem ................................ X ........... ...........

Mr. Holding ............................. X ........... ...........

Mr. Smith (MO) ....................... X ........... ...........

Mr. Rice .................................. X ........... ...........

Mr. Schweikert ........................ X ........... ...........

Ms. Walorski ........................... X ........... ...........

Mr. Curbelo ............................. X ........... ...........

Mr. Bishop .............................. X ........... ...........

The legislation was ordered favorably transmitted to the House 

of Representatives as amended by a roll call vote of 22 yeas and 

16 nays (with a quorum being present). The vote was as follows: 

Representative Yea Nay Present Representative Yea Nay Present 

Mr. Brady ................................ X ........... ........... Mr. Neal ................................. ........... X ...........

Mr. Johnson ............................. ........... ........... ........... Mr. Levin ................................ ........... X ...........

Mr. Nunes ............................... X ........... ........... Mr. Lewis ................................ ........... X ...........

Mr. Tiberi ................................ X ........... ........... Mr. Doggett ............................ ........... X ...........

10 

Representative Yea Nay Present Representative Yea Nay Present 

Mr. Reichert ............................ X ........... ........... Mr. Thompson ........................ ........... X ...........

Mr. Roskam ............................. X ........... ........... Mr. Larson .............................. ........... X ...........

Mr. Buchanan ......................... X ........... ........... Mr. Blumenauer ..................... ........... X ...........

Mr. Smith (NE) ........................ X ........... ........... Mr. Kind ................................. ........... X ...........

Ms. Jenkins ............................. X ........... ........... Mr. Pascrell ............................ ........... X ...........

Mr. Paulsen ............................. X ........... ........... Mr. Crowley ............................ ........... X ...........

Mr. Marchant .......................... X ........... ........... Mr. Davis ................................ ........... X ...........

Ms. Black ................................ ........... ........... ........... Ms. Sanchez ........................... ........... X ...........

Mr. Reed ................................. X ........... ........... Mr. Higgins ............................ ........... X ...........

Mr. Kelly .................................. X ........... ........... Ms. Sewell .............................. ........... X ...........

Mr. Renacci ............................. X ........... ........... Ms. DelBene ........................... ........... X ...........

Mr. Meehan ............................. X ........... ........... Ms. Chu .................................. ........... X ...........

Ms. Noem ................................ X ........... ...........

Mr. Holding ............................. X ........... ...........

Mr. Smith (MO) ....................... X ........... ...........

Mr. Rice .................................. X ........... ...........

Mr. Schweikert ........................ X ........... ...........

Ms. Walorski ........................... X ........... ...........

Mr. Curbelo ............................. X ........... ...........

Mr. Bishop .............................. X ........... ...........

IV. BUDGET EFFECTS OF THE BILL 

A. COMMITTEE ESTIMATE OF BUDGETARY EFFECTS

In compliance with clause 3(d) of rule XIII of the Rules of the 

House of Representatives, the following statement is made concerning the effects on the budget of the bill, H.R. 2581, as reported. 

The bill, as reported, is estimated to have no effect on Federal 

fiscal year budget receipts for fiscal years 2017–2027. 

Pursuant to clause 8 of rule XIII of the Rules of the House of 

Representatives, the following statement is made by the Joint Committee on Taxation with respect to the provisions of the bill amending the Internal Revenue Code of 1986: The gross budgetary effect 

(before incorporating macroeconomic effects) in any fiscal year is 

less than 0.25 percent of the current projected gross domestic product of the United States for that fiscal year; therefore, the bill is 

not ‘‘major legislation’’ for purposes of requiring that the estimate 

include the budgetary effects of changes in economic output, employment, capital stock and other macroeconomic variables. 

B. STATEMENT REGARDING NEW BUDGET AUTHORITY AND TAX

EXPENDITURES BUDGET AUTHORITY

In compliance with clause 3(c)(2) of rule XIII of the Rules of the 

House of Representatives, the Committee states that the bill involves no new or increased budget authority. The Committee further states that the revenue provisions of the bill do not increase 

or decrease tax expenditures. 

C. COST ESTIMATE PREPARED BY THE CONGRESSIONAL BUDGET

OFFICE

In compliance with clause 3(c)(3) of rule XIII of the Rules of the 

House of Representatives, requiring a cost estimate prepared by 

the CBO, the following statement by CBO is provided. 

11 

U.S. CONGRESS, CONGRESSIONAL BUDGET OFFICE, Washington, DC, June 1, 2017. 

Hon. KEVIN BRADY, 

Chairman, Committee on Ways and Means, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 2581, the Verify First 

Act. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Mark Booth. 

Sincerely, 

KEITH HALL, Director. 

Enclosure. 

H.R. 2581—Verify First Act 

H.R. 2581 would amend the Internal Revenue Code related to advance payments of health-related tax credits, contingent upon enactment of the American Health Care Act of 2017. Under that contingency, H.R. 2581 would add additional verification procedures 

before the Department of Treasury could make payments of certain 

tax credits in advance to health insurers on behalf of enrollees. 

Specifically, the bill would require that no advance payments could 

be made unless the Secretary of the Treasury has received confirmation from the Secretary of Health and Human Services that 

either the Commissioner of Social Security or the Secretary of 

Homeland Security has verified the individual’s status either as a 

U.S. citizen or national or as an alien lawfully present in the country. The verification process would need to include information related to citizenship or immigration status, such as Social Security 

numbers. The requirements would apply through 2017 to the premium assistance credits that exist under current law and after 

2017 to the new credits that would be established by enactment of 

the American Health Care Act of 2017. 

Because the effects of the bill would be contingent upon enactment of subsequent legislation, the staff of the Joint Committee on 

Taxation estimates that the bill would in isolation have no effect 

on revenues or direct spending relative to current law. As a result, 

pay-as-you-go procedures do not apply. However, if the American 

Health Care Act of 2017 was enacted prior to this legislation, then 

relative to the new law the enactment of this bill could affect revenues or direct spending and, as a result, subsequent estimates of 

the effects of this legislation could change. 

CBO and JCT estimate that enacting the bill would not increase 

on-budget deficits or net direct spending by more than $5 billion 

in any of the four 10-year periods beginning in 2028. 

JCT has determined that the bill contains no intergovernmental 

or private-sector mandates as defined in the Unfunded Mandates 

Reform Act. 

The CBO staff contact for this estimate is Mark Booth. The estimate was approved by John McClelland, Assistant Director for Tax 

Analysis. 

12 

V. OTHER MATTERS TO BE DISCUSSED UNDER THE 

RULES OF THE HOUSE 

A. COMMITTEE OVERSIGHT FINDINGS AND RECOMMENDATIONS

Pursuant to clause 3(c)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee advises that the findings and 

recommendations of the Committee, based on oversight activities 

under clause 2(b)(1) of rule X of the Rules of the House of Representatives, are incorporated into the description portions of this 

report. 

B. STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

With respect to clause 3(c)(4) of rule XIII of the Rules of the 

House of Representatives, the Committee advises that the bill contains no measure that authorizes funding, so no statement of general performance goals and objectives for which any measure authorizes funding is required. 

C. INFORMATION RELATING TO UNFUNDED MANDATES

This information is provided in accordance with section 423 of 

the Unfunded Mandates Reform Act of 1995 (Pub. L. No. 104–4). 

The Committee has determined that the bill does not contain 

Federal mandates on the private sector. The Committee has determined that the bill does not impose a Federal intergovernmental 

mandate on State, local, or tribal governments. 

D. APPLICABILITY OF HOUSE RULE XXI 5(b) 

Rule XXI 5(b) of the Rules of the House of Representatives provides, in part, that ‘‘A bill or joint resolution, amendment, or conference report carrying a Federal income tax rate increase may not 

be considered as passed or agreed to unless so determined by a 

vote of not less than three-fifths of the Members voting, a quorum 

being present.’’ The Committee has carefully reviewed the bill and 

states that the bill does not involve any Federal income tax rate 

increases within the meaning of the rule. 

E. TAX COMPLEXITY ANALYSIS

Section 4022(b) of the Internal Revenue Service Restructuring 

and Reform Act of 1998 (‘‘IRS Reform Act’’) requires the staff of the 

Joint Committee on Taxation (in consultation with the Internal 

Revenue Service and the Treasury Department) to provide a tax 

complexity analysis. The complexity analysis is required for all legislation reported by the Senate Committee on Finance, the House 

Committee on Ways and Means, or any committee of conference if 

the legislation includes a provision that directly or indirectly 

amends the Internal Revenue Code of 1986 and has widespread applicability to individuals or small businesses. 

Pursuant to clause 3(h)(1) of rule XIII of the Rules of the House 

of Representatives, the staff of the Joint Committee on Taxation 

has determined that a complexity analysis is not required under 

section 4022(b) of the IRS Reform Act because the bill contains no 

provisions that amend the Internal Revenue Code of 1986 and that 

13 

have ‘‘widespread applicability’’ to individuals or small businesses, 

within the meaning of the rule. 

F. CONGRESSIONAL EARMARKS, LIMITED TAX BENEFITS, AND

LIMITED TARIFF BENEFITS

With respect to clause 9 of rule XXI of the Rules of the House 

of Representatives, the Committee has carefully reviewed the provisions of the bill and states that the provisions of the bill do not 

contain any congressional earmarks, limited tax benefits, or limited 

tariff benefits within the meaning of the rule. 

G. DUPLICATION OF FEDERAL PROGRAMS

In compliance with Sec. 3(c)(5) of rule XIII of the Rules of the 

House of Representatives, the Committee states that no provision 

of the bill establishes or reauthorizes: (1) a program of the Federal 

Government known to be duplicative of another Federal program, 

(2) a program included in any report from the Government Accountability Office to Congress pursuant to section 21 of Public 

Law 111–139, or (3) a program related to a program identified in 

the most recent Catalog of Federal Domestic Assistance, published 

pursuant to section 6104 of title 31, United States Code. 

H. DISCLOSURE OF DIRECTED RULE MAKINGS

In compliance with Sec. 3(i) of H. Res. 5 (115th Congress), the 

following statement is made concerning directed rule makings: The 

Committee advises that the bill requires no directed rule makings 

within the meaning of such section. 

VI. CHANGES IN EXISTING LAW MADE BY THE BILL, AS 

REPORTED 

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italic, 

and existing law in which no change is proposed is shown in 

roman): 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italic, 

and existing law in which no change is proposed is shown in 

roman): 

INTERNAL REVENUE CODE OF 1986 

* * * * * * * 

Subtitle A—Income Taxes 

* * * * * * * 

14 

CHAPTER 1—NORMAL TAXES AND SURTAXES 

* * * * * * * 

Subchapter A—Determination of Tax Liability 

* * * * * * * 

PART IV—CREDITS AGAINST TAX 

* * * * * * * 

Subpart C—Refundable Credits 

* * * * * * * 

øThe following shows proposed changes to current law section 36B 

of the Internal Revenue Code of 1986:¿ 

SEC. 36B. REFUNDABLE CREDIT FOR COVERAGE UNDER A QUALIFIED 

HEALTH PLAN. 

(a) IN GENERAL.—In the case of an applicable taxpayer, there 

shall be allowed as a credit against the tax imposed by this subtitle 

for any taxable year an amount equal to the premium assistance 

credit amount of the taxpayer for the taxable year. 

(b) PREMIUM ASSISTANCE CREDIT AMOUNT.—For purposes of this 

section— 

(1) IN GENERAL.—The term ‘‘premium assistance credit 

amount’’ means, with respect to any taxable year, the sum of 

the premium assistance amounts determined under paragraph 

(2) with respect to all coverage months of the taxpayer occurring during the taxable year. 

(2) PREMIUM ASSISTANCE AMOUNT.—The premium assistance 

amount determined under this subsection with respect to any 

coverage month is the amount equal to the lesser of— 

(A) the monthly premiums for such month for 1 or more 

qualified health plans offered in the individual market 

within a State which cover the taxpayer, the taxpayer’s 

spouse, or any dependent (as defined in section 152) of the 

taxpayer and which were enrolled in through an Exchange 

established by the State under 1311 of the Patient Protection and Affordable Care Act, or 

(B) the excess (if any) of— 

(i) the adjusted monthly premium for such month 

for the applicable second lowest cost silver plan with 

respect to the taxpayer, over 

(ii) an amount equal to 1/12 of the product of the applicable percentage and the taxpayer’s household income for the taxable year. 

(3) OTHER TERMS AND RULES RELATING TO PREMIUM ASSISTANCE AMOUNTS.—For purposes of paragraph (2)— 

(A) APPLICABLE PERCENTAGE.— 

(i) IN GENERAL.—Except as provided in clause (ii), 

the applicable percentage for any taxable year shall be 

the percentage such that the applicable percentage for 

any taxpayer whose household income is within an income tier specified in the following table shall increase, on a sliding scale in a linear manner, from the 

15 

initial premium percentage to the final premium percentage specified in such table for such income tier: 

In the case of household income (expressed as 

a percent of poverty line) within the following income tier: The initial premium percentage is-- The final premium percentage is-- 

Up to 133% 2.0% 2.0% 

133% up to 150% 3.0% 4.0% 

150% up to 200% 4.0% 6.3% 

200% up to 250% 6.3% 8.05% 

250% up to 300% 8.05% 9.5% 

300% up to 400% 9.5% 9.5% 

(ii) INDEXING.— (I) IN GENERAL.—Subject to subclause (II), in 

the case of taxable years beginning in any calendar year after 2014, the initial and final applicable percentages under clause (i) (as in effect for 

the preceding calendar year after application of 

this clause) shall be adjusted to reflect the excess 

of the rate of premium growth for the preceding 

calendar year over the rate of income growth for 

the preceding calendar year. 

(II) ADDITIONAL ADJUSTMENT.—Except as provided in subclause (III), in the case of any calendar year after 2018, the percentages described 

in subclause (I) shall, in addition to the adjustment under subclause (I), be adjusted to reflect 

the excess (if any) of the rate of premium growth 

estimated under subclause (I) for the preceding 

calendar year over the rate of growth in the consumer price index for the preceding calendar year. 

(III) FAILSAFE.—Subclause (II) shall apply for 

any calendar year only if the aggregate amount of 

premium tax credits under this section and costsharing reductions under section 1402 of the Patient Protection and Affordable Care Act for the 

preceding calendar year exceeds an amount equal 

to 0.504 percent of the gross domestic product for 

the preceding calendar year. 

(B) APPLICABLE SECOND LOWEST COST SILVER PLAN.—The 

applicable second lowest cost silver plan with respect to 

any applicable taxpayer is the second lowest cost silver 

plan of the individual market in the rating area in which 

the taxpayer resides which— 

(i) is offered through the same Exchange through 

which the qualified health plans taken into account 

under paragraph (2)(A) were offered, and 

(ii) provides— 

(I) self-only coverage in the case of an applicable 

taxpayer— 

(aa) whose tax for the taxable year is determined under section 1(c) (relating to unmarried individuals other than surviving spouses 

and heads of households) and who is not alVerDate Sep 11 2014 06:22 Jun 06, 2017 Jkt 069006 PO 00000 Frm 00015 Fmt 6659 Sfmt 6602 E:\HR\OC\HR161P1.XXX HR161P1
16 

lowed a deduction under section 151 for the 

taxable year with respect to a dependent, or 

(bb) who is not described in item (aa) but 

who purchases only self-only coverage, and 

(II) family coverage in the case of any other applicable taxpayer. 

If a taxpayer files a joint return and no credit is allowed 

under this section with respect to 1 of the spouses by reason of subsection (e), the taxpayer shall be treated as described in clause (ii)(I) unless a deduction is allowed under 

section 151 for the taxable year with respect to a dependent other than either spouse and subsection (e) does not 

apply to the dependent. 

(C) ADJUSTED MONTHLY PREMIUM.—The adjusted monthly premium for an applicable second lowest cost silver plan 

is the monthly premium which would have been charged 

(for the rating area with respect to which the premiums 

under paragraph (2)(A) were determined) for the plan if 

each individual covered under a qualified health plan 

taken into account under paragraph (2)(A) were covered by 

such silver plan and the premium was adjusted only for 

the age of each such individual in the manner allowed 

under section 2701 of the Public Health Service Act. In the 

case of a State participating in the wellness discount demonstration project under section 2705(d) of the Public 

Health Service Act, the adjusted monthly premium shall 

be determined without regard to any premium discount or 

rebate under such project. 

(D) ADDITIONAL BENEFITS.—If— 

(i) a qualified health plan under section 1302(b)(5) of 

the Patient Protection and Affordable Care Act offers 

benefits in addition to the essential health benefits required to be provided by the plan, or 

(ii) a State requires a qualified health plan under 

section 1311(d)(3)(B) of such Act to cover benefits in 

addition to the essential health benefits required to be 

provided by the plan, 

the portion of the premium for the plan properly allocable 

(under rules prescribed by the Secretary of Health and 

Human Services) to such additional benefits shall not be 

taken into account in determining either the monthly premium or the adjusted monthly premium under paragraph 

(2). 

(E) SPECIAL RULE FOR PEDIATRIC DENTAL COVERAGE.— 

For purposes of determining the amount of any monthly 

premium, if an individual enrolls in both a qualified health 

plan and a plan described in section 1311(d)(2)(B)(ii) (I) of 

the Patient Protection and Affordable Care Act for any 

plan year, the portion of the premium for the plan described in such section that (under regulations prescribed 

by the Secretary) is properly allocable to pediatric dental 

benefits which are included in the essential health benefits 

required to be provided by a qualified health plan under 

section 1302(b)(1)(J) of such Act shall be treated as a premium payable for a qualified health plan. 

17 

(c) DEFINITION AND RULES RELATING TO APPLICABLE TAXPAYERS, COVERAGE MONTHS, AND QUALIFIED HEALTH PLAN.—For purposes 

of this section— 

(1) APPLICABLE TAXPAYER.— (A) IN GENERAL.—The term ‘‘applicable taxpayer’’ means, 

with respect to any taxable year, a taxpayer whose household income for the taxable year equals or exceeds 100 percent but does not exceed 400 percent of an amount equal 

to the poverty line for a family of the size involved. 

(B) SPECIAL RULE FOR CERTAIN INDIVIDUALS LAWFULLY

PRESENT IN THE UNITED STATES.—If— 

(i) a taxpayer has a household income which is not 

greater than 100 percent of an amount equal to the 

poverty line for a family of the size involved, and 

(ii) the taxpayer is an alien lawfully present in the 

United States, but is not eligible for the medicaid program under title XIX of the Social Security Act by reason of such alien status, 

the taxpayer shall, for purposes of the credit under this 

section, be treated as an applicable taxpayer with a household income which is equal to 100 percent of the poverty 

line for a family of the size involved. 

(C) MARRIED COUPLES MUST FILE JOINT RETURN.—If the 

taxpayer is married (within the meaning of section 7703) 

at the close of the taxable year, the taxpayer shall be 

treated as an applicable taxpayer only if the taxpayer and 

the taxpayer’s spouse file a joint return for the taxable 

year. 

(D) DENIAL OF CREDIT TO DEPENDENTS.—No credit shall 

be allowed under this section to any individual with respect to whom a deduction under section 151 is allowable 

to another taxpayer for a taxable year beginning in the 

calendar year in which such individual’s taxable year begins. 

(2) COVERAGE MONTH.—For purposes of this subsection— 

(A) IN GENERAL.—The term ‘‘coverage month’’ means, 

with respect to an applicable taxpayer, any month if— 

(i) as of the first day of such month the taxpayer, 

the taxpayer’s spouse, or any dependent of the taxpayer is covered by a qualified health plan described 

in subsection (b)(2)(A) that was enrolled in through an 

Exchange established by the State under section 1311 

of the Patient Protection and Affordable Care Act, and 

(ii) the premium for coverage under such plan for 

such month is paid by the taxpayer (or through advance payment of the credit under subsection (a) 

under section 1412 of the Patient Protection and Affordable Care Act). 

(B) EXCEPTION FOR MINIMUM ESSENTIAL COVERAGE.— (i) IN GENERAL.—The term ‘‘coverage month’’ shall 

not include any month with respect to an individual if 

for such month the individual is eligible for minimum 

essential coverage other than eligibility for coverage 

described in section 5000A(f)(1)(C) (relating to coverage in the individual market). 

18 

(ii) MINIMUM ESSENTIAL COVERAGE.—The term ‘‘minimum essential coverage’’ has the meaning given such 

term by section 5000A(f). 

(C) SPECIAL RULE FOR EMPLOYER-SPONSORED MINIMUM

ESSENTIAL COVERAGE.—For purposes of subparagraph 

(B)— 

(i) COVERAGE MUST BE AFFORDABLE.—Except as provided in clause (iii), an employee shall not be treated 

as eligible for minimum essential coverage if such coverage— 

(I) consists of an eligible employer-sponsored 

plan (as defined in section 5000A(f)(2)), and 

(II) the employee’s required contribution (within 

the meaning of section 5000A(e)(1)(B)) with respect to the plan exceeds 9.5 percent of the applicable taxpayer’s household income. 

This clause shall also apply to an individual who is eligible to enroll in the plan by reason of a relationship 

the individual bears to the employee. 

(ii) COVERAGE MUST PROVIDE MINIMUM VALUE.—Except as provided in clause (iii), an employee shall not 

be treated as eligible for minimum essential coverage 

if such coverage consists of an eligible employer-sponsored plan (as defined in section 5000A(f)(2)) and the 

plan’s share of the total allowed costs of benefits provided under the plan is less than 60 percent of such 

costs. 

(iii) EMPLOYEE OR FAMILY MUST NOT BE COVERED

UNDER EMPLOYER PLAN.—Clauses (i) and (ii) shall not 

apply if the employee (or any individual described in 

the last sentence of clause (i)) is covered under the eligible employer-sponsored plan or the grandfathered 

health plan. 

(iv) INDEXING.—In the case of plan years beginning 

in any calendar year after 2014, the Secretary shall 

adjust the 9.5 percent under clause (i)(II) in the same 

manner as the percentages are adjusted under subsection (b)(3)(A)(ii). 

(3) DEFINITIONS AND OTHER RULES.— (A) QUALIFIED HEALTH PLAN.—The term ‘‘qualified 

health plan’’ has the meaning given such term by section 

1301(a) of the Patient Protection and Affordable Care Act, 

except that such term shall not include a qualified health 

plan which is a catastrophic plan described in section 

1302(e) of such Act. 

(B) GRANDFATHERED HEALTH PLAN.—The term ‘‘grandfathered health plan’’ has the meaning given such term by 

section 1251 of the Patient Protection and Affordable Care 

Act. 

(4) SPECIAL RULES FOR QUALIFIED SMALL EMPLOYER HEALTH

REIMBURSEMENT ARRANGEMENTS.— (A) IN GENERAL.—The term ‘‘coverage month’’ shall not 

include any month with respect to an employee (or any 

spouse or dependent of such employee) if for such month 

the employee is provided a qualified small employer health 

19 

reimbursement arrangement which constitutes affordable 

coverage. 

(B) DENIAL OF DOUBLE BENEFIT.—In the case of any employee who is provided a qualified small employer health 

reimbursement arrangement for any coverage month (determined without regard to subparagraph (A)), the credit 

otherwise allowable under subsection (a) to the taxpayer 

for such month shall be reduced (but not below zero) by 

the amount described in subparagraph (C)(i)(II) for such 

month. 

(C) AFFORDABLE COVERAGE.—For purposes of subparagraph (A), a qualified small employer health reimbursement arrangement shall be treated as constituting affordable coverage for a month if— 

(i) the excess of— 

(I) the amount that would be paid by the employee as the premium for such month for selfonly coverage under the second lowest cost silver 

plan offered in the relevant individual health insurance market, over 

(II) 1⁄12 of the employee’s permitted benefit (as 

defined in section 9831(d)(3)(C)) under such arrangement, does not exceed— 

(ii) 1⁄12 of 9.5 percent of the employee’s household income. 

(D) QUALIFIED SMALL EMPLOYER HEALTH REIMBURSEMENT ARRANGEMENT.—For purposes of this paragraph, the 

term ‘‘qualified small employer health reimbursement arrangement’’ has the meaning given such term by section 

9831(d)(2). 

(E) COVERAGE FOR LESS THAN ENTIRE YEAR.—In the case 

of an employee who is provided a qualified small employer 

health reimbursement arrangement for less than an entire 

year, subparagraph (C)(i)(II) shall be applied by substituting ′′the number of months during the year for which 

such arrangement was provided′′ for ′′12’. 

(F) INDEXING.—In the case of plan years beginning in 

any calendar year after 2014, the Secretary shall adjust 

the 9.5 percent amount under subparagraph (C)(ii) in the 

same manner as the percentages are adjusted under subsection (b)(3)(A)(ii). 

(d) TERMS RELATING TO INCOME AND FAMILIES.—For purposes of 

this section— 

(1) FAMILY SIZE.—The family size involved with respect to 

any taxpayer shall be equal to the number of individuals for 

whom the taxpayer is allowed a deduction under section 151 

(relating to allowance of deduction for personal exemptions) for 

the taxable year. 

(2) HOUSEHOLD INCOME.— 

(A) HOUSEHOLD INCOME.—The term ‘‘household income’’ 

means, with respect to any taxpayer, an amount equal to 

the sum of— 

(i) the modified adjusted gross income of the taxpayer, plus 

20 

(ii) the aggregate modified adjusted gross incomes of 

all other individuals who— 

(I) were taken into account in determining the 

taxpayer’s family size under paragraph (1), and 

(II) were required to file a return of tax imposed 

by section 1 for the taxable year. 

(B) MODIFIED ADJUSTED GROSS INCOME.—The term 

‘‘modified adjusted gross income’’ means adjusted gross income increased by— 

(i) any amount excluded from gross income under 

section 911, 

(ii) any amount of interest received or accrued by 

the taxpayer during the taxable year which is exempt 

from tax, and 

(iii) an amount equal to the portion of the taxpayer’s 

social security benefits (as defined in section 86(d)) 

which is not included in gross income under section 86 

for the taxable year. 

(3) POVERTY LINE.— 

(A) IN GENERAL.—The term ‘‘poverty line’’ has the meaning given that term in section 2110(c)(5) of the Social Security Act (42 U.S.C. 1397jj(c)(5)). 

(B) POVERTY LINE USED.—In the case of any qualified 

health plan offered through an Exchange for coverage during a taxable year beginning in a calendar year, the poverty line used shall be the most recently published poverty 

line as of the 1st day of the regular enrollment period for 

coverage during such calendar year. 

(e) RULES FOR INDIVIDUALS NOT LAWFULLY PRESENT.— 

(1) IN GENERAL.—If 1 or more individuals for whom a taxpayer is allowed a deduction under section 151 (relating to allowance of deduction for personal exemptions) for the taxable 

year (including the taxpayer or his spouse) are individuals who 

are not lawfully present— 

(A) the aggregate amount of premiums otherwise taken 

into account under clauses (i) and (ii) of subsection 

(b)(2)(A) shall be reduced by the portion (if any) of such 

premiums which is attributable to such individuals, and 

(B) for purposes of applying this section, the determination as to what percentage a taxpayer’s household income 

bears to the poverty level for a family of the size involved 

shall be made under one of the following methods: 

(i) A method under which— 

(I) the taxpayer’s family size is determined by 

not taking such individuals into account, and 

(II) the taxpayer’s household income is equal to 

the product of the taxpayer’s household income 

(determined without regard to this subsection) 

and a fraction— 

(aa) the numerator of which is the poverty 

line for the taxpayer’s family size determined 

after application of subclause (I), and 

(bb) the denominator of which is the poverty line for the taxpayer’s family size determined without regard to subclause (I). 

21 

(ii) A comparable method reaching the same result 

as the method under clause (i). 

(2) LAWFULLY PRESENT.—For purposes of this section, an individual shall be treated as lawfully present only if the individual is, and is reasonably expected to be for the entire period 

of enrollment for which the credit under this section is being 

claimed, a citizen or national of the United States or an alien 

lawfully present in the United States. 

(3) SECRETARIAL AUTHORITY.—The Secretary of Health and 

Human Services, in consultation with the Secretary, shall prescribe rules setting forth the methods by which calculations of 

family size and household income are made for purposes of this 

subsection. Such rules shall be designed to ensure that the 

least burden is placed on individuals enrolling in qualified 

health plans through an Exchange and taxpayers eligible for 

the credit allowable under this section. 

(f) RECONCILIATION OF CREDIT AND ADVANCE CREDIT.— 

(1) IN GENERAL.—The amount of the credit allowed under 

this section for any taxable year shall be reduced (but not 

below zero) by the amount of any advance payment of such 

credit under section 1412 of the Patient Protection and Affordable Care Act. 

(2) EXCESS ADVANCE PAYMENTS.— 

(A) IN GENERAL.—If the advance payments to a taxpayer 

under section 1412 of the Patient Protection and Affordable Care Act for a taxable year exceed the credit allowed 

by this section (determined without regard to paragraph 

(1)), the tax imposed by this chapter for the taxable year 

shall be increased by the amount of such excess. 

(B) LIMITATION ON INCREASE.— 

(i) IN GENERAL.—In the case of a taxpayer whose 

household income is less than 400 percent of the poverty line for the size of the family involved for the taxable year, the amount of the increase under subparagraph (A) shall in no event exceed the applicable dollar amount determined in accordance with the following table (one-half of such amount in the case of a 

taxpayer whose tax is determined under section 1(c) 

for the taxable year): 

If the household income (expressed as a percent of poverty line) is: The applicable dollar amount is: 

Less than 200% $600 

At least 200% but less than 300% $1,500 

At least 300% but less than 400% $2,500 

(ii) INDEXING OF AMOUNT.—In the case of any calendar year beginning after 2014, each of the dollar 

amounts in the table contained under clause (i) shall 

be increased by an amount equal to— 

(I) such dollar amount, multiplied by 

(II) the cost-of-living adjustment determined 

under section 1(f)(3) for the calendar year, deterVerDate Sep 11 2014 06:22 Jun 06, 2017 Jkt 069006 PO 00000 Frm 00021 Fmt 6659 Sfmt 6602 E:\HR\OC\HR161P1.XXX HR161P1
22 

mined by substituting ‘‘calendar year 2013’’ for 

‘‘calendar year 1992’’ in subparagraph (B) thereof. 

If the amount of any increase under clause (i) is not 

a multiple of $50, such increase shall be rounded to 

the next lowest multiple of $50. 

(3) INFORMATION REQUIREMENT.—Each Exchange (or any 

person carrying out 1 or more responsibilities of an Exchange 

under section 1311(f)(3) or 1321(c) of the Patient Protection 

and Affordable Care Act) shall provide the following information to the Secretary and to the taxpayer with respect to any 

health plan provided through the Exchange: 

(A) The level of coverage described in section 1302(d) of 

the Patient Protection and Affordable Care Act and the period such coverage was in effect. 

(B) The total premium for the coverage without regard 

to the credit under this section or cost-sharing reductions 

under section 1402 of such Act. 

(C) The aggregate amount of any advance payment of 

such credit or reductions under section 1412 of such Act. 

(D) The name, address, and TIN of the primary insured 

and the name and TIN of each other individual obtaining 

coverage under the policy. 

(E) Any information provided to the Exchange, including 

any change of circumstances, necessary to determine eligibility for, and the amount of, such credit. 

(F) Information necessary to determine whether a taxpayer has received excess advance payments. 

(g) VERIFICATION OF STATUS IN UNITED STATES FOR ADVANCE

PAYMENT.—No advance payment of the credit allowed under this 

section with respect to any premium under subsection (b)(2)(A) with 

respect to any individual shall be made under section 1412 of the 

Patient Protection and Affordable Care Act unless the Secretary has 

received confirmation from the Secretary of Health and Human 

Services that the Commissioner of Social Security or the Secretary 

of Homeland Security has verified under section 1411(c)(2) of such 

Act the individual’s status as a citizen or national of the United 

States or an alien lawfully present in the United States using a 

process that includes the appropriate use of information related to 

citizenship or immigration status, such as social security account 

numbers (but not individual taxpayer identification numbers). 

ø(g)¿ (h) REGULATIONS.—The Secretary shall prescribe such regulations as may be necessary to carry out the provisions of this section, including regulations which provide for— 

(1) the coordination of the credit allowed under this section 

with the program for advance payment of the credit under section 1412 of the Patient Protection and Affordable Care Act, 

and 

(2) the application of subsection (f) where the filing status of 

the taxpayer for a taxable year is different from such status 

used for determining the advance payment of the credit. 

øThe following shows proposed changes to section 36B of the Internal Revenue Code of 1986 as such section is proposed to read after 

amendment by section 214 of the American Health Care Act of 

2017 (H.R. 1628, as engrossed in the House):¿ 

23 

SEC. 36B. REFUNDABLE CREDIT FOR COVERAGE UNDER A QUALIFIED 

HEALTH PLAN. 

(a) ALLOWANCE OF PREMIUM TAX CREDIT.—In the case of an individual, there shall be allowed as a credit against the tax imposed 

by this subtitle for the taxable year the sum of the monthly credit 

amounts with respect to such taxpayer for calendar months during 

such taxable year which are eligible coverage months appropriately 

taken into account under subsection (b)(2) with respect to the taxpayer or any qualifying family member of the taxpayer. 

(b) MONTHLY CREDIT AMOUNTS.— 

(1) IN GENERAL.—The monthly credit amount with respect to 

any taxpayer for any calendar month is the lesser of— 

(A) the sum of the monthly limitation amounts determined under subsection (c) with respect to the taxpayer 

and the taxpayer’s qualifying family members for such 

month, or 

(B) the amount paid for a qualified health plan for the 

taxpayer and the taxpayer’s qualifying family members for 

such month. 

(2) ELIGIBLE COVERAGE MONTH REQUIREMENT.—No amount 

shall be taken into account under subparagraph (A) or (B) of 

paragraph (1) with respect to any individual for any month unless such month is an eligible coverage month with respect to 

such individual. 

(c) MONTHLY LIMITATION AMOUNTS.— 

(1) IN GENERAL.—The monthly limitation amount with respect to any individual for any eligible coverage month during 

any taxable year is 1⁄12 of— 

(A) $2,000 in the case of an individual who has not attained age 30 as of the beginning of such taxable year, 

(B) $2,500 in the case of an individual who has attained 

age 30 but who has not attained age 40 as of such time, 

(C) $3,000 in the case of an individual who has attained 

age 40 but who has not attained age 50 as of such time, 

(D) $3,500 in the case of an individual who has attained 

age 50 but who has not attained age 60 as of such time, 

and 

(E) $4,000 in the case of an individual who has attained 

age 60 as of such time. 

(2) LIMITATION BASED ON MODIFIED ADJUSTED GROSS INCOME.—The credit allowed under subsection (a) with respect to 

any taxpayer for any taxable year shall be reduced (but not 

below zero) by 10 percent of the excess (if any) of— 

(A) the taxpayer’s modified adjusted gross income (as defined in section 36B(d)(2)(B), as in effect for taxable years 

beginning before January 1, 2020) for such taxable year, 

over 

(B) $75,000 (twice such amount in the case of a joint return). 

(3) OTHER LIMITATIONS.— 

(A) AGGREGATE DOLLAR LIMITATION.—The sum of the 

monthly limitation amounts taken into account under this 

section with respect to any taxpayer for any taxable year 

shall not exceed $14,000. 

24 

(B) MAXIMUM NUMBER OF INDIVIDUALS TAKEN INTO ACCOUNT.—With respect to any taxpayer for any month, 

monthly limitation amounts shall be taken into account 

under this section only with respect to the 5 oldest individuals with respect to whom monthly limitation amounts 

could (without regard to this subparagraph) otherwise be 

so taken into account. 

(d) ELIGIBLE COVERAGE MONTH.—For purposes of this section, 

the term ‘‘eligible coverage month’’ means, with respect to any individual, any month if, as of the first day of such month, the individual meets the following requirements: 

(1) The individual is covered by a health insurance coverage 

which is certified by the State in which such insurance is offered as coverage that meets the requirements for qualified 

health plans under subsection (f). 

(2) The individual is not eligible for— 

(A) coverage under a group health plan (within the 

meaning of section 5000(b)(1)) other than coverage under 

a plan substantially all of the coverage of which is of excepted benefits described in section 9832(c), or 

(B) coverage described in section 5000A(f)(1)(A). 

(3) The individual is either— 

(A) a citizen or national of the United States, or 

(B) a qualified alien (within the meaning of section 431 

of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1641)). 

(4) The individual is not incarcerated, other than incarceration pending the disposition of charges. 

(e) QUALIFYING FAMILY MEMBER.—For purposes of this section, 

the term ‘‘qualifying family member’’ means— 

(1) in the case of a joint return, the taxpayer’s spouse, 

(2) any dependent of the taxpayer, and 

(3) with respect to any eligible coverage month, any child (as 

defined in section 152(f)(1)) of the taxpayer who as of the end 

of the taxable year has not attained age 27 if such child is covered for such month under a qualified health plan which also 

covers the taxpayer (in the case of a joint return, either 

spouse). 

(f) QUALIFIED HEALTH PLAN.—For purposes of this section, the 

term ‘‘qualified health plan’’ means any health insurance coverage 

(as defined in section 9832(b)) if— 

(1) such coverage is offered in the individual health insurance market within a State (within the meaning of section 

5000A(f)(1)(C)), 

(2) substantially all of such coverage is not of excepted benefits described in section 9832(c), 

(3) such coverage does not consist of short-term limited duration insurance (within the meaning of section 2791(b)(5) of the 

Public Health Service Act), 

(4) such coverage is not a grandfathered health plan (as defined in section 1251 of the Patient Protection and Affordable 

Care Act) or a grandmothered health plan (as defined in section 36B(c)(3)(C) as in effect for taxable years beginning before 

January 1, 2020), and 

25 

(5) such coverage does not include coverage for abortions 

(other than any abortion necessary to save the life of the mother or any abortion with respect to a pregnancy that is the result of an act of rape or incest). 

(g) SPECIAL RULES.— 

(1) MARRIED COUPLES MUST FILE JOINT RETURN.— 

(A) IN GENERAL.—Except as provided in subparagraph 

(B), if the taxpayer is married (within the meaning of section 7703) at the close of the taxable year, no credit shall 

be allowed under this section to such taxpayer unless such 

taxpayer and the taxpayer’s spouse file a joint return for 

such taxable year. 

(B) EXCEPTION FOR CERTAIN TAXPAYERS.—Subparagraph 

(A) shall not apply to any married taxpayer who— 

(i) is living apart from the taxpayer’s spouse at the 

time the taxpayer files the tax return, 

(ii) is unable to file a joint return because such taxpayer is a victim of domestic abuse or spousal abandonment, 

(iii) certifies on the tax return that such taxpayer 

meets the requirements of clauses (i) and (ii), and 

(iv) has not met the requirements of clauses (i), (ii), 

and (iii) for each of the 3 preceding taxable years. 

(2) DENIAL OF CREDIT TO DEPENDENTS.— 

(A) IN GENERAL.—No credit shall be allowed under this 

section to any individual who is a dependent with respect 

to another taxpayer for a taxable year beginning in the 

calendar year in which such individual’s taxable year begins. 

(B) COORDINATION WITH RULE FOR OLDER CHILDREN.—In 

the case of any individual who is a qualifying family member described in subsection (e)(3) with respect to another 

taxpayer for any month, in determining the amount of any 

credit allowable to such individual under this section for 

any taxable year of such individual which includes such 

month, the monthly limitation amount with respect to 

such individual for such month shall be zero and no 

amount paid for any qualified health plan with respect to 

such individual for such month shall be taken into account. 

(3) COORDINATION WITH MEDICAL EXPENSE DEDUCTION.— 

Amounts described in subsection (b)(1)(B) with respect to any 

month shall not be taken into account in determining the deduction allowed under section 213 except to the extent that 

such amounts exceed the amount described in subsection 

(b)(1)(A) with respect to such month. 

(4) COORDINATION WITH ADVANCE PAYMENTS OF CREDIT.— 

With respect to any taxable year— 

(A) the amount which would (but for this subsection) be 

allowed as a credit to the taxpayer under subsection (a) 

shall be reduced (but not below zero) by the aggregate 

amount paid on behalf of such taxpayer under section 1412 

of the Patient Protection and Affordable Care Act for 

months beginning in such taxable year, and 

26 

(B) the tax imposed by section 1 for such taxable year 

shall be increased by the excess (if any) of— 

(i) the aggregate amount paid on behalf of such taxpayer under such section 1412 for months beginning 

in such taxable year, over 

(ii) the amount which would (but for this subsection) 

be allowed as a credit to the taxpayer under subsection (a). 

(5) SPECIAL RULES FOR QUALIFIED SMALL EMPLOYER HEALTH

REIMBURSEMENT ARRANGEMENTS.— 

(A) IN GENERAL.—If the taxpayer or any qualifying family member of the taxpayer is provided a qualified small 

employer health reimbursement arrangement for an eligible coverage month, the sum determined under subsection 

(b)(1)(A) with respect to the taxpayer shall be reduced (but 

not below zero) by 1⁄12 of the permitted benefit (as defined 

in section 9831(d)(3)(C)) under such arrangement for each 

such month such arrangement is provided to such taxpayer. 

(B) QUALIFIED SMALL EMPLOYER HEALTH REIMBURSEMENT ARRANGEMENT.—For purposes of this paragraph, the 

term ‘‘qualified small employer health reimbursement arrangement’’ has the meaning given such term by section 

9831(d)(2). 

(C) COVERAGE FOR LESS THAN ENTIRE YEAR.—In the case 

of an employee who is provided a qualified small employer 

health reimbursement arrangement for less than an entire 

year, subparagraph (A) shall be applied by substituting 

‘‘the number of months during the year for which such arrangement was provided’’ for ‘‘12’’. 

(6) CERTAIN RULES RELATED TO NONQUALIFIED HEALTH

PLANS.—The rules of section 36B(c)(3)(D), as in effect for taxable years beginning before January 1, 2020, shall apply with 

respect to subsection (f)(5). 

(7) INFLATION ADJUSTMENT.— 

(A) IN GENERAL.—In the case of any taxable year beginning in a calendar year after 2020, each dollar amount in 

subsection (c)(1), the $75,000 amount in subsection 

(c)(2)(B), and the dollar amount in subsection (c)(3)(A), 

shall be increased by an amount equal to— 

(i) such dollar amount, multiplied by 

(ii) the cost-of-living adjustment determined under 

section 1(f)(3) for the calendar year in which the taxable year begins, determined— 

(I) by substituting ‘‘calendar year 2019’’ for ‘‘calendar year 1992’’ in subparagraph (B) thereof, and 

(II) by substituting for the CPI referred to section 1(f)(3)(A) the amount that such CPI would 

have been if the annual percentage increase in 

CPI with respect to each year after 2019 had been 

one percentage point greater. 

(B) TERMS RELATED TO CPI.— 

(i) ANNUAL PERCENTAGE INCREASE.—For purposes of 

subparagraph (A)(ii)(II), the term ‘‘annual percentage 

27 

increase’’ means the percentage (if any) by which CPI 

for any year exceeds CPI for the prior year. 

(ii) OTHER TERMS.—Terms used in this paragraph 

which are also used in section 1(f)(3) shall have the 

same meanings as when used in such section. 

(C) ROUNDING.—Any increase determined under subparagraph (A) shall be rounded to the nearest multiple of 

$50. 

(8) RULES RELATED TO STATE CERTIFICATION OF QUALIFIED

HEALTH PLANS.—A certification shall not be taken into account 

under subsection (d)(1) unless such certification is made available to the public and meets such other requirements as the 

Secretary may provide. 

(9) REGULATIONS.—The Secretary may prescribe such regulations and other guidance as may be necessary or appropriate 

to carry out this section and section 1412 of the Patient Protection and Affordable Care Act. 

(h) VERIFICATION OF STATUS IN UNITED STATES FOR ADVANCE

PAYMENT.—No advance payment of the credit allowed under this 

section with respect to any amount under subparagraph (A) or (B) 

of subsection (b)(1) with respect to any individual shall be made 

under section 1412 of the Patient Protection and Affordable Care 

Act unless the Secretary has received confirmation from the Secretary of Health and Human Services that the Commissioner of Social Security or the Secretary of Homeland Security has verified 

under section 1411(c)(2) of such Act the individual’s status as a citizen or national of the United States or a qualified alien (within the 

meaning of section 431 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 1641)) using a process that includes the appropriate use of information related to citizenship or immigration status, such as social security account numbers (but not individual taxpayer identification numbers). 

* * * * * * * 

SECTION 2710A OF THE PUBLIC HEALTH SERVICE ACT 

øThe following shows proposed changes to section 2710A of the 

Public Health Service Act as such section is proposed to read after 

amendment by section 133 of the American Health Care Act of 

2017 (H.R. 1628, as engrossed in the House):¿ 

SEC. 2710A. ENCOURAGING CONTINUOUS HEALTH INSURANCE COVERAGE. 

(a) PENALTY APPLIED.— 

(1) IN GENERAL.—Subject to the succeeding provisions of this 

section, a health insurance issuer offering health insurance 

coverage in the individual market shall, in the case of an individual who is an applicable policyholder of such coverage with 

respect to an enforcement period applicable to enrollments for 

a plan year beginning with plan year 2019 (or, in the case of 

enrollments during a special enrollment period, beginning with 

plan year 2018), increase the monthly premium rate otherwise 

applicable to such individual for such coverage during each 

month of such period, by an amount determined under paragraph (2). 

28 

(2) AMOUNT OF PENALTY.—The amount determined under 

this paragraph for an applicable policyholder enrolling in 

health insurance coverage described in paragraph (1) for a plan 

year, with respect to each month during the enforcement period applicable to enrollments for such plan year, is the 

amount that is equal to 30 percent of the monthly premium 

rate otherwise applicable to such applicable policyholder for 

such coverage during such month. 

(b) DEFINITIONS.—For purposes of this section: 

(1) APPLICABLE POLICYHOLDER.—The term ‘‘applicable policyholder’’ means, with respect to months of an enforcement period and health insurance coverage, an individual who— 

(A) is a policyholder of such coverage for such months; 

(B) cannot demonstrate that (through presentation of 

certifications described in section 2704(e) or in such other 

manner as may be specified in regulations, such as a return or statement made under section 6055(d) or 36B of 

the Internal Revenue Code of 1986), during the look-back 

period that is with respect to such enforcement period, 

there was not a period of at least 63 continuous days during which the individual did not have creditable coverage 

(as defined in paragraph (1) of section 2704(c) and credited 

in accordance with paragraphs (2) and (3) of such section); 

and 

(C) in the case of an individual who had been enrolled 

under dependent coverage under a group health plan or 

health insurance coverage by reason of section 2714 and 

such dependent coverage of such individual ceased because 

of the age of such individual, is not enrolling during the 

first open enrollment period following the date on which 

such coverage so ceased. 

In the case of an individual who applies for advance payment 

of a credit under section 1412 of the Patient Protection and Affordable Care Act and for whom a determination of eligibility 

for such advance payment is delayed by reason of the requirement for verification of the individual’s status in the United 

States under section 1411(c)(2) of such Act, the period of days 

beginning with the date of application for advance payment 

and ending with the date of such verification shall not be taken 

into account in applying subparagraph (B). The Secretary shall 

establish a procedure by which information relating to this period is provided to the individual. 

(2) LOOK-BACK PERIOD.—The term ‘‘look-back period’’ means, 

with respect to an enforcement period applicable to an enrollment of an individual for a plan year beginning with plan year 

2019 (or, in the case of an enrollment of an individual during 

a special enrollment period, beginning with plan year 2018) in 

health insurance coverage described in subsection (a)(1), the 

12-month period ending on the date the individual enrolls in 

such coverage for such plan year. 

(3) ENFORCEMENT PERIOD.—The term ‘‘enforcement period’’ 

means— 

(A) with respect to enrollments during a special enrollment period for plan year 2018, the period beginning with 

the first month that is during such plan year and that beVerDate Sep 11 2014 06:22 Jun 06, 2017 Jkt 069006 PO 00000 Frm 00028 Fmt 6659 Sfmt 6601 E:\HR\OC\HR161P1.XXX HR161P1
29 

gins subsequent to such date of enrollment, and ending 

with the last month of such plan year; and 

(B) with respect to enrollments for plan year 2019 or a 

subsequent plan year, the 12-month period beginning on 

the first day of the respective plan year. 

* * * * * * * 

PATIENT PROTECTION AND AFFORDABLE CARE ACT 

* * * * * * * 

TITLE I—QUALITY, AFFORDABLE 

HEALTH CARE FOR ALL AMERICANS 

* * * * * * * 

Subtitle E—Affordable Coverage Choices 

for All Americans 

PART I—PREMIUM TAX CREDITS AND COSTSHARING REDUCTIONS 

* * * * * * * 

Subpart B—Eligibility Determinations 

øThe following shows proposed changes to current law section 1411 

of the Patient Protection and Affordable Care Act:¿ 

SEC. 1411. PROCEDURES FOR DETERMINING ELIGIBILITY FOR EXCHANGE PARTICIPATION, PREMIUM TAX CREDITS AND 

REDUCED COST-SHARING, AND INDIVIDUAL RESPONSIBILITY EXEMPTIONS. 

(a) ESTABLISHMENT OF PROGRAM.—The Secretary shall establish 

a program meeting the requirements of this section for determining— 

(1) whether an individual who is to be covered in the individual market by a qualified health plan offered through an 

Exchange, or who is claiming a premium tax credit or reduced 

cost-sharing, meets the requirements of sections 1312(f)(3), 

1402(e), and 1412(d) of this title and section 36B(e) of the Internal Revenue Code of 1986 that the individual be a citizen 

or national of the United States or an alien lawfully present 

in the United States; 

(2) in the case of an individual claiming a premium tax credit or reduced cost-sharing under section 36B of such Code or 

section 1402— 

(A) whether the individual meets the income and coverage requirements of such sections; and 

(B) the amount of the tax credit or reduced cost-sharing; 

(3) whether an individual’s coverage under an employersponsored health benefits plan is treated as unaffordable under 

sections 36B(c)(2)(C) and 5000A(e)(2); and 

30 

(4) whether to grant a certification under section 

1311(d)(4)(H) attesting that, for purposes of the individual responsibility requirement under section 5000A of the Internal 

Revenue Code of 1986, an individual is entitled to an exemption from either the individual responsibility requirement or 

the penalty imposed by such section. 

(b) INFORMATION REQUIRED TO BE PROVIDED BY APPLICANTS.— (1) IN GENERAL.—An applicant for enrollment in a qualified 

health plan offered through an Exchange in the individual 

market shall provide— 

(A) the name, address, and date of birth of each individual who is to be covered by the plan (in this subsection 

referred to as an ‘‘enrollee’’); and 

(B) the information required by any of the following 

paragraphs that is applicable to an enrollee. 

(2) CITIZENSHIP OR IMMIGRATION STATUS.—The following information shall be provided with respect to every enrollee: 

(A) In the case of an enrollee whose eligibility is based 

on an attestation of citizenship of the enrollee, the enrollee’s social security number. 

(B) In the case of an individual whose eligibility is based 

on an attestation of the enrollee’s immigration status, the 

enrollee’s social security number (if applicable) and such 

identifying information with respect to the enrollee’s immigration status as the Secretary, after consultation with the 

Secretary of Homeland Security, determines appropriate. 

(3) ELIGIBILITY AND AMOUNT OF TAX CREDIT OR REDUCED

COST-SHARING.—In the case of an enrollee with respect to 

whom a premium tax credit or reduced cost-sharing under section 36B of such Code or section 1402 is being claimed, the following information: 

(A) INFORMATION REGARDING INCOME AND FAMILY SIZE.— 

The information described in section 6103(l)(21) for the 

taxable year ending with or within the second calendar 

year preceding the calendar year in which the plan year 

begins. 

(B) CERTAIN INDIVIDUAL HEALTH INSURANCE POLICIES OB- TAINED THROUGH SMALL EMPLOYERS.—The amount of the 

enrollee’s permitted benefit (as defined in section 

9831(d)(3)(C) of the Internal Revenue Code of 1986) under 

a qualified small employer health reimbursement arrangement (as defined in section 9831(d)(2) of such Code). 

(C) CHANGES IN CIRCUMSTANCES.—The information described in section 1412(b)(2), including information with 

respect to individuals who were not required to file an income tax return for the taxable year described in subparagraph (A) or individuals who experienced changes in marital status or family size or significant reductions in income. 

(4) EMPLOYER-SPONSORED COVERAGE.—In the case of an enrollee with respect to whom eligibility for a premium tax credit 

under section 36B of such Code or cost-sharing reduction under 

section 1402 is being established on the basis that the enrollee’s (or related individual’s) employer is not treated under section 36B(c)(2)(C) of such Code as providing minimum essential 

31 

coverage or affordable minimum essential coverage, the following information: 

(A) The name, address, and employer identification number (if available) of the employer. 

(B) Whether the enrollee or individual is a full-time employee and whether the employer provides such minimum 

essential coverage. 

(C) If the employer provides such minimum essential 

coverage, the lowest cost option for the enrollee’s or individual’s enrollment status and the enrollee’s or individual’s 

required contribution (within the meaning of section 

5000A(e)(1)(B) of such Code) under the employer-sponsored 

plan. 

(D) If an enrollee claims an employer’s minimum essential coverage is unaffordable, the information described in 

paragraph (3). 

If an enrollee changes employment or obtains additional employment while enrolled in a qualified health plan for which 

such credit or reduction is allowed, the enrollee shall notify the 

Exchange of such change or additional employment and provide the information described in this paragraph with respect 

to the new employer. 

(5) EXEMPTIONS FROM INDIVIDUAL RESPONSIBILITY REQUIREMENTS.—In the case of an individual who is seeking an exemption certificate under section 1311(d)(4)(H) from any requirement or penalty imposed by section 5000A, the following information: 

(A) In the case of an individual seeking exemption based 

on the individual’s status as a member of an exempt religious sect or division, as a member of a health care sharing ministry, as an Indian, or as an individual eligible for 

a hardship exemption, such information as the Secretary 

shall prescribe. 

(B) In the case of an individual seeking exemption based 

on the lack of affordable coverage or the individual’s status 

as a taxpayer with household income less than 100 percent 

of the poverty line, the information described in paragraphs (3) and (4), as applicable. 

(c) VERIFICATION OF INFORMATION CONTAINED IN RECORDS OF

SPECIFIC FEDERAL OFFICIALS.— 

(1) INFORMATION TRANSFERRED TO SECRETARY.—An Exchange shall submit the information provided by an applicant 

under subsection (b) to the Secretary for verification in accordance with the requirements of this subsection and subsection 

(d). 

(2) CITIZENSHIP OR IMMIGRATION STATUS.— 

(A) COMMISSIONER OF SOCIAL SECURITY.—The Secretary 

shall submit to the Commissioner of Social Security the 

following information for a determination as to whether 

the information provided is consistent with the information in the records of the Commissioner: 

(i) The name, date of birth, and social security number of each individual for whom such information was 

provided under subsection (b)(2). 

32 

(ii) The attestation of an individual that the individual is a citizen. 

(B) SECRETARY OF HOMELAND SECURITY.— (i) IN GENERAL.—In the case of an individual— 

(I) who attests that the individual is an alien 

lawfully present in the United States; or 

(II) who attests that the individual is a citizen 

but with respect to whom the Commissioner of Social Security has notified the Secretary under subsection (e)(3) that the attestation is inconsistent 

with information in the records maintained by the 

Commissioner; 

the Secretary shall submit to the Secretary of Homeland Security the information described in clause (ii) 

for a determination as to whether the information provided is consistent with the information in the records 

of the Secretary of Homeland Security. 

(ii) INFORMATION.—The information described in 

clause (ii) is the following: 

(I) The name, date of birth, and any identifying 

information with respect to the individual’s immigration status provided under subsection (b)(2). 

(II) The attestation that the individual is an 

alien lawfully present in the United States or in 

the case of an individual described in clause (i)(II), 

the attestation that the individual is a citizen. 

(3) ELIGIBILITY FOR TAX CREDIT AND COST-SHARING REDUC- TION.—The Secretary shall submit the information described in 

subsection (b)(3)(A) provided under paragraph (3), (4), or (5) of 

subsection (b) to the Secretary of the Treasury for verification 

of household income and family size for purposes of eligibility. 

(4) METHODS.— 

(A) IN GENERAL.—The Secretary, in consultation with 

the Secretary of the Treasury, the Secretary of Homeland 

Security, and the Commissioner of Social Security, shall 

provide that verifications and determinations under this 

subsection shall be done— 

(i) through use of an on-line system or otherwise for 

the electronic submission of, and response to, the information submitted under this subsection with respect to an applicant; or 

(ii) by determining the consistency of the information submitted with the information maintained in the 

records of the Secretary of the Treasury, the Secretary 

of Homeland Security, or the Commissioner of Social 

Security through such other method as is approved by 

the Secretary. 

(B) FLEXIBILITY.—The Secretary may modify the methods used under the program established by this section for 

the Exchange and verification of information if the Secretary determines such modifications would reduce the administrative costs and burdens on the applicant, including 

allowing an applicant to request the Secretary of the 

Treasury to provide the information described in paragraph (3) directly to the Exchange or to the Secretary. The 

33 

Secretary shall not make any such modification unless the 

Secretary determines that any applicable requirements 

under this section and section 6103 of the Internal Revenue Code of 1986 with respect to the confidentiality, disclosure, maintenance, or use of information will be met. 

(d) VERIFICATION BY SECRETARY.—In the case of information provided under subsection (b) that is not required under subsection (c) 

to be submitted to another person for verification, the Secretary 

shall verify the accuracy of such information in such manner as the 

Secretary determines appropriate, including delegating responsibility for verification to the Exchange. 

(e) ACTIONS RELATING TO VERIFICATION.— 

(1) IN GENERAL.—Each person to whom the Secretary provided information under subsection (c) shall report to the Secretary under the method established under subsection (c)(4) 

the results of its verification and the Secretary shall notify the 

Exchange of such results. Each person to whom the Secretary 

provided information under subsection (d) shall report to the 

Secretary in such manner as the Secretary determines appropriate. 

(2) VERIFICATION.— 

(A) ELIGIBILITY FOR ENROLLMENT AND PREMIUM TAX

CREDITS AND COST-SHARING REDUCTIONS.—If information 

provided by an applicant under paragraphs (1), (2), (3), 

and (4) of subsection (b) is verified under subsections (c) 

and (d)— 

(i) the individual’s eligibility to enroll through the 

Exchange and to apply for premium tax credits and 

cost-sharing reductions shall be satisfied; and 

(ii) the Secretary shall, if applicable, notify the Secretary of the Treasury under section 1412(c) of the 

amount of any advance payment to be made. 

(B) EXEMPTION FROM INDIVIDUAL RESPONSIBILITY.—If information provided by an applicant under subsection (b)(5) 

is verified under subsections (c) and (d), the Secretary 

shall issue the certification of exemption described in section 1311(d)(4)(H). 

(3) INCONSISTENCIES INVOLVING ATTESTATION OF CITIZENSHIP

OR LAWFUL PRESENCE.—If the information provided by any applicant under subsection (b)(2) is inconsistent with information 

in the records maintained by the Commissioner of Social Security or Secretary of Homeland Security, whichever is applicable, the applicant’s eligibility (other than eligibility for advance 

payment of a credit under section 1412) will be determined in 

the same manner as an individual’s eligibility under the medicaid program is determined under section 1902(ee) of the Social Security Act (as in effect on January 1, 2010). 

(4) INCONSISTENCIES INVOLVING OTHER INFORMATION.— 

(A) IN GENERAL.—If the information provided by an applicant under subsection (b) (other than subsection (b)(2)) 

is inconsistent with information in the records maintained 

by persons under subsection (c) or is not verified under 

subsection (d), the Secretary shall notify the Exchange and 

the Exchange shall take the following actions: 

34 

(i) REASONABLE EFFORT.—The Exchange shall make 

a reasonable effort to identify and address the causes 

of such inconsistency, including through typographical 

or other clerical errors, by contacting the applicant to 

confirm the accuracy of the information, and by taking 

such additional actions as the Secretary, through regulation or other guidance, may identify. 

(ii) NOTICE AND OPPORTUNITY TO CORRECT.—In the 

case the inconsistency or inability to verify is not resolved under subparagraph (A), the Exchange shall— 

(I) notify the applicant of such fact; 

(II) provide the applicant an opportunity to either present satisfactory documentary evidence or 

resolve the inconsistency with the person verifying 

the information under subsection (c) or (d) during 

the 90-day period beginning the date on which the 

notice required under subclause (I) is sent to the 

applicant. 

The Secretary may extend the 90-day period under 

subclause (II) for enrollments occurring during 2014. 

(B) SPECIFIC ACTIONS NOT INVOLVING CITIZENSHIP OR

LAWFUL PRESENCE.— (i) IN GENERAL.—Except as provided in paragraph 

(3), the Exchange shall, during any period before the 

close of the period under subparagraph (A)(ii)(II), 

make any determination under paragraphs (2), (3), 

and (4) of subsection (a) on the basis of the information contained on the application. 

(ii) ELIGIBILITY OR AMOUNT OF CREDIT OR REDUCTION.—If an inconsistency involving the eligibility for, 

or amount of, any premium tax credit or cost-sharing 

reduction is unresolved under this subsection as of the 

close of the period under subparagraph (A)(ii)(II), the 

Exchange shall notify the applicant of the amount (if 

any) of the credit or reduction that is determined on 

the basis of the records maintained by persons under 

subsection (c). 

(iii) EMPLOYER AFFORDABILITY.—If the Secretary notifies an Exchange that an enrollee is eligible for a 

premium tax credit under section 36B of such Code or 

cost-sharing reduction under section 1402 because the 

enrollee’s (or related individual’s) employer does not 

provide minimum essential coverage through an employer-sponsored plan or that the employer does provide that coverage but it is not affordable coverage, 

the Exchange shall notify the employer of such fact 

and that the employer may be liable for the payment 

assessed under section 4980H of such Code. 

(iv) EXEMPTION.—In any case where the inconsistency involving, or inability to verify, information provided under subsection (b)(5) is not resolved as of the 

close of the period under subparagraph (A)(ii)(II), the 

Exchange shall notify an applicant that no certification of exemption from any requirement or payment 

under section 5000A of such Code will be issued. 

35 

(C) APPEALS PROCESS.—The Exchange shall also notify 

each person receiving notice under this paragraph of the 

appeals processes established under subsection (f). 

(5) DELAY PERMITTED IN COVERAGE DATE IN CASE OF DELAY

IN VERIFICATION OF STATUS FOR INDIVIDUALS APPLYING FOR AD- VANCE PAYMENT OF CREDIT.—In the case of an individual whose 

eligibility for advance payments is delayed by reason of the requirement for verification under subsection (c)(2), if, for coverage to be effective as of the date requested in the individual’s 

application for enrollment, the individual would (but for this 

paragraph) be required to pay 2 or more months of retroactive 

premiums, the individual shall be provided the option to elect 

to postpone the effective date of coverage to the date that is not 

more than 1 month later than the date requested in the individual’s application for enrollment. 

(f) APPEALS AND REDETERMINATIONS.— 

(1) IN GENERAL.—The Secretary, in consultation with the 

Secretary of the Treasury, the Secretary of Homeland Security, 

and the Commissioner of Social Security, shall establish procedures by which the Secretary or one of such other Federal officers— 

(A) hears and makes decisions with respect to appeals of 

any determination under subsection (e); and 

(B) redetermines eligibility on a periodic basis in appropriate circumstances. 

(2) EMPLOYER LIABILITY.— (A) IN GENERAL.—The Secretary shall establish a separate appeals process for employers who are notified under 

subsection (e)(4)(C) that the employer may be liable for a 

tax imposed by section 4980H of the Internal Revenue 

Code of 1986 with respect to an employee because of a determination that the employer does not provide minimum 

essential coverage through an employer-sponsored plan or 

that the employer does provide that coverage but it is not 

affordable coverage with respect to an employee. Such 

process shall provide an employer the opportunity to— 

(i) present information to the Exchange for review of 

the determination either by the Exchange or the person making the determination, including evidence of 

the employer-sponsored plan and employer contributions to the plan; and 

(ii) have access to the data used to make the determination to the extent allowable by law. 

Such process shall be in addition to any rights of appeal 

the employer may have under subtitle F of such Code. 

(B) CONFIDENTIALITY.—Notwithstanding any provision of 

this title (or the amendments made by this title) or section 

6103 of the Internal Revenue Code of 1986, an employer 

shall not be entitled to any taxpayer return information 

with respect to an employee for purposes of determining 

whether the employer is subject to the penalty under section 4980H of such Code with respect to the employee, except that— 

(i) the employer may be notified as to the name of 

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come is above or below the threshold by which the affordability of an employer’s health insurance coverage 

is measured; and 

(ii) this subparagraph shall not apply to an employee who provides a waiver (at such time and in 

such manner as the Secretary may prescribe) authorizing an employer to have access to the employee’s taxpayer return information. 

(g) CONFIDENTIALITY OF APPLICANT INFORMATION.— (1) IN GENERAL.—An applicant for insurance coverage or for 

a premium tax credit or cost-sharing reduction shall be required to provide only the information strictly necessary to authenticate identity, determine eligibility, and determine the 

amount of the credit or reduction. 

(2) RECEIPT OF INFORMATION.—Any person who receives information provided by an applicant under subsection (b) 

(whether directly or by another person at the request of the applicant), or receives information from a Federal agency under 

subsection (c), (d), or (e), shall— 

(A) use the information only for the purposes of, and to 

the extent necessary in, ensuring the efficient operation of 

the Exchange, including verifying the eligibility of an individual to enroll through an Exchange or to claim a premium tax credit or cost-sharing reduction or the amount 

of the credit or reduction; and 

(B) not disclose the information to any other person except as provided in this section. 

(h) PENALTIES.— (1) FALSE OR FRAUDULENT INFORMATION.— 

(A) CIVIL PENALTY.— 

(i) IN GENERAL.—If— 

(I) any person fails to provides correct information under subsection (b); and 

(II) such failure is attributable to negligence or 

disregard of any rules or regulations of the Secretary, 

such person shall be subject, in addition to any other 

penalties that may be prescribed by law, to a civil penalty of not more than $25,000 with respect to any failures involving an application for a plan year. For purposes of this subparagraph, the terms ‘‘negligence’’ and 

‘‘disregard’’ shall have the same meanings as when 

used in section 6662 of the Internal Revenue Code of 

1986. 

(ii) REASONABLE CAUSE EXCEPTION.—No penalty 

shall be imposed under clause (i) if the Secretary determines that there was a reasonable cause for the 

failure and that the person acted in good faith. 

(B) KNOWING AND WILLFUL VIOLATIONS.—Any person 

who knowingly and willfully provides false or fraudulent 

information under subsection (b) shall be subject, in addition to any other penalties that may be prescribed by law, 

to a civil penalty of not more than $250,000. 

(2) IMPROPER USE OR DISCLOSURE OF INFORMATION.—Any 

person who knowingly and willfully uses or discloses informaVerDate Sep 11 2014 06:22 Jun 06, 2017 Jkt 069006 PO 00000 Frm 00036 Fmt 6659 Sfmt 6601 E:\HR\OC\HR161P1.XXX HR161P1
37 

tion in violation of subsection (g) shall be subject, in addition 

to any other penalties that may be prescribed by law, to a civil 

penalty of not more than $25,000. 

(3) LIMITATIONS ON LIENS AND LEVIES.—The Secretary (or, if 

applicable, the Attorney General of the United States) shall 

not— 

(A) file notice of lien with respect to any property of a 

person by reason of any failure to pay the penalty imposed 

by this subsection; or 

(B) levy on any such property with respect to such failure. 

(i) STUDY OF ADMINISTRATION OF EMPLOYER RESPONSIBILITY.— 

(1) IN GENERAL.—The Secretary of Health and Human Services shall, in consultation with the Secretary of the Treasury, 

conduct a study of the procedures that are necessary to ensure 

that in the administration of this title and section 4980H of the 

Internal Revenue Code of 1986 (as added by section 1513) that 

the following rights are protected: 

(A) The rights of employees to preserve their right to 

confidentiality of their taxpayer return information and 

their right to enroll in a qualified health plan through an 

Exchange if an employer does not provide affordable coverage. 

(B) The rights of employers to adequate due process and 

access to information necessary to accurately determine 

any payment assessed on employers. 

(2) REPORT.—Not later than January 1, 2013, the Secretary 

of Health and Human Services shall report the results of the 

study conducted under paragraph (1), including any recommendations for legislative changes, to the Committees on 

Finance and Health, Education, Labor and Pensions of the 

Senate and the Committees of Education and Labor and Ways 

and Means of the House of Representatives. 

* * * * * * * 

(38) 

VII. DISSENTING VIEWS 

H.R. 2581 (Barletta, R–PA) amends H.R. 1628, the American 

Health Care Act (AHCA), to require individuals to complete identity authentication by providing a Social Security number (SSN) 

(and disallowing the use of an Individual Taxpayer Identification 

number (ITIN)) before receiving any advanceable tax credit established by the AHCA, as well as advanced premium tax credits 

(APTC) provided under current law, and on any tax return claiming health insurance premium tax credits. The Barletta bill 

amends AHCA, which has not passed the Senate or been enacted 

into law. 

The Barletta bill fails to address the major, underlying flaws in 

the bill it amends. According to the nonpartisan, independent Congressional Budget Office (CBO), the AHCA would cause 23 million 

Americans to lose health insurance coverage, erode important consumer protections, and raise out-of-pocket health care costs for 

countless more Americans. H.R. 2581 does not address any of the 

problems that would undermine the health security for millions of 

working families. 

Instead, the Barletta bill could exacerbate the ability to access 

affordable coverage that would be created by the AHCA for working families by increasing administrative barriers, requiring more 

government paperwork, and reducing access to affordable coverage. 

Ultimately, for someone who is ill, delayed care could mean the difference between accessing life-saving treatment and going without 

much needed care. 

The Barletta bill fails to recognize unique circumstances of 

American families, forcing a one-size-fits-all approach to accessing 

financial help. Not all individuals who are eligible for tax credits 

have an SSN or are eligible to obtain an SSN that can be verified 

at the time of application. Some people, like newborns, may not 

have an SSN at the time their family applies on their behalf. Other 

individuals, like domestic violence survivors and survivors of 

human trafficking, may have no need to have an SSN related to 

work and would experience delays in accessing health coverage as 

a result of this requirement. 

Delays in the eligibility process would be significant because people must enroll during open enrollment or within a special enrollment period. People can enroll without premium tax credits (PTCs) 

but even one or two months of enrollment without PTCs could result in significant financial hardship. For some people, like newborn babies, the delay in obtaining an SSN will be modest (on average, four weeks). Other groups may experience far longer delays if 

they must take steps like getting a work authorization prior to 

being able to obtain an SSN. In fact, the legislation itself acknowledges that this new bureaucratic barrier could cause delays in accessing credits of more than two months. 

39 

Under current law, initial verification of eligibility for APTCs occurs at the time an individual applies for coverage through the 

Marketplace. If an individual does not have an SSN, or if there is 

a problem verifying the SSN, a secondary verification process occurs. Under the law, the agency needs to notify the consumer of the 

problem verifying eligibility, and the applicant has 90 days to provide documentation or otherwise address the issues. During this 

verification process, individuals are presumed eligible to enroll in 

Marketplace coverage and, if appropriate, also provided financial 

assistance. If the individual is unable to provide documentation of 

eligibility, coverage and financial assistance is terminated. Under 

current law, individuals are not left in the position of needing coverage but having to wait potentially months to receive verification 

of eligibility for tax credits to afford that coverage. 

This legislation would simply make it harder for individuals in 

need of financial assistance to purchase insurance coverage. Some 

people would forgo coverage due to the bureaucratic complications, 

and others would experience delays in accessing that coverage. 

No evidence exists that says the current process isn’t working or 

ineligible individuals fraudulently are claiming the APTCs. Rep. 

Barletta claims that 500,000 undocumented immigrants received 

$750 million in premium tax credits. These claims are false and 

there is no evidence that supports these allegations. 

As the source of information to support his claim, Rep. Barletta 

has pointed to a February 2016 majority staff report from the 

United States Senate Committee on Homeland Security and Governmental Affairs. However, this report does not make this claim, 

rather the report claims that ‘‘as of September 30, 2015, CMS 

awarded approximately $750 million in APTCs to individuals enrolled in FFMs who CMS later determined to be ineligible because 

the individuals failed to verify their citizenship, status as a national, or legal presence.’’ 

The report does not make the leap that these individuals are undocumented immigrants, rather it focuses on their termination 

being linked to failure to verify their status. There is no evidence 

that suggests these individuals were undocumented immigrants— 

only that they never got around to providing the remaining documentation to keep coverage. This could have happened for any 

number of reasons, for example, they could have abandoned the 

process because of securing a job with coverage or moving out of 

state. 

The number of people whose coverage was terminated for failure 

to provide necessary documentation continues to decline. Efforts 

have become more refined as the program matures, meaning fewer 

individuals are experiencing documentation problems, especially as 

electronic interfaces have improved. 

Democrats offered two amendments to highlight serious shortcomings with H.R. 2581 and the continued issue that President 

Trump has not released his tax returns. Both amendments were 

ruled non-germane by Chairman Kevin Brady (R–TX) and appealed 

by Democratic Members. The appeals were then defeated by partyline votes. 

Congresswoman Sanchez (D–CA) offered an amendment to stop 

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eral of the Department of Health and Human Services determines 

that more than three percent (3%) of American citizens eligible for 

APTCs experience a disbursement delay. By having an impartial 

organization certify this threshold, the amendment would protect 

American citizens from suffering a delay in the disbursement of 

their APTCs as a result of this bill. Specifically, this amendment 

would protect the many APTC-eligible American citizens most likely to suffer the unintended consequences of this bill. Low-income 

American citizens, particularly naturalized Americans from immigrant families, have a more difficult time producing the documentation needed to verify their citizenship. These Americans are also 

more likely to have errors in their records because of the spelling 

of their surnames or the number of people who share the same 

name. This common sense fix would ensure that those who need 

coverage the most, including newborn children, will not have to 

wait for our system to ‘‘verify’’ their status. 

Congressman Doggett (D–TX) offered an amendment to require 

President Trump to provide his tax returns under the Committee’s 

oversight authority. The Committee considered this matter previously. Congress, the Legislative Branch, has the responsibility 

and the authority to check the Executive Branch. As we have discussed, Section 6103 of the tax code allows for an examination of 

the President’s tax returns—authority put in place following the 

Teapot Dome scandal specifically so Congress could examine conflicts of interest in the Executive Branch. This is a genuine ‘‘Verify 

First’’ amendment. Before Congress assumes fraud and delays 

Americans’ access to health care, we need to verify first how much 

President Trump and his family would be enriched by changes 

made by the AHCA and how the many corporate entities over 

which he exercises control would be enriched. Moreover, we also 

need to know whether this is about personal enrichment of President Trump or if it is about the enrichment of our nation’s economy. We also should take this opportunity to verify that there is 

no other conflicts of interest as we move forward in legislation impacting the tax code. 

For the reasons stated above, Democrats opposed this legislation 

as it imposes additional and unnecessary bureaucratic paperwork 

on working families that are in need of financial assistance to afford their health insurance premiums. 

RICHARD E. NEAL, 

Ranking Member. 

Æ