39–008 

113TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 113–422 

PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 4414) TO CLARIFY 

THE TREATMENT UNDER THE PATIENT PROTECTION AND AFFORDABLE 

CARE ACT OF HEALTH PLANS IN WHICH EXPATRIATES ARE THE PRIMARY ENROLLEES, AND FOR OTHER PURPOSES 

APRIL 28, 2014.—Referred to the House Calendar and ordered to be printed 

Mr. BURGESS, from the Committee on Rules, 

submitted the following 

R E P O R T 

[To accompany H. Res. 555] 

The Committee on Rules, having had under consideration House 

Resolution 555, by a nonrecord vote, report the same to the House 

with the recommendation that the resolution be adopted. 

SUMMARY OF PROVISIONS OF THE RESOLUTION

The resolution provides for consideration of H.R. 4414, the Expatriate Health Coverage Clarification Act of 2014, under a closed 

rule. The resolution provides one hour of debate equally divided 

and controlled by the chair and ranking minority member of the 

Committee on Ways and Means. The resolution waives all points 

of order against consideration of the bill. The resolution provides 

that the amendment printed in this report shall be considered as 

adopted and the bill, as amended, shall be considered as read. The 

resolution waives all points of order against provisions in the bill, 

as amended. The resolution provides one motion to recommit with 

or without instructions. 

EXPLANATION OF WAIVERS

The waiver of all points of order against consideration of the bill 

includes a waiver of section 311 of the Congressional Budget Act 

of 1974, which prohibits consideration of legislation that would 

cause revenues to be less than the level of total revenues for the 

first fiscal year or for the total of that first fiscal year and the ensuing fiscal years for which allocations are provided. 

Although the resolution waives all points of order against provisions in the bill, as amended, the Committee is not aware of any 

points of order. The waiver is prophylactic in nature. 


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COMMITTEE VOTES

The results of each record vote on an amendment or motion to 

report, together with the names of those voting for and against, are 

printed below: 

Rules Committee record vote No. 127 

Motion by Mr. McGovern to report an open rule. Defeated: 3–7. 

Majority Members Vote Minority Members Vote 

Ms. Foxx ............................................................ Nay Ms. Slaughter .................................................. Yea 

Mr. Bishop of Utah .......................................... ................... Mr. McGovern ................................................... Yea 

Mr. Cole ............................................................ Nay Mr. Hastings of Florida ................................... ...................

Mr. Woodall ...................................................... Nay Mr. Polis ........................................................... Yea 

Mr. Nugent ....................................................... Nay 

Mr. Webster ...................................................... Nay 

Ms. Ros-Lehtinen ............................................. ...................

Mr. Burgess ...................................................... Nay 

Mr. Sessions, Chairman ................................... Nay 

SUMMARY OF THE AMENDMENT CONSIDERED AS ADOPTED

Nunes (CA), Carney (DE): Clarifies that an expatriate health 

plan offered by an employer must be actuarially similar or better 

than a domestic plan offered by the employer that meets the minimum value test defined in the Internal revenue code section 36B 

or in the case where the employer does not offer a domestic plan, 

the expatriate plan must at least meet minimum value. Clarifies 

that an expatriate health plan must make payments in two or 

more currencies, and the plans must comply with laws that existed 

prior to the passage of the Affordable Care Act. Clarifies that an 

individual must be abroad for at least 6 months in any 12 consecutive months to be qualified to enroll in an expatriate plan. 

TEXT OF AMENDMENT CONSIDERED AS ADOPTED

Page 2, line 7, strike ‘‘2011’’ and insert ‘‘2010’’. 

Page 5, beginning on line 23, amend subparagraph (D) to read 

as follows: 

(D) In the case of an expatriate health plan that is a 

group health plan offered by a plan sponsor that— 

(i) also offers a qualifying minimum value domestic 

group health plan, the plan sponsor reasonably believes that the benefits provided by the expatriate 

health plan are actuarially similar to, or better than, 

the benefits provided under a qualifying minimum 

value domestic group health plan offered by that plan 

sponsor; or 

(ii) does not also offer a qualifying minimum value 

domestic group health plan, the plan sponsor reasonably believes that the benefits provided by the expatriate health plan are actuarially similar to, or better 

than, the benefits provided under a qualifying minimum value domestic group health plan. 

Page 6, beginning on line 13, amend subparagraph (F) to read as 

follows: 

(F) The plan or coverage— 


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(i) is issued by an expatriate health plan issuer, or 

administered by an administrator, that maintains, 

with respect to such plan or coverage— 

(I) network provider agreements with health 

care providers that are outside of the United 

States; and 

(II) call centers in more than one country and 

accepts calls from customers in multiple languages; and 

(ii) offers reimbursements for items or services 

under such plan or coverage in more than two currencies. 

Page 6, after line 22, insert the following: 

(G) The plan or coverage, and the plan sponsor or expatriate health insurance issuer with respect to such plan or 

coverage, satisfies the provisions of title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.), chapter 

100 of the Internal Revenue Code of 1986, and part 7 of 

subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1181 et seq.), which would 

otherwise apply to such a plan or coverage, and sponsor or 

issuer, if not for the enactment of the Patient Protection 

and Affordable Care Act and title I and subtitle B of title 

II of the Health Care and Education Reconciliation Act of 

2010. 

Page 7, line 2, insert ‘‘an alien residing outside the United 

States,’’ after ‘‘who is’’. 

Page 7, line 8, strike ‘‘90 days’’ and insert ‘‘180 days’’. 

Page 7, beginning on line 9, strike ‘‘12 consecutive months of enrollment’’ and all that follows through line 12, and insert ‘‘12 consecutive months.’’ 

Page 7, beginning on line 20, amend paragraph (4) to read as follows: 

(4) QUALIFYING MINIMUM VALUE DOMESTIC GROUP HEALTH

PLAN.—The term ‘‘qualifying minimum value domestic group 

health plan’’ means a group health plan that is offered in the 

United States that meets the following requirements: 

(A) Substantially all of the primary enrollees in the plan 

are not qualified expatriates, with respect to such plan. 

(B) Substantially all of the benefits provided under the 

plan are not excepted benefits described in section 9832(c) 

of the Internal Revenue Code of 1986. 

(C) The application of section 36B(c)(2)(C)(ii) of such 

Code to such plan would not prevent an employee eligible 

for coverage under such plan from being treated as eligible 

for minimum essential coverage for purposes of section 

36B(c)(2)(B) of such Code. 

Æ 


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