II 

116TH CONGRESS 

2D SESSION S. 4557 

To support efforts to provide intensive, individualized assistance for enrolling 

in health care coverage. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 10, 2020 

Ms. BALDWIN (for herself, Mr. BOOKER, Ms. SMITH, Ms. CORTEZ MASTO, 

Ms. HIRONO, Mr. MERKLEY, Mr. BLUMENTHAL, and Ms. ROSEN) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To support efforts to provide intensive, individualized 

assistance for enrolling in health care coverage. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘COVid Enrollment Re5 sponse Act’’ or the ‘‘COVER Act’’. 

6 SEC. 2. INTENSIVE, INDIVIDUALIZED ASSISTANCE FOR EN7 ROLLING IN HEALTH CARE. 

8 Section 1311(i)(6) of the Patient Protection and Af9 fordable Care Act (42 U.S.C. 18031(i)(6)) is amended— 


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1 (1) by striking ‘‘Grants under this subsection 

2 shall be made from’’ and inserting the following: 

3 ‘‘(A) IN GENERAL.—Grants under this 

4 subsection shall be made from funds appro5 priated under subparagraph (B) and’’; and 

6 (2) by adding at the end thereof the following: 

7 ‘‘(B) APPROPRIATION.— 

8 ‘‘(i) AMOUNT.—Out of any funds in 

9 the Treasury not otherwise appropriated, 

10 there are hereby appropriated, to carry out 

11 this subsection, $150,000,000 for fiscal 

12 year 2020, and $600,000,000 for fiscal 

13 year 2021. 

14 ‘‘(ii) ALLOTMENTS.— 

15 ‘‘(I) IN GENERAL.—Payments of 

16 allotments under this subparagraph 

17 shall be made as soon as possible and 

18 remain available until expended. 

19 ‘‘(II) NUMBER OF UNINSURED.— 

20 Fifty percent of the funds appro21 priated under this subparagraph for a 

22 fiscal year shall be expended in annual 

23 allotments for a State and the District 

24 of Columbia in proportion to the num25 ber of uninsured individuals in such 


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1 State or District during calendar year 

2 2018, as demonstrated by American 

3 Community Survey State-level data. 

4 ‘‘(III) RECIPIENTS OF UNEM5 PLOYMENT INSURANCE.—Fifty per6 cent of the funds appropriated under 

7 this subparagraph for a fiscal year 

8 shall be expended in quarterly allot9 ments for a State and the District of 

10 Columbia in proportion to the average 

11 number of recipients of unemployment 

12 insurance in the State or Districts, in13 cluding all categories of assistance, 

14 during the most recent calendar quar15 ter for which data are available from 

16 the Department of Labor. 

17 ‘‘(iii) USE.—Notwithstanding any 

18 other provision of this subsection, funds 

19 described in this subparagraph shall be— 

20 ‘‘(I) used at any point during the 

21 calendar year to facilitate enrolling in22 dividuals into and maintaining indi23 viduals’ coverage in State Medicaid 

24 plans under title XIX of the Social 

25 Security Act, State Children’s Health 


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1 Insurance Programs under title XXI 

2 of such Act, qualified health plans, 

3 COBRA continuation coverage, group 

4 health plans offered to furloughed em5 ployees on the same terms they are of6 fered to other employees, and other 

7 health coverage programs sponsored 

8 by States and localities, with coun9 seling and assistance provided by enti10 ties that assume a fiduciary duty to 

11 act in such individuals’ best interests; 

12 ‘‘(II) used to develop relation13 ships with State workforce agencies 

14 (and, at the entity’s option, employ15 ers) through which an entity funded 

16 through this subparagraph reaches 

17 out to individuals losing employment 

18 and helps them enroll into minimum 

19 essential coverage; 

20 ‘‘(III) awarded to organizations 

21 (which may include agencies of States 

22 or political subdivision using hired or 

23 rehired employees) with a dem24 onstrated capacity to perform the du25 ties specified in paragraph (3) (exVerDate Sep 11 2014 23:53 Sep 10, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4557.IS S4557

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1 tended, for purposes of this subpara2 graph, to include all programs de3 scribed in subclause (I)) and this sub4 paragraph, including relationships 

5 with and experience in successfully 

6 serving laid-off and furloughed work7 ers, residents of rural areas and com8 munities of color, low-income individ9 uals, members of immigrant families, 

10 and other historically underserved 

11 populations; 

12 ‘‘(IV) awarded to organizations, 

13 within each State, that include at 

14 least two organizations located in the 

15 State serviced by such organizations, 

16 at least one of which is a community17 based and consumer-oriented non18 profit group; and 

19 ‘‘(V) used to supplement rather 

20 than supplant other funding, staffing, 

21 and programming provided under this 

22 subsection. 

23 ‘‘(iv) DEFINITION.—For purposes of 

24 this subparagraph, the term ‘COBRA con25 tinuation coverage’ means continuation 


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1 coverage provided pursuant to part 6 of 

2 subtitle B of title I of the Employee Re3 tirement Income Security Act of 1974 

4 (other than under section 609), title XXII 

5 of the Public Health Service Act, section 

6 4980B of the Internal Revenue Code of 

7 1986 (other than subsection (f)(1) of such 

8 section insofar as it relates to pediatric 

9 vaccines), or section 8905a of title 5, 

10 United States Code, or under a State pro11 gram that provides comparable continu12 ation coverage. Such term does not include 

13 coverage under a health flexible spending 

14 arrangement under a cafeteria plan within 

15 the meaning of section 125 of the Internal 

16 Revenue Code of 1986.’’. 

Æ 


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