I 

117TH CONGRESS 

1ST SESSION H. R. 1896 

To amend title I of the Patient Protection and Affordable Care Act to 

provide for additional grants for States to conduct activities related 

to establishing American Health Benefit Exchanges. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 16, 2021 

Mr. KIM of New Jersey (for himself and Mr. FITZPATRICK) introduced the 

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

A BILL 

To amend title I of the Patient Protection and Affordable 

Care Act to provide for additional grants for States 

to conduct activities related to establishing American 

Health Benefit Exchanges. 

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 ‘‘State Allowance for 

5 a Variety of Exchanges Act of 2021’’ or the ‘‘SAVE Act 

6 of 2021’’. 


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•HR 1896 IH

1 SEC. 2. PRESERVING STATE OPTION TO IMPLEMENT 

2 HEALTH CARE MARKETPLACES. 

3 (a) IN GENERAL.—Section 1311 of the Patient Pro4 tection and Affordable Care Act (42 U.S.C. 18031) is 

5 amended— 

6 (1) in subsection (a)— 

7 (A) in paragraph (4)(B), by striking 

8 ‘‘under this subsection’’ and inserting ‘‘under 

9 this paragraph or paragraph (1)’’; and 

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

11 paragraph: 

12 ‘‘(6) ADDITIONAL PLANNING AND ESTABLISH13 MENT GRANTS.— 

14 ‘‘(A) IN GENERAL.—There shall be appro15 priated to the Secretary, out of any moneys in 

16 the Treasury not otherwise appropriated, $200 

17 million to award grants to eligible States for 

18 the uses described in paragraph (3). 

19 ‘‘(B) DURATION AND RENEWABILITY.—A 

20 grant awarded under subparagraph (A) shall be 

21 for a period of 2 years and may not be renewed. 

22 ‘‘(C) LIMITATION.—A grant may not be 

23 awarded under subparagraph (A) after Decem24 ber 31, 2024. 

25 ‘‘(D) ELIGIBLE STATE DEFINED.—For 

26 purposes of this paragraph, the term ‘eligible 


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1 State’ means a State that, as of January 1, 

2 2019, was not operating an Exchange (other 

3 than an Exchange described in section 

4 155.200(f) of title 45, Code of Federal Regula5 tions).’’; and 

6 (2) in subsection (d)(5)(A)— 

7 (A) by striking ‘‘OPERATIONS.—In estab8 lishing an Exchange under this section’’ and in9 serting ‘‘OPERATIONS.— 

10 ‘‘(i) IN GENERAL.—In establishing an 

11 Exchange under this section (other than in 

12 establishing an Exchange with respect to 

13 which a grant is awarded under subsection 

14 (a)(6))’’; and 

15 (B) by adding at the end the following: 

16 ‘‘(ii) ADDITIONAL PLANNING AND ES17 TABLISHMENT GRANTS.—In establishing 

18 an Exchange with respect to which a grant 

19 is awarded under subsection (a)(6), the 

20 State shall ensure that such Exchange is 

21 self-sustaining beginning on January 1, 

22 2026, including allowing the Exchange to 

23 charge assessments or user fees to partici24 pating health insurance issuers, or to othVerDate Sep 11 2014 22:16 May 15, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1896.IH H1896

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•HR 1896 IH

1 erwise generate funding, to support its op2 erations.’’. 

3 (b) CLARIFICATION REGARDING FAILURE TO ESTAB4 LISH EXCHANGE OR IMPLEMENT REQUIREMENTS.—Sec5 tion 1321(c) of the Patient Protection and Affordable 

6 Care Act (42 U.S.C. 18041(c)) is amended— 

7 (1) in paragraph (1), by striking ‘‘If’’ and in8 serting ‘‘Subject to paragraph (3), if’’; and 

9 (2) by adding at the end the following new 

10 paragraph: 

11 ‘‘(3) CLARIFICATION.—This subsection shall 

12 not apply in the case of a State that elects to apply 

13 the requirements described in subsection (a) and 

14 satisfies the requirement described in subsection (b) 

15 on or after January 1, 2014.’’. 

Æ 


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