I 

117TH CONGRESS 

1ST SESSION H. R. 1872 

To amend the Patient Protection and Affordable Care Act to provide for 

Federal Exchange outreach and educational activities, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 12, 2021 

Ms. BLUNT ROCHESTER (for herself and Ms. SCANLON) introduced the 

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

A BILL 

To amend the Patient Protection and Affordable Care Act 

to provide for Federal Exchange outreach and educational activities, and for other purposes. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Marketing and Out5 reach Restoration to Empower Health Education Act of 

6 2021’’ or the ‘‘MORE Health Education Act’’. 


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1 SEC. 2. FEDERAL EXCHANGE OUTREACH AND EDU2 CATIONAL ACTIVITIES. 

3 Section 1321(c) of the Patient Protection and Afford4 able Care Act (42 U.S.C. 18041(c)) is amended by adding 

5 at the end the following new paragraphs: 

6 ‘‘(3) OUTREACH AND EDUCATIONAL ACTIVI7 TIES.— 

8 ‘‘(A) IN GENERAL.—In the case of an Ex9 change established or operated by the Secretary 

10 within a State pursuant to this subsection, the 

11 Secretary shall carry out outreach and edu12 cational activities for purposes of informing po13 tential enrollees in qualified health plans offered 

14 through the Exchange of the availability of cov15 erage under such plans and financial assistance 

16 for coverage under such plans. Such outreach 

17 and educational activities shall be provided in a 

18 manner that is culturally and linguistically ap19 propriate to the needs of the populations being 

20 served by the Exchange (including hard-to21 reach populations, such as racial and sexual mi22 norities, limited English proficient populations, 

23 and young adults). 

24 ‘‘(B) LIMITATION ON USE OF FUNDS.—No 

25 funds appropriated under this paragraph shall 


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1 be used for expenditures for promoting non2 ACA compliant health insurance coverage. 

3 ‘‘(C) NON-ACA COMPLIANT HEALTH IN4 SURANCE COVERAGE.—For purposes of this 

5 subparagraph (B): 

6 ‘‘(i) The term ‘non-ACA compliant 

7 health insurance coverage’ means health 

8 insurance coverage, or a group health plan, 

9 that is not a qualified health plan. 

10 ‘‘(ii) Such term includes the following: 

11 ‘‘(I) An association health plan. 

12 ‘‘(II) Short-term limited duration 

13 insurance. 

14 ‘‘(D) FUNDING.—Out of any funds in the 

15 Treasury not otherwise appropriated, there are 

16 hereby appropriated for fiscal year 2023 and 

17 each subsequent fiscal year, $100,000,000 to 

18 carry out this paragraph. Funds appropriated 

19 under this subparagraph shall remain available 

20 until expended. 

21 ‘‘(4) ANNUAL ENROLLMENT TARGETS.—For 

22 plan year 2022 and each subsequent plan year, in 

23 the case of an Exchange established or operated by 

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1 section, the Secretary shall establish annual enroll2 ment targets for such Exchange for such year.’’. 

3 SEC. 3. IMPROVING TRANSPARENCY AND ACCOUNTABILITY 

4 IN THE MARKETPLACE. 

5 (a) OPEN ENROLLMENT REPORTS.—For plan year 

6 2022 and each subsequent year, the Secretary of Health 

7 and Human Services (referred to in this section as the 

8 ‘‘Secretary’’), in coordination with the Secretary of the 

9 Treasury and the Secretary of Labor, shall issue biweekly 

10 public reports during the annual open enrollment period 

11 on the performance of the federally facilitated Exchange 

12 operated pursuant to section 1321(c) of the Patient Pro13 tection and Affordable Care Act (42 U.S.C. 18041(c)). 

14 Each such report shall include a summary, including in15 formation on a State-by-State basis where available, of— 

16 (1) the number of unique website visits; 

17 (2) the number of individuals who create an ac18 count; 

19 (3) the number of calls to the call center; 

20 (4) the average wait time for callers contacting 

21 the call center; 

22 (5) the number of individuals who enroll in a 

23 qualified health plan; and 

24 (6) the percentage of individuals who enroll in 

25 a qualified health plan through each of— 


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1 (A) the website; 

2 (B) the call center; 

3 (C) navigators; 

4 (D) agents and brokers; 

5 (E) the enrollment assistant program; 

6 (F) directly from issuers or web brokers; 

7 and 

8 (G) other means. 

9 (b) OPEN ENROLLMENT AFTER ACTION REPORT.— 

10 For plan year 2022 and each subsequent year, the Sec11 retary, in coordination with the Secretary of the Treasury 

12 and the Secretary of Labor, shall publish and make public 

13 an after action report not later than 3 months after the 

14 completion of the annual open enrollment period regarding 

15 the performance of the Exchange described in subsection 

16 (a) for the applicable plan year. Each such report shall 

17 be public and include a summary, including information 

18 on a State-by-State basis where available, of— 

19 (1) the open enrollment data reported under 

20 subsection (a) for the entirety of the enrollment pe21 riod; and 

22 (2) activities related to patient navigators de23 scribed in section 1311(i) of the Patient Protection 

24 and Affordable Care Act (42 U.S.C. 18031(i)), in25 cluding— 


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1 (A) the performance objectives established 

2 by the Secretary for such patient navigators; 

3 (B) the number of consumers enrolled by 

4 such a patient navigator; 

5 (C) an assessment of how such patient 

6 navigators have met established performance 

7 metrics, including a detailed list of all patient 

8 navigators, funding received by patient naviga9 tors, and whether established performance ob10 jectives of patient navigators were met; and 

11 (D) with respect to the performance objec12 tives described in subparagraph (A)— 

13 (i) whether such objectives assess the 

14 full scope of patient navigator responsibil15 ities, including general education, plan se16 lection, and determination of eligibility for 

17 tax credits, cost-sharing reductions, or 

18 other coverage; 

19 (ii) how the Secretary worked with pa20 tient navigators to establish such objec21 tives; and 

22 (iii) how the Secretary adjusted such 

23 objectives for case complexity and other 

24 contextual factors. 


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1 (c) REPORT ON ADVERTISING AND CONSUMER OUT2 REACH.—Not later than 3 months after the completion of 

3 the annual open enrollment period for plan year 2022, the 

4 Secretary shall issue a public report on advertising and 

5 outreach to consumers for the open enrollment period for 

6 plan year 2022. Such report shall include a description 

7 of— 

8 (1) the division of spending on individual adver9 tising platforms, including television and radio ad10 vertisements and digital media, to raise consumer 

11 awareness of open enrollment; 

12 (2) the division of spending on individual out13 reach platforms, including email and text messages, 

14 to raise consumer awareness of open enrollment; and 

15 (3) whether the Secretary conducted targeted 

16 outreach to specific demographic groups and geo17 graphic areas. 

18 (d) PROMOTING TRANSPARENCY AND ACCOUNT19 ABILITY IN THE ADMINISTRATION’S EXPENDITURES OF

20 EXCHANGE USER FEES.—For plan year 2022 and each 

21 subsequent plan year, not later than the date that is 3 

22 months after the end of such plan year, the Secretary of 

23 Health and Human Services shall submit to the appro24 priate committees of Congress and make available to the 

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1 partment of Health and Human Services of user fees col2 lected pursuant to section 156.50 of title 45, Code of Fed3 eral Regulations (or any successor regulations). Each such 

4 report for a plan year shall include a detailed accounting 

5 of the amount of such user fees collected during such plan 

6 year and of the amount of such expenditures used during 

7 such plan year for the federally facilitated Exchange oper8 ated pursuant to section 1321(c) of the Patient Protection 

9 and Affordable Care Act (42 U.S.C. 18041(c)) on out10 reach and enrollment activities, navigators, maintenance 

11 of Healthcare.gov, and operation of call centers. 

12 (e) STUDIES AND REPORTS.—Not later than 30 days 

13 after the date of the enactment of this Act, the Secretary 

14 of Health and Human Services shall release to Congress 

15 all aggregated documents relating to studies and data sets 

16 that were created on or after January 1, 2014, and related 

17 to marketing and outreach with respect to qualified health 

18 plans offered through Exchanges under title I of the Pa19 tient Protection and Affordable Care Act (42 U.S.C. 

20 18001 et seq.). 

Æ 


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