II 

113TH CONGRESS 

1ST SESSION S. 1886 

To ensure that individuals who attempted to, or who are enrolled in, qualified 

health plans offered through an Exchange have continuity of coverage 

and to require Exchanges to make coverage under qualified health plans 

retroactive to January 1, 2014. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 20, 2013 

Mr. MERKLEY (for himself, Mrs. SHAHEEN, Mr. UDALL of Colorado, Mr. 

KING, Ms. HEITKAMP, and Ms. LANDRIEU) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To ensure that individuals who attempted to, or who are 

enrolled in, qualified health plans offered through an 

Exchange have continuity of coverage and to require 

Exchanges to make coverage under qualified health plans 

retroactive to January 1, 2014. 

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 ‘‘Coverage Protection 

5 Act’’. 


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•S 1886 IS

1 SEC. 2. AUTHORITY TO PROVIDE TIMELY COVERAGE FOR 

2 INDIVIDUALS WHO WERE UNABLE TO EN3 ROLL IN A QUALIFIED HEALTH PLAN. 

4 (a) IN GENERAL.—In the case of an individual who 

5 enrolls in a qualified health plan offered through an Ex6 change established under title I of the Patient Protection 

7 and Affordable Care Act (Public Law 111–148) before 

8 February 1, 2014, the Secretary of Health and Human 

9 Services shall require that the issuer of the plan treat such 

10 individual as enrolled in such plan as of December 23, 

11 2013, if the following conditions are met: 

12 (1) ATTEMPTED TIMELY ENROLLMENT.—The 

13 individual submits, not later than January 31, 2014, 

14 an attestation (in such form and manner as the Sec15 retary may require) that the individual— 

16 (A) made reasonable, good-faith attempts, 

17 but was unable, to successfully enroll in such a 

18 plan through an Exchange before December 23, 

19 2013; or 

20 (B) was initially determined through 

21 healthcare.gov to be eligible to enroll in a Med22 icaid plan under title XIX of the Social Secu23 rity Act but is not eligible to so enroll in such 

24 a Medicaid plan and, because of such incorrect 

25 eligibility determination, was subsequently unVerDate Mar 15 2010 00:39 Dec 27, 2013 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1886.IS S1886

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1 able to enroll in a qualified health plan before 

2 December 23, 2013. 

3 (2) PAYMENT OF PREMIUMS.—The individual 

4 pays to the health insurance issuer issuing the quali5 fied health plan in which such individual is enrolled 

6 (either directly or through the Exchange) any appli7 cable premiums owed by such individual for enroll8 ment in the plan taking into account the amount of 

9 any premium assistance made available under sec10 tion 36B of the Internal Revenue Code of 1986. 

11 (b) APPLICATION FOR PURPOSES OF PREMIUM AS12 SISTANCE, REDUCED COST-SHARING, AND INDIVIDUAL

13 RESPONSIBILITY.—Coverage provided under a qualified 

14 health plan for January and February of 2014 under sub15 section (a) shall be counted as coverage under such a plan 

16 by or through an Exchange for such months for all pur17 poses, including the following: 

18 (1) PREMIUM ASSISTANCE.—Section 36B of the 

19 Internal Revenue Code of 1986. 

20 (2) COST-SHARING REDUCTIONS.—Section 1402 

21 of the Patient Protection and Affordable Care Act 

22 (42 U.S.C. 18071). 

23 (3) INDIVIDUAL RESPONSIBILITY REQUIRE24 MENT.—Section 5000A of the Internal Revenue 

25 Code of 1986. 


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1 SEC. 3. RETROACTIVE COVERAGE AND PREMIUM ASSIST2 ANCE. 

3 Section 1311(c) of the Patient Protection and Afford4 able Care Act (42 U.S.C. 18031(c)) is amended by adding 

5 at the end the following: 

6 ‘‘(7) STATE OPTION TO MAKE INITIAL COV7 ERAGE RETROACTIVE.— 

8 ‘‘(A) IN GENERAL.—Notwithstanding any 

9 other provision of law, the Secretary shall per10 mit a State, at the option of the State, to make 

11 coverage under a qualified health plan retro12 active to January 1, 2014, with respect to an 

13 individual who enrolls in such plan through the 

14 State Exchange (or the Federal Exchange in 

15 the case of a State that has not established a 

16 State Exchange) during the period established 

17 by the State under subparagraph (B). Any 

18 health care items or services provided to such 

19 enrollee in January of 2014 shall be covered 

20 retroactively under the plan as if the enrollee 

21 had been enrolled on January 1 of such year. 

22 ‘‘(B) PERIOD.—The period established 

23 under this subparagraph shall be the period be24 ginning on December 23, 2013, and ending on 

25 a date determined by the State, but in no event 

26 later than January 31, 2014, except that a 


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1 State that has an enrollment deadline that is 

2 prior to December 23, 2013, may modify the 

3 period under this subparagraph to encompass 

4 such deadline. 

5 ‘‘(C) TAX CREDITS AND COST SHARING AS6 SISTANCE.—If an individual is determined to be 

7 eligible for a tax credit under section 36B of 

8 the Internal Revenue Code of 1986 or cost9 sharing assistance under section 1402, but such 

10 determination has not been verified by the date 

11 on which the individual enrolls in the qualified 

12 health plan involved, the credit and assistance 

13 shall be applied on a retroactive basis to Janu14 ary 1, 2014, and the initial premium payment 

15 amount shall be offset to include such credit 

16 and assistance amounts for such month.’’. 

17 SEC. 4. TRANSITIONAL USE OF RECEIPT OF INSURANCE 

18 PAYMENT AS ALTERNATIVE TO HEALTH IN19 SURANCE CARD FOR EXCHANGE PLANS. 

20 (a) IN GENERAL.—The Secretary of Health and 

21 Human Services shall require a health insurance issuer 

22 that offers a qualified health plan through an Exchange 

23 under title I of the Patient Protection and Affordable Care 

24 Act (Public Law 111–148)— 


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1 (1) to allow in-network providers in such plan 

2 to treat, for purposes of coverage under the plan, a 

3 receipt of payment of premiums by an individual en4 rolled under the plan for January or February 2014 

5 who has not received a health insurance card from 

6 the issuer in the same manner as if such receipt 

7 were such a health insurance card issued to such in8 dividual by the issuer for services furnished during 

9 such month; and 

10 (2) to notify such in-network providers of the 

11 policy under paragraph (1). 

12 (b) RULE OF CONSTRUCTION.—Nothing in this sec13 tion shall be construed as precluding a health care pro14 vider from directly seeking to verify the status of the en15 rollment of an individual in a qualified health plan offered 

16 through an Exchange by contacting the Exchange or the 

17 issuer of such plan. 

Æ 


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