I 

115TH CONGRESS 

1ST SESSION H. R. 4620 

To amend the Patient Protection and Affordable Care Act to provide 

temporary relief from the annual fee imposed on health insurance providers. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 12, 2017 

Mrs. NOEM (for herself and Ms. SINEMA) introduced the following bill; which 

was referred to the Committee on Energy and Commerce, and in addition 

to the Committee on Ways and Means, for a period to be subsequently 

determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend the Patient Protection and Affordable Care Act 

to provide temporary relief from the annual fee imposed 

on health insurance providers. 

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 ‘‘Protecting Families 

5 and Small Businesses Act of 2017’’. 


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1 SEC. 2. RELIEF FROM ANNUAL FEE ON HEALTH INSUR2 ANCE PROVIDERS. 

3 (a) PARTIAL RELIEF FOR 2018 FOR CERTAIN PRO4 VIDERS.— 

5 (1) IN GENERAL.—Section 9010 of the Patient 

6 Protection and Affordable Care Act is amended by 

7 adding at the end the following new subsection: 

8 ‘‘(k) OPTIONAL RELIEF FOR 2018.— 

9 ‘‘(1) IN GENERAL.—In the case of a covered en10 tity that meets the requirements of paragraph (2), 

11 the fee described in subsection (a)(1) shall be re12 duced by the sum of the premium rebates provided 

13 pursuant to paragraph (2). 

14 ‘‘(2) REBATES FOR INDIVIDUALS.—A covered 

15 entity meets the requirements of this paragraph if 

16 such entity demonstrates to the satisfaction of the 

17 Secretary of the Treasury (in consultation with the 

18 Secretary of Health and Human Services, Adminis19 trator of the Centers for Medicare and Medicaid 

20 Services, and the National Association of Insurance 

21 Commissioners, as appropriate) that such entity will 

22 provide— 

23 ‘‘(A) not later than April 30, 2019, to each 

24 individual enrolled in calendar year 2018 in a 

25 qualified rebate plan offered by such entity a 

26 premium rebate equal to the lesser of— 


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1 ‘‘(i) 2 percent of the net premiums 

2 written for coverage under such plan for 

3 such individual for calendar year 2018, or 

4 ‘‘(ii) the amount of the premiums de5 scribed in subparagraph (A) paid by such 

6 individual, and 

7 ‘‘(B) for individuals who will receive a pre8 mium rebate described in subparagraph (A) 

9 after September 30, 2018, notice to such indi10 viduals by such date of such premium rebate. 

11 ‘‘(3) QUALIFIED REBATE PLAN.—For purposes 

12 of this subsection, the term ‘qualified rebate plan’ 

13 means, with respect to a covered entity, any com14 bination, as elected by the covered entity, of the fol15 lowing categories of health plans: 

16 ‘‘(A) A health plan offered in the indi17 vidual market. 

18 ‘‘(B) A health plan offered in the group 

19 market. 

20 ‘‘(C) A Medicare Advantage plan under 

21 part C of title XVIII of the Social Security Act. 

22 ‘‘(D) A prescription drug plan offered 

23 under part D of such title XVIII. 

24 ‘‘(4) REDUCTION IN PREMIUMS TREATED AS

25 REBATES.—For purposes of this subsection, a reducVerDate Sep 11 2014 22:57 Dec 14, 2017 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4620.IH H4620

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1 tion in premiums owed by an individual for a month 

2 shall be treated as a premium rebate paid to such 

3 individual on the first day of such month. 

4 ‘‘(l) MEDICAID MANAGED CARE PLANS REDUCTION

5 FOR 2018.—In the case of a medicaid managed care orga6 nization (as defined in section 1903(m)(1)(A) of the Social 

7 Security Act), the fee described in subsection (a)(1) shall 

8 be reduced by an amount equal to 2 percent of the net 

9 premiums written for coverage under a medicaid managed 

10 care plan (under section 1903(m) or section 1932 of such 

11 Act) for calendar year 2018.’’. 

12 (2) CONFORMING AMENDMENT.—Paragraph (1) 

13 of section 9010(b) of the Patient Protection and Af14 fordable Care Act is amended by striking ‘‘the fee 

15 under this section’’ and inserting ‘‘the amount deter16 mined under this subsection’’. 

17 (b) RELIEF FOR 2019.— 

18 (1) IN GENERAL.—Section 9010(j) of the Pa19 tient Protection and Affordable Care Act is amended 

20 by striking ‘‘and’’ at the end of paragraph (1), by 

21 striking the period at the end of paragraph (2) and 

22 inserting ‘‘, and ending before January 1, 2019, 

23 and’’, and by adding at the end the following new 

24 paragraph: 

25 ‘‘(3) beginning after December 31, 2019.’’. 


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1 (c) MEDICAL LOSS RATIO.—Section 2718 of the 

2 Public Health Service Act is amended by adding at the 

3 end the following new subsection: 

4 ‘‘(f) AMOUNTS EXPENDED FOR PREMIUM REBATES

5 NOT INCLUDED.—No amount expended pursuant to sub6 sections (k) or (l) of section 9010 of the Patient Protec7 tion and Affordable Care Act shall be taken into account 

8 for purposes of this section.’’. 

9 (d) EFFECTIVE DATE.— 

10 (1) The amendments made by subsections (a) 

11 and (b) shall apply with respect to calendar years 

12 beginning after December 31, 2017. 

13 (2) The amendment made by subsection (c) 

14 shall apply with respect to plan years beginning 

15 after December 31, 2017. 

Æ 


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