I 

115TH CONGRESS 

2D SESSION H. R. 4894 

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 

JANUARY 29, 2018 

Mrs. NOEM 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 ‘‘Harmful Tax Preven5 tion Act’’. 


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1 SEC. 2. PARTIAL RELIEF FROM ANNUAL FEE ON HEALTH 

2 INSURANCE PROVIDERS. 

3 (a) IN GENERAL.—Section 9010 of the Patient Pro4 tection and Affordable Care Act is amended by adding at 

5 the end the following new subsection: 

6 ‘‘(k) OPTIONAL RELIEF FOR 2018.— 

7 ‘‘(1) IN GENERAL.—In the case of a covered en8 tity that meets the requirements of paragraph (2), 

9 the fee described in subsection (a)(1) shall be re10 duced by the sum of the premium rebates provided 

11 pursuant to paragraph (2). 

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

13 entity meets the requirements of this paragraph if 

14 such entity demonstrates to the satisfaction of the 

15 Secretary of the Treasury (in consultation with the 

16 Secretary of Health and Human Services, Adminis17 trator of the Centers for Medicare and Medicaid 

18 Services, and the National Association of Insurance 

19 Commissioners, as appropriate) that such entity will 

20 provide— 

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

22 individual enrolled in calendar year 2018 in a 

23 qualified rebate plan offered by such entity a 

24 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 03:43 Jan 30, 2018 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4894.IH H4894

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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 (b) MEDICAL LOSS RATIO.—Section 2718 of the 

13 Public Health Service Act is amended by adding at the 

14 end the following new subsection: 

15 ‘‘(f) AMOUNTS EXPENDED FOR PREMIUM REBATES

16 NOT INCLUDED.—No amount expended pursuant to sub17 sections (k) or (l) of section 9010 of the Patient Protec18 tion and Affordable Care Act shall be taken into account 

19 for purposes of this section.’’. 

20 (c) CONFORMING AMENDMENT.—Section 9010(b)(1) 

21 of the Patient Protection and Affordable Care Act is 

22 amended by striking ‘‘the fee under this section’’ and in23 serting ‘‘the amount determined under this subsection’’. 

24 (d) EFFECTIVE DATE.— 


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1 (1) IN GENERAL.—Except as otherwise pro2 vided in this subsection, the amendments made by 

3 this section shall apply with respect to calendar 

4 years beginning after December 31, 2017. 

5 (2) MEDICAL LOSS RATIO.—The amendment 

6 made by subsection (b) shall apply with respect to 

7 plan years beginning after December 31, 2017. 

Æ 


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