I 

115TH CONGRESS 

2D SESSION H. R. 5155 

To amend the Patient Protection and Affordable Care Act to improve affordability of, undo sabotage with respect to, and increase access to health 

insurance coverage, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 5, 2018 

Mr. PALLONE (for himself, Mr. SCOTT of Virginia, and Mr. NEAL) introduced 

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

Commerce, and in addition to the Committees on Ways and Means, and 

Education and the Workforce, 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 improve affordability of, undo sabotage with respect 

to, and increase access to health insurance coverage, 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Undo Sabotage and Expand Affordability of Health In6 surance Act of 2018’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents of 

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—EXPANDING AFFORDABILITY 

Sec. 101. Improve affordability and reduce premium costs for consumers. 

Sec. 102. Lower out-of-pocket costs for consumers. 

Sec. 103. Expand affordability for working families. 

TITLE II—UNDOING SABOTAGE 

Sec. 201. Protect comprehensive coverage for small businesses and workers. 

Sec. 202. Prevent junk plans and continue protections for consumers with preexisting conditions. 

Sec. 203. Ensure plans provide comprehensive benefits. 

Sec. 204. Undo Administration sabotage by requiring open enrollment outreach, 

education, and funding for navigators. 

Sec. 205. Improve marketplace stability to prevent sabotage from raising premiums. 

TITLE III—STATE INNOVATION AND TRANSPARENCY 

Sec. 301. Fund State health insurance education programs for consumers. 

Sec. 302. Fund State innovations to expand coverage. 

Sec. 303. Preserve State option to implement health care marketplaces. 

Sec. 304. Promote transparency and accountability in the Administration’s expenditures of Exchange user fees. 

3 TITLE I—EXPANDING 

4 AFFORDABILITY 

5 SEC. 101. IMPROVE AFFORDABILITY AND REDUCE PRE6 MIUM COSTS FOR CONSUMERS. 

7 (a) IN GENERAL.—Section 36B(b)(3)(A) of the In8 ternal Revenue Code of 1986 is amended to read as fol9 lows: 

10 ‘‘(A) APPLICABLE PERCENTAGE.—The ap11 plicable percentage for any taxable year shall be 

12 the percentage such that the applicable percent13 age for any taxpayer whose household income is 

14 within an income tier specified in the following 


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1 table shall increase, on a sliding scale in a lin2 ear manner, from the initial premium percent3 age to the final premium percentage specified in 

4 such table for such income tier: 

‘‘In the case of household 

income (expressed as 

a percent of poverty line) 

within the following income tier: 

The initial 

premium 

percentage is— 

The final premium 

percentage is— 

Over 100.0% up to 133.0% ................ 0.0% 1.0%

133.0% up to 150.0% ........................ 1.0% 2.0%

150.0% up to 200.0% ........................ 2.0% 4.0%

200.0% up to 250.0% ........................ 4.0% 6.0%

250.0% up to 300.0% ........................ 6.0% 7.0%

300.0% up to 400.0% ........................ 7.0% 8.5%

400.0% and higher ............................. 8.5% 8.5%’’. 

5 (b) CONFORMING AMENDMENT.—Section 

6 36B(c)(1)(A) of the Internal Revenue Code of 1986 is 

7 amended by striking ‘‘but does not exceed 400 percent’’. 

8 (c) EFFECTIVE DATE.—The amendments made by 

9 this section shall apply to taxable years beginning after 

10 December 31, 2019. 

11 SEC. 102. LOWER OUT-OF-POCKET COSTS FOR CONSUMERS. 

12 (a) EXPANSION OF ELIGIBILITY.— 

13 (1) IN GENERAL.—Section 1402(c) of the Pa14 tient Protection and Affordable Care Act (42 U.S.C. 

15 18071(c)) is amended— 

16 (A) by striking paragraphs (1) and (2) and 

17 inserting the following: 

18 ‘‘(1) IN GENERAL.—The reduction in cost-shar19 ing under this subsection shall be achieved, with re20 spect to an issuer of a qualified health plan to which 


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1 this section applies, by reducing cost-sharing under 

2 the plan (and the applicable out-of pocket limit 

3 under section 1302(c)(1)) in a manner and amount 

4 sufficient to— 

5 ‘‘(A) in the case of an eligible insured 

6 whose household income is not less than 100 

7 percent but not more than 250 percent of the 

8 poverty line for a family of the size involved, in9 crease the plan’s share of the total allowed 

10 costs of benefits provided under the plan to 94 

11 percent of such costs; and 

12 ‘‘(B) in the case of an eligible insured 

13 whose household income is more than 250 per14 cent but not more than 400 percent of the pov15 erty line for a family of the size involved, in16 crease the plan’s share of the total allowed 

17 costs of benefits provided under the plan to 87 

18 percent of such costs.’’; and 

19 (B) by redesignating paragraphs (3), (4), 

20 and (5) as paragraphs (2), (3), and (4), respec21 tively. 

22 (2) EFFECTIVE DATE.—The amendments made 

23 by paragraph (1) shall apply with respect to plan 

24 years beginning after December 31, 2019. 


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1 (b) FUNDING COST SHARING REDUCTIONS.—Section 

2 1402 of the Patient Protection and Affordable Care Act 

3 (42 U.S.C. 18071) is amended by adding at the end the 

4 following new subsection: 

5 ‘‘(g) FUNDING.—Out of any funds in the Treasury 

6 not otherwise appropriated, there is hereby appropriated 

7 to the Secretary such sums as may be necessary for pay8 ments under this section.’’. 

9 SEC. 103. EXPAND AFFORDABILITY FOR WORKING FAMI10 LIES. 

11 (a) IN GENERAL.—Clause (i) of section 36B(c)(2)(C) 

12 of the Internal Revenue Code of 1986 is amended to read 

13 as follows: 

14 ‘‘(i) COVERAGE MUST BE AFFORD15 ABLE.— 

16 ‘‘(I) EMPLOYEES.—An employee 

17 shall not be treated as eligible for 

18 minimum essential coverage if such 

19 coverage consists of an eligible em20 ployer-sponsored plan (as defined in 

21 section 5000A(f)(2)) and the employ22 ee’s required contribution (within the 

23 meaning of section 5000A(e)(1)(B)) 

24 with respect to the plan exceeds 9.5 


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1 percent of the employee’s household 

2 income. 

3 ‘‘(II) FAMILY MEMBERS.—An in4 dividual who is eligible to enroll in an 

5 eligible employer-sponsored plan (as 

6 defined in section 5000A(f)(2)) by 

7 reason of a relationship the individual 

8 bears to the employee shall not be 

9 treated as eligible for minimum essen10 tial coverage by reason of such eligi11 bility to enroll if the employee’s re12 quired contribution (within the mean13 ing of section 5000A(e)(1)(B), deter14 mined by substituting ‘family’ for 

15 ‘self-only’) with respect to the plan ex16 ceeds 9.5 percent of the employee’s 

17 household income.’’. 

18 (b) CONFORMING AMENDMENTS.— 

19 (1) Clause (ii) of section 36B(c)(2)(C) of the 

20 Internal Revenue Code of 1986 is amended by strik21 ing ‘‘Except as provided in clause (iii), an employee’’ 

22 and inserting ‘‘An individual’’. 

23 (2) Clause (iii) of section 36B(c)(2)(C) of such 

24 Code is amended by striking ‘‘the last sentence of 

25 clause (i)’’ and inserting ‘‘clause (i)(II)’’. 


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1 (3) Clause (iv) of section 36B(c)(2)(C) of such 

2 Code is amended by striking ‘‘9.5 percent under 

3 clause (i)(II)’’ and inserting ‘‘the 9.5 percent under 

4 clauses (i)(I) and (i)(II)’’. 

5 (c) EFFECTIVE DATE.—The amendments made by 

6 this section shall apply to taxable years beginning after 

7 December 31, 2019. 

8 TITLE II—UNDOING SABOTAGE 

9 SEC. 201. PROTECT COMPREHENSIVE COVERAGE FOR 

10 SMALL BUSINESSES AND WORKERS. 

11 Notwithstanding any other provision of law, the Sec12 retary of Labor may not take any action to implement, 

13 finalize, or enforce the proposed rule published on January 

14 5, 2018, on pages 614 through 636 of volume 83 of the 

15 Federal Register, or any substantially similar proposed 

16 rule. 

17 SEC. 202. PREVENT JUNK PLANS AND CONTINUE PROTEC18 TIONS FOR CONSUMERS WITH PREEXISTING 

19 CONDITIONS. 

20 (a) INCLUDING SHORT-TERM LIMITED DURATION

21 INSURANCE AS INDIVIDUAL HEALTH INSURANCE COV22 ERAGE.—Section 2791(b)(5) of the Public Health Service 

23 Act (42 U.S.C. 300g–91(b)(5)) is amended by striking 

24 ‘‘but does not include short-term limited duration insurVerDate Sep 11 2014 02:43 Mar 09, 2018 Jkt 079200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5155.IH H5155

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1 ance’’ and inserting ‘‘, including short-term limited dura2 tion insurance’’. 

3 (b) EFFECTIVE DATE.—The amendments made by 

4 this section shall apply with respect to plan years begin5 ning after December 31, 2018. 

6 SEC. 203. ENSURE PLANS PROVIDE COMPREHENSIVE BENE7 FITS. 

8 (a) ESSENTIAL HEALTH BENEFITS.—Section 

9 1302(b)(4) of the Patient Protection and Affordable Care 

10 Act (42 U.S.C. 18022(b)(4)) is amended— 

11 (1) in subparagraph (A), by inserting ‘‘and so 

12 that benefits are included within each of such cat13 egories’’; 

14 (2) in subparagraph (G), by striking at the end 

15 ‘‘and’’; 

16 (3) in subparagraph (H), by striking the period 

17 at the end and inserting ‘‘; and’’; and 

18 (4) by adding at the end the following new sub19 paragraph: 

20 ‘‘(I) ensure that, beginning January 1, 

21 2019— 

22 ‘‘(i) in the case of health benefits that 

23 are established as essential health benefits, 

24 there shall not be substitution of such ben25 efits across benefit categories; 


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1 ‘‘(ii) a qualified health plan shall not 

2 be treated as providing coverage for the es3 sential health benefits unless under such 

4 plan— 

5 ‘‘(I) coverage of prescription 

6 drugs provides for access to a wide 

7 variety of classes of drugs within the 

8 prescription drug formulary of such 

9 plan; and 

10 ‘‘(II) in the case that a drug that 

11 is medically necessary for an enrollee 

12 under such plan is not included within 

13 such formulary, such individual has 

14 access to such drug through an excep15 tions process established by the plan; 

16 and 

17 ‘‘(iii) habilitative services are covered 

18 at parity with rehabilitative services.’’. 

19 (b) STANDARD BENEFIT PLANS.—Section 1302(d) of 

20 the Patient Protection and Affordable Care Act (42 

21 U.S.C. 18022(d)) is amended by adding at the end the 

22 following new paragraph: 

23 ‘‘(5) STANDARD BENEFIT PLANS.— 

24 ‘‘(A) IN GENERAL.—For purposes of pro25 viding individuals with the opportunity to make 


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1 simpler comparisons of health plans offered by 

2 different health insurance issuers and simplify 

3 the selection process, the Secretary shall, for 

4 each plan year beginning with plan year 2020, 

5 through rulemaking, specify a structure de6 scribed in subparagraph (B)(i) for a standard 

7 benefit plan for such plan year for each of the 

8 bronze, silver, and gold levels of coverage and 

9 for each actuarial value variation of a silver 

10 plan resulting from the application of section 

11 1402(c). A standard benefit plan for a plan 

12 year for a level of coverage or actuarial value 

13 variation of a silver plan shall be modeled on 

14 the most commonly purchased plans (deter15 mined by enrollments in such plans) during the 

16 previous 2 plan years offered in the federally fa17 cilitated Exchange operated pursuant to section 

18 1321(c) in such level or variation and shall in19 clude coverage of deductible-exempt services 

20 consistent with actual purchasing patterns of 

21 consumers in the previous two plan years. 

22 ‘‘(B) STANDARD BENEFIT PLAN.—For 

23 purposes of this paragraph, the term ‘standard 

24 benefit plan’ means a qualified health plan to 


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1 be offered through an Exchange on the indi2 vidual market that has either— 

3 ‘‘(i) a standardized cost-sharing struc4 ture specified by the Secretary pursuant to 

5 rulemaking; or 

6 ‘‘(ii) a standardized cost-sharing 

7 structure specified by the Secretary pursu8 ant to rulemaking that is modified by the 

9 health insurance issuer of such plan only 

10 to the extent necessary to align with high 

11 deductible health plan requirements under 

12 section 223 of the Internal Revenue Code 

13 of 1986 or the applicable annual limitation 

14 on cost sharing under subsection (c) and 

15 actuarial value requirements specified by 

16 the Secretary.’’. 

17 SEC. 204. UNDO ADMINISTRATION SABOTAGE BY REQUIR18 ING OPEN ENROLLMENT OUTREACH, EDU19 CATION, AND FUNDING FOR NAVIGATORS. 

20 Section 1321(c) of the Patient Protection and Afford21 able Care Act (42 U.S.C. 18041(c)) is amended by adding 

22 at the end the following new paragraph: 

23 ‘‘(3) NAVIGATOR PROGRAM AND OUTREACH

24 AND ENROLLMENT ACTIVITIES.— 

25 ‘‘(A) NAVIGATOR PROGRAM.— 


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1 ‘‘(i) IN GENERAL.—In the case of an 

2 Exchange established or operated by the 

3 Secretary pursuant to this subsection, the 

4 Secretary shall establish a program under 

5 which it awards grants to entities that 

6 would be described in paragraph (2) of sec7 tion 1311(i) to carry out the duties that 

8 would be described in paragraph (3) of 

9 such section if the references in such sec10 tion 1311(i) to ‘this subsection’ and ‘para11 graph (1)’ were each instead a reference to 

12 ‘paragraph (3)(A) of section 1321(c)’. 

13 ‘‘(ii) APPLICATION OF STATE EX14 CHANGE NAVIGATOR PROVISIONS.—For 

15 purposes of carrying out this subpara16 graph, the provisions of paragraphs (2) 

17 through (5) of section 1311(i) shall apply 

18 to the Secretary with respect to an Ex19 change described in clause (i) and the pro20 gram under this subparagraph in the same 

21 manner as such provisions apply to a State 

22 with respect to an Exchange described in 

23 section 1311(i) and the program estab24 lished under such section. 


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1 ‘‘(iii) FUNDING.—For purposes of 

2 carrying out this subparagraph, the Sec3 retary shall obligate $100,000,000 out of 

4 amounts collected through the user fees on 

5 participating health insurance issuers pur6 suant to section 156.50 of title 45, Code of 

7 Federal Regulations (or any successor reg8 ulations) for each of fiscal years 2019 

9 through 2021. Such amount shall remain 

10 available without fiscal year limitation 

11 until expended. 

12 ‘‘(B) OUTREACH AND EDUCATIONAL AC13 TIVITIES.— 

14 ‘‘(i) IN GENERAL.—In the case of an 

15 Exchange established or operated by the 

16 Secretary pursuant to this subsection, the 

17 Secretary shall carry out outreach and 

18 educational activities for purposes of in19 forming potential enrollees in qualified 

20 health plans offered through the Exchange 

21 of the availability of coverage under such 

22 plans and financial assistance for coverage 

23 under such plans. 

24 ‘‘(ii) FUNDING.—For purposes of car25 rying out this subparagraph, the Secretary 


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1 shall obligate $100,000,000 out of the 

2 amounts collected through the user fees on 

3 participating health insurance issuers pur4 suant to section 156.50 of title 45, Code of 

5 Federal Regulations (or any successor reg6 ulations) for each of fiscal years 2019 

7 through 2021. Such amount shall remain 

8 available without fiscal year limitation 

9 until expended.’’. 

10 SEC. 205. IMPROVE MARKETPLACE STABILITY TO PREVENT 

11 SABOTAGE FROM RAISING PREMIUMS. 

12 (a) FUND.— 

13 (1) IN GENERAL.—There is hereby established 

14 the National Reinsurance Program Fund to be ad15 ministered by the Secretary of Health and Human 

16 Services for purposes of carrying out a national rein17 surance program to make reinsurance payments, in 

18 accordance with this section. 

19 (2) APPROPRIATION.—There is hereby appro20 priated to the Fund established under paragraph 

21 (1), out of any funds in the Treasury not otherwise 

22 appropriated, such sums as are necessary for car23 rying out the purpose described in such paragraph. 

24 (b) PAYMENTS.— 


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1 (1) IN GENERAL.—The Secretary of Health and 

2 Human Services shall use amounts available in the 

3 Fund to establish a national reinsurance program 

4 under which the Secretary makes reinsurance pay5 ments to health insurance issuers with respect to 

6 claims for individuals enrolled under qualifying rein7 surance plans offered by such issuers for plan year 

8 2019 or a subsequent plan year that exceed, subject 

9 to paragraph (2), $50,000 in an amount equal to 75 

10 percent of the amount of such claims, but not to ex11 ceed $1,000,000. 

12 (2) INDEXING.—For plan year 2020 or subse13 quent plan year, in lieu of each dollar amount speci14 fied in paragraph (1), each such dollar amount ap15 plied under this subsection for such plan year shall 

16 be the dollar amount applied under this subsection 

17 for the previous year, increased by the annual per18 centage increase in the Consumer Price Index for All 

19 Urban Consumers (all items; United States city av20 erage as of June of the previous fiscal year). 

21 (3) METHODS.—Payments under this sub22 section shall be based on such a method as the Sec23 retary determines. The Secretary may establish a 

24 payment method by which interim payments of 

25 amounts under this subsection are made during a 


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1 plan year based on the Secretary’s best estimate of 

2 amounts that will be payable after obtaining all of 

3 necessary information. 

4 (c) QUALIFYING REINSURANCE PLAN.— 

5 (1) IN GENERAL.—For purposes of this section, 

6 the term ‘‘qualifying reinsurance plan’’ means, with 

7 respect to a health insurance issuer a qualified 

8 health plan (as defined in section 1301 of the Pa9 tient Protection and Affordable Care Act (42 U.S.C. 

10 18021)) offered by such issuer on the individual 

11 market. Such term does not include a grandfathered 

12 health plan (as defined in section 1251 of such Act 

13 (42 U.S.C. 18011)), transitional health plan, or a 

14 standard health plan offered in connection with a 

15 basic health program established under section 1331 

16 of such Act (42 U.S.C. 18051). 

17 (2) TRANSITIONAL HEALTH PLAN.—For pur18 poses of paragraph (1), the term ‘‘transitional health 

19 plan’’ means a plan continued under the letter 

20 issued by the Centers for Medicare & Medicaid Serv21 ices on November 14, 2013, to the State Insurance 

22 Commissioners outlining a transitional policy for 

23 coverage in the individual and small group markets 

24 to which section 1251 of the Patient Protection and 

25 Affordable Care Act (42 U.S.C. 18011) does not 


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1 apply, and under the extension of the transitional 

2 policy for such coverage set forth in the Insurance 

3 Standards Bulletin Series guidance issued by the 

4 Centers for Medicare & Medicaid Services on March 

5 5, 2014, February 29, 2016, and February 13, 

6 2017, or under any subsequent extensions thereof. 

7 (d) COORDINATION WITH RISK ADJUSTMENT.—The 

8 Secretary shall make adjustments to the risk adjustment 

9 program operated under section 1343 of the Patient Pro10 tection and Affordable Care Act (42 U.S.C. 18063), as 

11 appropriate, to account for the effects of this section on 

12 the actuarial risk of enrollees. 

13 TITLE III—STATE INNOVATION 

14 AND TRANSPARENCY 

15 SEC. 301. FUND STATE HEALTH INSURANCE EDUCATION 

16 PROGRAMS FOR CONSUMERS. 

17 Section 2793(e) of the Public Health Service Act (42 

18 U.S.C. 300gg–93(e)) is amended by adding at the end the 

19 following new paragraph: 

20 ‘‘(3) APPROPRIATIONS.—For purposes of car21 rying out this section, there is hereby appropriated 

22 to the Secretary, out of any funds in the Treasury 

23 not otherwise appropriated, $100,000,000 for each 

24 of the fiscal years 2019 through 2021. Such amount 

25 shall remain available until expended.’’. 


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1 SEC. 302. FUND STATE INNOVATIONS TO EXPAND COV2 ERAGE. 

3 (a) IN GENERAL.—Subject to subsection (d), the Sec4 retary of Health and Human Services shall award grants 

5 to eligible State agencies to enable such States to explore 

6 innovative solutions to promote greater enrollment in 

7 health insurance coverage in the individual and small 

8 group markets, including activities described in subsection 

9 (c). 

10 (b) ELIGIBILITY.—For purposes of subsection (a), el11 igible State agencies are Exchanges established by a State 

12 under title I of the Patient Protection and Affordable Care 

13 Act and State agencies with primary responsibility over 

14 health and human services for the State involved. 

15 (c) USE OF FUNDS.—For purposes of subsection (a), 

16 the activities described in this subsection are the following: 

17 (1) State efforts to streamline health insurance 

18 enrollment procedures in order to reduce burdens on 

19 consumers and facilitate greater enrollment in health 

20 insurance coverage in the individual and small group 

21 markets, including automatic enrollment and re22 enrollment of, or pre-populated applications for, in23 dividuals without health insurance who are eligible 

24 for tax credits under section 36B of the Internal 

25 Revenue Code of 1986, with the ability to opt out 

26 of such enrollment. 


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1 (2) State investment in technology to improve 

2 data sharing and collection for the purposes of facili3 tating greater enrollment in health insurance cov4 erage in such markets. 

5 (3) Implementation of a State version of an in6 dividual mandate to be enrolled in health insurance 

7 coverage. 

8 (4) Feasibility studies to develop comprehensive 

9 and coherent State plan for increasing enrollment in 

10 the individual and small group market. 

11 (d) FUNDING.—For purposes of carrying out this 

12 section, there is hereby appropriated, out of any funds in 

13 the Treasury not otherwise appropriated, $200,000,000 

14 for each of the fiscal years 2019 through 2021. Such 

15 amount shall remain available until expended. 

16 SEC. 303. PRESERVE STATE OPTION TO IMPLEMENT 

17 HEALTH CARE MARKETPLACES. 

18 Section 1311(a)(4) of the Patient Protection and Af19 fordable Care Act (42 U.S.C. 18031(a)(4)) is amended— 

20 (1) by striking subparagraph (B); 

21 (2) by striking ‘‘RENEWABILITY OF GRANT’’ 

22 and all that follows through ‘‘Subject to subsection 

23 (d)(4)’’ and inserting ‘‘RENEWABILITY OF GRANT.— 

24 Subject to subsection (d)(4)’’; 


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1 (3) by redesignating clauses (i) and (ii) as sub2 paragraphs (A) and (B), respectively, with appro3 priate indentation; and 

4 (4) in subparagraph (A), as redesignated by 

5 paragraph (3), by redesignating subclauses (I) and 

6 (II) as clauses (i) and (ii), respectively, with appro7 priate indentation. 

8 SEC. 304. PROMOTE TRANSPARENCY AND ACCOUNT9 ABILITY IN THE ADMINISTRATION’S EXPENDI10 TURES OF EXCHANGE USER FEES. 

11 For each of plan years 2018, 2019, and 2020, not 

12 later than the date that is 3 months after of the end of 

13 such fiscal year, the Secretary of Health and Human Serv14 ices shall submit to the appropriate committees of Con15 gress and make available to the public an annual report 

16 on the expenditure by the Department of Health and 

17 Human Services of user fees collected pursuant to section 

18 156.50 of title 45, Code of Federal Regulations (or any 

19 successor regulations). Each such report for a plan year 

20 shall include a detailed accounting of the amount of such 

21 user fees collected during such plan year and of the 

22 amount of such expenditures used during such plan year 

23 for the federally facilitated Exchange operated pursuant 

24 to section 1321(c) of the Patient Protection and Afford25 able Care Act (42 U.S.C. 18041(c)) on outreach and enVerDate Sep 11 2014 02:43 Mar 09, 2018 Jkt 079200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\H5155.IH H5155

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1 rollment activities, navigators, maintenance of 

2 Healthcare.gov, and operation of call centers. 

Æ 


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