I 

113TH CONGRESS 

1ST SESSION H. R. 2951 

To require certain preconditions for allowing premium tax credits, reductions 

in cost-sharing, and funding of Navigators and related Exchange enrollment activities, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

AUGUST 1, 2013 

Mrs. MCMORRIS RODGERS 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 require certain preconditions for allowing premium tax 

credits, reductions in cost-sharing, and funding of Navigators and related Exchange enrollment 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, 


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1 SECTION 1. PRECONDITIONS FOR PREMIUM TAX CREDITS, 

2 REDUCTIONS IN COST-SHARING, AND FUND3 ING OF NAVIGATORS AND RELATED EX4 CHANGE ENROLLMENT ACTIVITIES. 

5 (a) IN GENERAL.—Notwithstanding any other provi6 sion of law, no premium tax credit shall be allowed under 

7 section 36B of the Internal Revenue Code of 1986, no re8 duction in cost-sharing shall be allowed under section 

9 1402 of the Patient Protection and Affordable Care Act 

10 (42 U.S.C. 18071), and no funds may be awarded under 

11 section 1311 of such Act (42 U.S.C. 18031) for the oper12 ation of a Navigator program under subsection (i) of such 

13 section or for facilitation or advocacy for enrollment under 

14 subsections (d)(6)(B) and (E) of such section, until— 

15 (1) 1 year after the date the Secretary certifies 

16 to Congress that the ACA verification methods (as 

17 defined in subsection (c)(1))— 

18 (A) have been tested to verify their accu19 racy; and 

20 (B) have safeguards in place to protect 

21 personally identifiable information; and 

22 (2) the Inspector General of the Department of 

23 Health and Human Services reviews such 

24 verification methods and certifies to Congress— 

25 (A) the quality, accuracy, response time, 

26 and integrity of such verification methods; and 


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1 (B) that the level of improper subsidy pay2 ments is not likely to exceed 3 percent of the 

3 level of the total subsidy payments (as defined 

4 in subsection (c)(3)). 

5 (b) SUBSEQUENT ANNUAL CERTIFICATION OF

6 VERIFICATION METHODS.— 

7 (1) IN GENERAL.—The Inspector General of 

8 the Department of Health and Human Services shall 

9 annually review the quality, accuracy, response time, 

10 and integrity of the ACA verification methods in 

11 order to determine the level of improper subsidy pay12 ments as a percentage of the level of total subsidy 

13 payments. 

14 (2) SUSPENSION IF EXCESSIVE IMPROPER SUB15 SIDY PAYMENTS.—If the Inspector General deter16 mines for a year as a result of such review that the 

17 level of improper subsidy payments is projected to 

18 exceed 3 percent of the level of total subsidy pay19 ments, for years beginning after the date of such de20 termination awards shall be suspended until such 

21 time as the Secretary and the Inspector General cer22 tify that the level of improper subsidy payments is 

23 not likely to exceed 3 percent of the level of total 

24 subsidy payment. 

25 (c) DEFINITIONS.—In this section: 


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1 (1) The term ‘‘ACA verification methods’’ 

2 means the verification methods required under sub3 sections (c)(4) and (d) of section 1411 of the Pa4 tient Protection and Affordable Care Act (42 U.S.C. 

5 18081). 

6 (2) The term ‘‘Secretary’’ means the Secretary 

7 of Health and Human Services, acting in consulta8 tion with the Secretary of the Treasury and other 

9 appropriate Federal officials in implementing section 

10 1411 of the Patient Protection and Affordable Care 

11 Act (42 U.S.C. 18081). 

12 (3) The term ‘‘subsidy payments’’ means pre13 mium tax credits allowed under section 36B of the 

14 Internal Revenue Code of 1986 and reductions in 

15 cost-sharing effected under section 1402 of the Pa16 tient Protection and Affordable Care Act (42 U.S.C. 

17 18071). 

Æ 


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