II 

115TH CONGRESS 

1ST SESSION S. 2052 

To provide for temporary funding for health insurance cost-sharing reduction 

payments and provide targeted tax relief, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 1, 2017 

Mr. HATCH introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To provide for temporary funding for health insurance costsharing reduction payments and provide targeted tax relief, 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. 

4 This Act may be cited as the ‘‘Health Care Market 

5 Certainty and Mandate Relief Act’’. 

6 SEC. 2. COST-SHARING REDUCTION PAYMENTS. 

7 (a) IN GENERAL.— 

8 (1) APPROPRIATIONS.—There is appropriated 

9 to the Secretary of Health and Human Services, out 

10 of any funds in the Treasury not otherwise approVerDate Sep 11 2014 23:42 Nov 02, 2017 Jkt 079200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2052.IS S2052

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1 priated, such sums as may be necessary for pay2 ments for cost-sharing reductions authorized by sec3 tion 1402 of Public Law 111–148, including through 

4 advanced payment of such reductions under section 

5 1412 of such Public Law for plan years 2017, 2018, 

6 and 2019 (and including for adjustments to any 

7 prior obligations for such payments). 

8 (2) ADJUSTMENTS.—Notwithstanding any 

9 other provision of this Act, payments and other ac10 tions for adjustments to obligations incurred prior to 

11 December 31, 2019, may be made through Decem12 ber 31, 2020. 

13 (3) LIMITATION.—Amounts appropriated under 

14 paragraph (1) shall not include payment to an issuer 

15 of a qualified health plan that includes coverage of 

16 abortion (other than any abortion necessary to save 

17 the life of the mother or any abortion with respect 

18 to a pregnancy that is the result of an act of rape 

19 or incest). 

20 (b) SPECIAL RULE FOR PLAN YEAR 2018 PAY21 MENTS.—Section 1402(c) of Public Law 111–148 (42 

22 U.S.C. 18071(c)) is amended— 

23 (1) in paragraph (3)(A), by striking ‘‘An 

24 issuer’’ and inserting ‘‘Subject to paragraph (6), an 

25 issuer’’; and 


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1 (2) by adding at the end the following new 

2 paragraph: 

3 ‘‘(6) SPECIAL RULE FOR PLAN YEAR 2018 PAY4 MENTS.— 

5 ‘‘(A) IN GENERAL.—The Secretary shall 

6 make payments under paragraph (3)(A), includ7 ing through advanced payment for cost-sharing 

8 reduction under section 1412, for plan year 

9 2018 to an issuer of a qualified health plan, 

10 subject to subparagraph (C), only if the Sec11 retary determines, based on a certification and 

12 appropriate documentation from the issuer and 

13 a certification from State regulators, that the 

14 premium rates applied under such plan for such 

15 plan year were based on the assumption of re16 ceiving payments under paragraph (3)(A) for 

17 such plan year (including by reason of the plan 

18 being offered in a State in which the State reg19 ulators instructed issuers of health plans in 

20 such State to make such an assumption). 

21 ‘‘(B) RECOVERY OF PAST PAYMENTS.—If 

22 the Secretary makes payments to an issuer of 

23 a qualified health plan under paragraph (3)(A) 

24 for plan year 2018 and subsequently determines 

25 that such issuer increased premium rates for 


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1 that plan year because the issuer expected, or 

2 was instructed by applicable State regulators to 

3 expect, that the issuer would not receive such 

4 payments (or, in the case of such payments 

5 made to an issuer of a qualified health plan for 

6 plan year 2018 pursuant to subparagraph (C), 

7 determines that such issuer did not reduce pre8 mium rates under such plan for such plan year 

9 to such rates as described in clause (i)(I) of 

10 such subparagraph) the Secretary may reduce 

11 payments due to such issuer under paragraph 

12 (3)(A) for a subsequent plan year by the 

13 amount paid to such issuer under such para14 graph for plan year 2018. 

15 ‘‘(C) PAYMENTS ALLOWED IN CASE OF

16 ISSUERS IN STATES PROVIDING FOR PREMIUM

17 ADJUSTMENT PROCESS.—Notwithstanding sub18 paragraph (A), the Secretary may make pay19 ments under paragraph (3)(A) for plan year 

20 2018 to an issuer of a qualified health plan not 

21 otherwise eligible for such payments pursuant 

22 to subparagraph (A) if— 

23 ‘‘(i) the qualified health plan is of24 fered in a State for such plan year for 

25 which the State insurance commissioner 


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1 notifies the Secretary of the Treasury and 

2 the Secretary of Health and Human Serv3 ices of a process provided for in the State 

4 under which— 

5 ‘‘(I) issuers of qualified health 

6 plans in such State choosing to par7 ticipate in such process are required 

8 to reduce premium rates under such 

9 plans for plan year 2018 to the rates 

10 that would have been applied under 

11 such plans for such plan year had the 

12 issuers assumed payments for cost13 sharing reductions under such para14 graph would be received for such plan 

15 year; and 

16 ‘‘(II) the State submits to the 

17 Secretaries information to verify that 

18 the reduction of the premium rate 

19 under a qualified health plan offered 

20 by an issuer participating under such 

21 process satisfies the reduction require22 ment described in subclause (I); and 

23 ‘‘(ii) the issuer of such qualified 

24 health plan chooses to participate in such 

25 process. 


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1 ‘‘(D) RECONCILIATION PROCESS.—The 

2 Secretary of the Treasury and the Secretary of 

3 Health and Human Services shall adjust the 

4 methodologies under section 156.430 of title 45, 

5 Code of Federal Regulations (as in effect on the 

6 date of enactment of the Health Care Market 

7 Certainty and Mandate Relief Act), as may be 

8 necessary to correct for any overpayments or 

9 underpayments made under this section to an 

10 issuer in accordance with this paragraph.’’. 

11 SEC. 3. MORATORIUM ON INDIVIDUAL MANDATE. 

12 Section 5000A of the Internal Revenue Code of 1986 

13 is amended— 

14 (1) in subsection (a), by striking ‘‘An applica15 ble’’ and inserting ‘‘Except as provided in subsection 

16 (h), an applicable’’; and 

17 (2) by adding at the end the following new sub18 section: 

19 ‘‘(h) SUSPENSION.—This section shall not apply to 

20 any month beginning after December 31, 2016, and before 

21 January 1, 2022.’’. 

22 SEC. 4. MORATORIUM ON EMPLOYER MANDATE. 

23 Section 4980H of the Internal Revenue Code of 1986 

24 is amended by adding at the end the following new sub25 section: 


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1 ‘‘(e) SUSPENSION.—This section shall not apply to 

2 any month beginning after December 31, 2014, and before 

3 January 1, 2018.’’. 

4 SEC. 5. MAXIMUM CONTRIBUTION LIMIT TO HEALTH SAV5 INGS ACCOUNT INCREASED TO AMOUNT OF 

6 DEDUCTIBLE AND OUT-OF-POCKET LIMITA7 TION. 

8 (a) IN GENERAL.—Subsection (b) of section 223 of 

9 the Internal Revenue Code of 1986 is amended by adding 

10 at the end the following new paragraph: 

11 ‘‘(9) INCREASED LIMITATION.—In the case of 

12 any month beginning after December 31, 2017, and 

13 before January 1, 2023— 

14 ‘‘(A) paragraph (2)(A) shall be applied by 

15 substituting ‘the amount in effect under sub16 section (c)(2)(A)(ii)(I)’ for ‘$2,250’, and 

17 ‘‘(B) paragraph (2)(B) shall be applied by 

18 substituting ‘the amount in effect under sub19 section (c)(2)(A)(ii)(II)’ for ‘$4,500’.’’. 

20 (b) EFFECTIVE DATE.—The amendment made by 

21 this section shall apply to taxable years beginning after 

22 December 31, 2017. 

Æ 


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