I 

114TH CONGRESS 

1ST SESSION H. R. 3659 

To amend the Patient Protection and Affordable Care Act to remove citizenship and immigration barriers to access the Exchanges under such Act. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 30, 2015 

Mr. GUTIE ́RREZ (for himself and Ms. JUDY CHU of California) 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 remove citizenship and immigration barriers to access 

the Exchanges under such Act. 

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 ‘‘Exchange Inclusion 

5 for a Healthy America Act of 2015’’. 


smartinez on DSK4TPTVN1PROD with BILLS
2 

•HR 3659 IH

1 SEC. 2. REMOVING CITIZENSHIP AND IMMIGRATION BAR2 RIERS TO ACCESS TO AFFORDABLE HEALTH 

3 CARE UNDER THE ACA. 

4 (a) IN GENERAL.— 

5 (1) PREMIUM TAX CREDITS.—Section 36B of 

6 the Internal Revenue Code of 1986 is amended— 

7 (A) in subsection (c)(1)(B)— 

8 (i) by amending the subparagraph 

9 heading to read as follows: ‘‘SPECIAL RULE

10 FOR CERTAIN INDIVIDUALS INELIGIBLE

11 FOR MEDICAID DUE TO STATUS’’; and 

12 (ii) in clause (ii), by striking ‘‘lawfully 

13 present in the United States, but’’ and in14 serting ‘‘who’’; and 

15 (B) by striking subsection (e). 

16 (2) COST-SHARING REDUCTIONS.—Section 1402 

17 of the Patient Protection and Affordable Care Act 

18 (42 U.S.C. 18071) is amended by striking sub19 section (e). 

20 (3) PREEXISTING CONDITION INSURANCE

21 PLAN.—Section 1101(d) of the Patient Protection 

22 and Affordable Care Act (42 U.S.C. 18001(d)) is 

23 amended by striking paragraph (1) and redesig24 nating paragraphs (2) and (3) as paragraphs (1) 

25 and (2), respectively. 


smartinez on DSK4TPTVN1PROD with BILLS
3 

•HR 3659 IH

1 (4) BASIC HEALTH PROGRAM ELIGIBILITY.— 

2 Section 1331(e)(1)(B) of the Patient Protection and 

3 Affordable Care Act (42 U.S.C. 18051(e)(1)(B)) is 

4 amended by striking ‘‘lawfully present in the United 

5 States,’’. 

6 (5) RESTRICTIONS ON FEDERAL PAYMENTS.— 

7 Section 1412 of the Patient Protection and Afford8 able Care Act (42 U.S.C. 18082) is amended by 

9 striking subsection (d). 

10 (6) REQUIREMENT TO MAINTAIN MINIMUM ES11 SENTIAL COVERAGE.—Subsection (d) of section 

12 5000A of the Internal Revenue Code of 1986 is 

13 amended by striking paragraph (3) and by redesig14 nating paragraph (4) as paragraph (3). 

15 (b) CONFORMING AMENDMENTS.— 

16 (1) ESTABLISHMENT OF PROGRAM.—Section 

17 1411(a) of the Patient Protection and Affordable 

18 Care Act (42 U.S.C. 18081(a)) is amended by strik19 ing paragraph (1) and redesignating paragraphs (2), 

20 (3), and (4) as paragraphs (1), (2), and (3), respec21 tively. 

22 (2) QUALIFIED INDIVIDUALS.—Section 1312(f) 

23 of the Patient Protection and Affordable Care Act 

24 (42 U.S.C. 18032(f)) is amended— 


smartinez on DSK4TPTVN1PROD with BILLS
4 

•HR 3659 IH

1 (A) in the subsection heading, by striking 

2 the semicolon and all that follows through 

3 ‘‘RESIDENTS’’; and 

4 (B) by striking paragraph (3). 

5 (c) RULE OF CONSTRUCTION.—Nothing in this Act 

6 shall be construed as affecting the application of para7 graph (a)(3) of section 155.305 of title 45, Code of Fed8 eral Regulations (relating to residency requirements for 

9 eligibility for enrollment in the Exchanges), or of para10 graph (f)(4) of such section (relating to tax filing require11 ments for advance payments of the premium tax credit) 

12 or any successor to either such paragraph. 

13 (d) EFFECTIVE DATE.—The amendments made by 

14 this section shall apply to years, plan years, and taxable 

15 years, as applicable, beginning after December 31, 2015. 

16 SEC. 3. TREATMENT OF INDIVIDUALS GRANTED DEFERRED 

17 ACTION. 

18 (a) IN GENERAL.—For purposes of eligibility under 

19 any of the provisions referred to in subsection (c), notwith20 standing paragraph (8) of section 152.2 of title 45, Code 

21 of Federal Regulations, individuals described in subsection 

22 (b) shall be considered lawfully present in the United 

23 States. 


smartinez on DSK4TPTVN1PROD with BILLS
5 

•HR 3659 IH

1 (b) INDIVIDUALS DESCRIBED.—For purposes of sub2 section (a), the individuals described in this subsection are 

3 the following: 

4 (1) An individual with deferred action under 

5 the Department of Homeland Security’s deferred ac6 tion for childhood arrivals process, as described in 

7 the Secretary of Homeland Security’s June 15, 

8 2012, memorandum. 

9 (2) An individual with deferred action under 

10 the Department of Homeland Security’s deferred ac11 tion process for expanded deferred action for child12 hood arrivals and parents of United States citizens 

13 and lawful permanent residents, as described in the 

14 Secretary of Homeland Security’s November 20, 

15 2014, memorandum. 

16 (c) PROVISIONS DESCRIBED.—For purposes of sub17 section (a), the provisions described in this subsection are 

18 the following: 

19 (1) EXCHANGE ELIGIBILITY.—Section 1311 of 

20 the Patient Protection and Affordable Care Act (42 

21 U.S.C. 18031). 

22 (2) REDUCED COST-SHARING ELIGIBILITY.— 

23 Section 1402 of the Patient Protection and Afford24 able Care Act (42 U.S.C. 18071). 


smartinez on DSK4TPTVN1PROD with BILLS
6 

•HR 3659 IH

1 (3) PREMIUM SUBSIDY ELIGIBILITY.—Section 

2 36B of the Internal Revenue Code of 1986. 

Æ 


smartinez on DSK4TPTVN1PROD with BILLS