I 

113TH CONGRESS 

2D SESSION H. R. 5557 

To reform the verification and reporting processes for the health care 

premium and cost-sharing subsidies. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 18, 2014 

Mrs. BLACK introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy 

and Commerce, 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 reform the verification and reporting processes for the 

health care premium and cost-sharing subsidies. 

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 ‘‘Streamlining 

5 Verification for Americans Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) Employer reporting requirements under the 

9 Patient Protection and Affordable Care Act (Public 


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1 Law 111–148) should strike the appropriate balance 

2 between sufficient reporting to enforce the law and 

3 protecting the privacy of individuals. 

4 (2) Protection of the privacy of the primary in5 sured individual and each other individual covered 

6 under the policy, which should include minimizing 

7 the transmittal of social security numbers, should be 

8 a priority when implementing reporting require9 ments. 

10 SEC. 3. IMPROVING THE ACCURACY OF EXCHANGE DETER11 MINATIONS OF ELIGIBILITY FOR PREMIUM 

12 ASSISTANCE TAX CREDITS. 

13 (a) IN GENERAL.—If an employer provides prospec14 tive reporting for any calendar year under subsection (b), 

15 such employer shall be treated as making the return de16 scribed in section 6056(b) of the Internal Revenue Code 

17 of 1986 for such year if such return contains, consistent 

18 with the requirements of subsection (c)(2), only informa19 tion with respect to employees with respect to whom the 

20 employer has received a notification under section 

21 1411(e)(4)(B)(iii) of the Patient Protection and Afford22 able Care Act (42 U.S.C. 18081(e)(4)(B)(iii)). If the pre23 ceding sentence applies to any employer for any calendar 

24 year, such employer shall be treated as furnishing the 

25 statements required under section 6056(c) of such Code, 


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1 if the employer furnishes such statements to such employ2 ees with respect to the information included in the return 

3 made under the preceding sentence. 

4 (b) PROSPECTIVE REPORTING.—Not later than 60 

5 days after the date of the enactment of this Act, the Sec6 retary of the Treasury, in consultation with the Secretary 

7 of Health and Human Services, the Secretary of Labor, 

8 and the Administrator of the Small Business Administra9 tion, shall implement a reporting system under which an 

10 employer may elect to provide the following information 

11 with respect to a calendar year before the beginning of 

12 such year: 

13 (1) The name, date, and employer identification 

14 number of the employer. 

15 (2) A certification as to whether the employer 

16 offers to its full-time employees the opportunity to 

17 enroll in minimum essential coverage under an eligi18 ble employer-sponsored plan (as defined in section 

19 5000A(f)(2) of the Internal Revenue Code of 1986) 

20 and whether the employer offers the spouses of such 

21 full-time employees the opportunity to enroll in such 

22 coverage. 

23 (3) The months during the year for which cov24 erage is generally available to full-time employees. 


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1 (4) A certification as to whether the coverage 

2 described in paragraph (2) satisfies the requirements 

3 to qualify for one of the affordability safe harbors 

4 promulgated by the Secretary of the Treasury for 

5 purposes of section 4980H of the Internal Revenue 

6 Code of 1986. 

7 (5) A certification as to whether an employee’s 

8 effective date of coverage is generally affected by a 

9 waiting period. 

10 (c) REQUIREMENTS.—The reporting system estab11 lished under subsection (b) shall provide for— 

12 (1) the processes necessary to ensure that Ex13 changes can access the information described in sub14 section (b) to assist in verifying eligibility determina15 tions for advance payment of the premium tax cred16 its under section 36B of the Internal Revenue Code 

17 of 1986 and the cost-sharing subsidies under section 

18 1402 of the Patient Protection and Affordable Care 

19 Act (42 U.S.C. 18071); and 

20 (2) guidance on how employers who voluntarily 

21 report in advance under this section could satisfy the 

22 report and statement requirements under sub23 sections (b) and (c) of section 6056 of the Internal 

24 Revenue Code of 1986 by reporting only with re25 spect to employees with respect to whom the emVerDate Sep 11 2014 22:07 Sep 26, 2014 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5557.IH H5557

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1 ployer has received a notification under section 

2 1411(e)(4)(B)(iii) of the Patient Protection and Af3 fordable Care Act (42 U.S.C. 18081(e)(4)(B)(iii)). 

4 SEC. 4. USE OF CURRENT YEAR INFORMATION IN DETER5 MINING SUBSIDY ELIGIBILITY OF APPLI6 CANTS . 

7 (a) IN GENERAL.—Section 1412(b)(2) of the Patient 

8 Protection and Affordable Care Act (42 U.S.C. 

9 18082(b)(2)) is amended to read as follows: 

10 ‘‘(2) CHANGES IN CIRCUMSTANCES.—The Sec11 retary shall provide procedures for making advance 

12 determinations on the basis of information other 

13 than that described in paragraph (1)(B) upon the 

14 request of the individual. Such procedures shall in15 clude allowing an individual to have eligibility deter16 mined on the basis of household income for a later 

17 period or on the basis of the individual’s estimate of 

18 such income for the taxable year.’’. 

19 (b) CONFORMING AMENDMENT.—Section 

20 1411(b)(3)(B) of the Patient Protection and Affordable 

21 Care Act (42 U.S.C. 18081(b)(3)(B)) is amended to read 

22 as follows: 

23 ‘‘(B) CHANGES IN CIRCUMSTANCE.—In the 

24 case of an individual with respect to whom secVerDate Sep 11 2014 22:07 Sep 26, 2014 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5557.IH H5557

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1 tion 1412(b)(2) applies, the information de2 scribed in such section.’’. 

3 SEC. 5. EVALUATING THE DEVELOPMENT AND UTILIZA4 TION OF SYSTEMS FOR EXCHANGES TO NO5 TIFY EMPLOYERS OF POTENTIAL EXCISE TAX 

6 LIABILITY UNDER THE EMPLOYER MANDATE. 

7 Not later than 90 days after the date of the enact8 ment of this Act, the Comptroller General of the United 

9 States shall conduct a study evaluating, with respect to 

10 the period beginning on October 1, 2013, and ending on 

11 the date of the enactment of this Act— 

12 (1) the notification of employers by Exchanges 

13 established under title I of the Patient Protection 

14 and Affordable Care Act that a full-time employee 

15 has been determined eligible for an advanced pre16 mium assistance tax credit, as required by sub17 section (e)(4)(B)(iii) of section 1411 of such Act (42 

18 U.S.C. 18081); and 

19 (2) the extent to which the Secretary of Health 

20 and Human Services has established a separate ap21 peals process for employers who have been notified 

22 that an employee has been determined eligible for an 

23 advanced premium assistance tax credit to challenge 

24 that eligibility determination, as required by sub25 section (f)(2) of such section. 


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1 SEC. 6. PROTECTING DEPENDENT PRIVACY. 

2 (a) IN GENERAL.—Paragraph (1) of section 6055(b) 

3 of the Internal Revenue Code of 1986 is amended by add4 ing at the end the following flush sentence: 

5 ‘‘For purposes of subparagraph (B)(i), in the case of 

6 an individual other than the primary insured, if the 

7 person required to make the return does not collect 

8 or maintain information on the TINs of such indi9 viduals (other than for purposes of this section), the 

10 individual’s name and date of birth may be sub11 stituted for the individual’s name and TIN.’’. 

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

13 this section shall apply to returns the due date for which 

14 is after December 31, 2013. 

15 SEC. 7. ELECTRONIC STATEMENTS. 

16 (a) STATEMENTS FROM EMPLOYERS.—Subsection 

17 (c) of section 6056 of the Internal Revenue Code of 1986 

18 is amended by adding at the end the following new para19 graph: 

20 ‘‘(3) ELECTRONIC DELIVERY.—The statement 

21 required to be furnished to any employee under 

22 paragraph (1) may be furnished to such employee 

23 electronically if such employee has consented to re24 ceive such statement electronically. For purposes of 

25 the preceding sentence, if an employee has con26 sented, before the date of the enactment of this 


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1 paragraph, to electronically receive, from the person 

2 furnishing such statement, other documents used in 

3 filing the employee’s return of tax, such employee 

4 shall be treated as having consented to receive such 

5 statement electronically unless such employee re6 quests that such consent not apply to such state7 ment.’’. 

8 (b) STATEMENTS FROM INSURANCE PROVIDERS.— 

9 Subsection (c) of section 6055 of the Internal Revenue 

10 Code of 1986 is amended by adding at the end the fol11 lowing new paragraph: 

12 ‘‘(3) ELECTRONIC DELIVERY.—The statement 

13 required to be furnished to any individual under 

14 paragraph (1) may be furnished to such individual 

15 electronically if such individual has consented to re16 ceive such statement electronically. For purposes of 

17 the preceding sentence, if an individual has con18 sented, before the date of the enactment of this 

19 paragraph, to electronically receive, from the person 

20 furnishing such statement, other documents con21 taining private health information, such individual 

22 shall be treated as having consented to receive such 

23 statement electronically unless such individual re24 quests that such consent not apply to such state25 ment.’’. 


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

2 this section shall apply to statements the due date for 

3 which is after December 31, 2013. 

4 SEC. 8. DELAYING PROVISION OF ACA PREMIUM AND COST5 SHARING SUBSIDIES UNTIL ELIGIBILITY 

6 VERIFICATION PROCESS FOR SUCH SUB7 SIDIES IS COMPLETE. 

8 (a) IN GENERAL.—Notwithstanding any other provi9 sion of law, no premium tax credit under section 36B of 

10 the Internal Revenue Code of 1986 or reduced cost-shar11 ing under section 1402 of the Patient Protection and Af12 fordable Care Act (42 U.S.C. 18071) shall be allowed with 

13 respect to any individual for any coverage month which 

14 begins after December 31, 2014, and before the date on 

15 which the process to verify, in accordance with section 

16 1411 of the Patient Protection and Affordable Care Act 

17 (42 U.S.C. 18081), the estimated household income and 

18 coverage requirements of such individual for purposes of 

19 determining eligibility for, and the accurate amount of, 

20 such credit or reduction, respectively, has been completed. 

21 For purposes of the previous sentence, the verification 

22 process described in such sentence with respect to an indi23 vidual shall not be treated as complete unless a manual 

24 or electronic review has been completed of applicable infor25 mation required to be submitted by such individual under 


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1 section 1411(b) of such Act (42 U.S.C. 18081(b)) and any 

2 inconsistency of such information with records of the Sec3 retary of the Treasury, the Secretary of Homeland Secu4 rity, or the Commissioner of Social Security has been re5 solved. 

6 (b) TREATMENT OF INDIVIDUAL MANDATE.—Not7 withstanding any other provision of law, no penalty shall 

8 be imposed under section 5000A of the Internal Revenue 

9 Code of 1986 with respect to an individual for any 

10 month— 

11 (1) with respect to which such individual would 

12 (but for subsection (a)) be allowed a premium tax 

13 credit under section 36B of the Internal Revenue 

14 Code of 1986; and 

15 (2) which begins after December 31, 2014, and 

16 before the date on which the verification process de17 scribed in subsection (a) has been completed, in ac18 cordance with such subsection, with respect to the 

19 eligibility of such individual for such credit. 

Æ 


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