II 

113TH CONGRESS 

2D SESSION S. 2173 

To amend the Patient Protection and Affordable Care Act to provide a 

permanent path for the direct enrollment of individuals in qualified 

health plans. 

IN THE SENATE OF THE UNITED STATES 

MARCH 27, 2014 

Ms. LANDRIEU (for herself, Mr. MANCHIN, Mr. WARNER, Ms. HEITKAMP, and 

Mr. BEGICH) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Patient Protection and Affordable Care Act 

to provide a permanent path for the direct enrollment 

of individuals in qualified health plans. 

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 ‘‘Consumers Having Op5 tions in Choosing Enrollment Act’’ or the ‘‘CHOICE Act’’. 

6 SEC. 2. PERMANENT PATHWAY FOR DIRECT ENROLLMENT. 

7 (a) FINDINGS.—Congress finds the following: 

8 (1) Successful implementation of the Patient 

9 Protection and Affordable Care Act (referred to in 


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1 this section as the ‘‘ACA’’) is critical to ensuring 

2 that more Americans are able to access health care 

3 coverage. 

4 (2) The ACA provided for the establishment of 

5 new State-based or, in the absence of State action, 

6 federally facilitated marketplaces to help connect 

7 consumers with health insurance options and cov8 erage. 

9 (3) As part of the regulatory guidance related 

10 to the marketplaces, the Department of Health and 

11 Human Services provided consumers with an option 

12 to enroll in health insurance coverage directly, 

13 known as direct enrollment. 

14 (4) The Department of Health and Human 

15 Services also permits enrollment through an Ex16 change with the assistance of an agent or broker, in17 cluding permitting consumers to select a product on 

18 the Internet website of an agent or broker. 

19 (5) Consumers should be permitted a perma20 nent option to enroll directly with a qualified health 

21 plan issuer, or Internet website of an agent or 

22 broker, in a manner consistent with the market23 places and as long as certain consumer protections 

24 are followed. 


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1 (6) Consumers should continue to be informed 

2 that other health insurance products are available 

3 and offered. 

4 (7) Consumers should be notified of their eligi5 bility determination for coverage through the Ex6 change Internet website for premium tax credits and 

7 cost sharing reductions. 

8 (8) Direct enrollment is not a new idea and has 

9 proven to work successfully in getting seniors cov10 erage through the Medicare Advantage program and 

11 the Medicare Part D program. 

12 (9) Providing a permanent pathway for con13 sumers to directly enroll with a qualified health plan 

14 issuer or the certified Internet website of an agent 

15 or broker gives such consumers another option to 

16 sign up for health insurance coverage and takes the 

17 United States one step closer to achieving the goals 

18 of the ACA. 

19 (b) DIRECT ENROLLMENT.—Section 1312 of the Pa20 tient Protection and Affordable Care Act (42 U.S.C. 

21 18032) is amended by adding at the end the following: 

22 ‘‘(g) DIRECT ENROLLMENT.— 

23 ‘‘(1) IN GENERAL.—Not later than 30 days 

24 after the date of enactment of this subsection, the 

25 Secretary shall issue guidelines and necessary operVerDate Mar 15 2010 02:57 Mar 29, 2014 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2173.IS S2173

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1 ational specifications to provide for the establish2 ment of a permanent pathway to enable individuals 

3 to enroll in qualified health plans through— 

4 ‘‘(A) in the case of a State with a State5 based Exchange, the Exchange, or if deter6 mined appropriate by the State, a health insur7 ance issuer, a certified agent or broker, or a 

8 Centers for Medicare & Medicaid Services cer9 tified Internet web-based broker or entity; or 

10 ‘‘(B) in the case of a State with no State 

11 Exchange, the Federal Exchange, a health in12 surance issuer, an agent or broker certified by 

13 the Federal Exchange, or a Centers for Medi14 care & Medicaid Services certified Internet web15 based broker or entity. 

16 ‘‘(2) AVAILABILITY.—Guidelines and oper17 ational capabilities issued under paragraph (1) shall 

18 be available to consumers and applicable health in19 surance issuers and entities for any enrollment pe20 riod required under section 1311(c)(6).’’. 

Æ 


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