II 

113TH CONGRESS 

2D SESSION S. 2383 

To direct the Office of the Actuary of the Centers for Medicare & Medicaid 

Services and the Comptroller General of the United States to study 

the impact of the Patient Protection and Affordable Care Act on small 

businesses. 

IN THE SENATE OF THE UNITED STATES 

MAY 22, 2014 

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

referred to the Committee on Finance 

A BILL 

To direct the Office of the Actuary of the Centers for Medicare & Medicaid Services and the Comptroller General 

of the United States to study the impact of the Patient 

Protection and Affordable Care Act on small businesses. 

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 ‘‘Certify It Act of 

5 2014’’. 

6 SEC. 2. STUDY ON IMPACT ON SMALL BUSINESS JOBS. 

7 (a) STUDY AND REPORT.— 


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1 (1) IN GENERAL.—Not later than 1 year after 

2 the date of enactment of this Act, and December 1 

3 for each of the 4 consecutive years thereafter, the 

4 Comptroller General of the United States, shall con5 duct a study on the impact of the Affordable Care 

6 Act on small businesses, including— 

7 (A) the impact of any increased health in8 surance costs resulting from the provisions of 

9 such Act on economic indicators (including jobs 

10 lost, hours worked per employee, and any re11 sulting loss of wages); and 

12 (B) the impact of section 4980H of the In13 ternal Revenue Code of 1986 (relating to 

14 shared responsibility for employers regarding 

15 health coverage) on economic indicators, includ16 ing any jobs lost. 

17 (2) REPORT.—The Comptroller General of the 

18 United States, using data from the Office of the Ac19 tuary, Centers for Medicare & Medicaid Services, 

20 under section 3 and economic indicators data from 

21 other Federal agencies, shall submit to the appro22 priate committees of Congress a report on the study 

23 conducted under paragraph (1). 

24 (b) APPROPRIATE COMMITTEES OF CONGRESS.—For 

25 purposes of this section, the term ‘‘appropriate committees 


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1 of Congress’’ means the Committee on Ways and Means, 

2 the Committee on Education and the Workforce, the Com3 mittee on Energy and Commerce, and the Small Business 

4 Committee of the House of Representatives and the Com5 mittee on Finance, the Committee on Health, Education, 

6 Labor, and Pensions, and the Small Business and Entre7 preneurship Committee of the Senate. 

8 (c) DEFINITIONS.—For purposes of this Act: 

9 (1) AFFORDABLE CARE ACT.—The term ‘‘Af10 fordable Care Act’’ means the Patient Protection 

11 and Affordable Care Act (Public Law 111–148) and 

12 title I and subtitle B of title II of the Health Care 

13 and Education Reconciliation Act of 2010 (Public 

14 Law 111–152). 

15 (2) SMALL BUSINESS.—The term ‘‘small busi16 ness’’ means an employer with 250 or fewer employ17 ees. 

18 SEC. 3. STUDY ON IMPACT ON SMALL BUSINESS HEALTH 

19 INSURANCE. 

20 (a) STUDY AND REPORT.— 

21 (1) IN GENERAL.—Not later than 1 year after 

22 the date of the enactment of this Act, and December 

23 1 for each of the 4 consecutive years thereafter, the 

24 Office of the Actuary, Centers for Medicare & Med25 icaid Services, shall conduct a study on the impact 


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1 of the Affordable Care Act on small group health in2 surance costs, including— 

3 (A) the impact of requirements and bene4 fits pursuant to such Act on the small group 

5 health insurance market, including community 

6 rating requirements, minimum actuarial value 

7 requirements, requirements to provide for es8 sential health benefits described in section 

9 1302(b) of the Patient Protection and Afford10 able Care Act (42 U.S.C. 18022(b)), require11 ments related to cost-sharing, the prohibition 

12 on annual and lifetime limits on benefits under 

13 section 2711 of the Public Health Service Act 

14 (42 U.S.C. 300gg–11), prohibitions on cost15 sharing requirements for preventive services, 

16 and the extension of dependent coverage under 

17 section 2714 of the Public Health Service Act 

18 (42 U.S.C. 300gg–14); and 

19 (B) the impact of new taxes and fees on 

20 the small group health insurance market costs, 

21 including the fee imposed under section 9010 of 

22 the Patient Protection and Affordable Care Act 

23 (relating to imposition of annual fee on health 

24 insurance providers), the transitional reinsur25 ance program contributions, the fees imposed 


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1 under subchapter B of chapter 34 of the Inter2 nal Revenue Code of 1986 (relating to the Pa3 tient Centered Outcome Research Institute 

4 fees), and Exchange assessments or user fees. 

5 (2) REPORT.—The Office of the Actuary, Cen6 ters for Medicare & Medicaid Services, in consulta7 tion with the Comptroller General for purposes of 

8 verifying the methodology, assumptions, validity, and 

9 reasonableness of the data used by the Actuary, 

10 shall submit to the appropriate committees of Con11 gress a report on the study conducted under para12 graph (1). 

13 (b) APPROPRIATE COMMITTEES OF CONGRESS.—For 

14 purposes of this section, the term ‘‘appropriate committees 

15 of Congress’’ means the Committee on Ways and Means, 

16 the Committee on Education and the Workforce, the Com17 mittee on Energy and Commerce, and the Small Business 

18 Committee of the House of Representatives and the Com19 mittee on Finance, the Committee on Health, Education, 

20 Labor, and Pensions, and the Small Business and Entre21 preneurship Committee of the Senate. 


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1 SEC. 4. ONE-YEAR DELAY FOR EMPLOYER MANDATE IN 

2 CASE OF NEGATIVE IMPACT ON SMALL BUSI3 NESS. 

4 (a) IN GENERAL.—If the Comptroller General of the 

5 United States or the Office of the Actuary, Centers for 

6 Medicare & Medicaid Services, determines in any report 

7 submitted under section 2 or 3 that the Affordable Care 

8 Act has caused net employment loss amongst small busi9 nesses or caused small group health insurance costs to 

10 rise, section 4980H of the Internal Revenue Code of 1986 

11 shall not apply for months beginning during the 1-year 

12 period beginning on the date of the submission of such 

13 report. 

14 (b) FAILURE TO SUBMIT.—If the Comptroller Gen15 eral of the United States or the Office of the Actuary, 

16 Centers for Medicare & Medicaid Services, fails to submit 

17 a report in accordance with the timelines specified in this 

18 Act, section 4980H of the Internal Revenue Code of 1986 

19 shall not apply the following calendar year. 

Æ 


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