II 

113TH CONGRESS 

2D SESSION S. 2749 

To establish a board of directors and CEO to oversee the Federal Exchange 

and State Exchanges, and to provide health insurance oversight. 

IN THE SENATE OF THE UNITED STATES 

JULY 31, 2014 

Mrs. SHAHEEN introduced the following bill; which was read twice and 

referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To establish a board of directors and CEO to oversee the 

Federal Exchange and State Exchanges, and to provide 

health insurance oversight. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. EXCHANGE OVERSIGHT. 

4 Subtitle D of title I of the Patient Protection and 

5 Affordable Care Act (42 U.S.C. 18021 et seq.) is amended 

6 by adding at the end the following: 

7 ‘‘PART 6—EXCHANGE OVERSIGHT 

8 ‘‘SEC. 1351. BOARD OF DIRECTORS AND CEO. 

9 ‘‘(a) IN GENERAL.—There is established the Market10 place Health Insurance Corporation headed by a Chief ExVerDate Mar 15 2010 20:35 Aug 09, 2014 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2749.IS S2749

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1 ecutive Officer and directed by a Board of Directors, to 

2 oversee management of the Federal Exchange and State 

3 Exchanges, and to provide health insurance oversight. 

4 ‘‘(b) CEO.— 

5 ‘‘(1) IN GENERAL.—The President shall ap6 point a Chief Executive Officer, by and with the con7 sent of the Senate, who shall be responsible for ad8 ministering the Federal Exchange, for overseeing 

9 State Exchanges, and for health insurance oversight. 

10 ‘‘(2) AUTHORITIES AND DUTIES.—The Chief 

11 Executive Officer shall— 

12 ‘‘(A) report directly to the President; 

13 ‘‘(B) be accountable for implementation of 

14 the Federal Exchange and oversight of the 

15 State Exchanges; 

16 ‘‘(C) be responsible for all Federal health 

17 insurance oversight; and 

18 ‘‘(D) serve the public interest of individ19 uals seeking health insurance, serve businesses 

20 seeking access to health coverage through the 

21 Exchanges, and ensure the efficient operation 

22 and function of the Exchanges. 

23 ‘‘(3) REQUIREMENT.—To be eligible for ap24 pointment as Chief Executive Officer, an individual 


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1 shall have a background in health care issues and 

2 private-sector management experience. 

3 ‘‘(c) BOARD OF DIRECTORS.— 

4 ‘‘(1) ESTABLISHMENT.—There is established a 

5 Board of Directors of the Marketplace Health Insur6 ance Corporation. 

7 ‘‘(2) DUTIES.—The Board of Directors shall 

8 advise the Chief Executive Officer on the operation 

9 of the Federal Exchange, implementation of the 

10 State Exchanges, and health insurance oversight, in11 cluding— 

12 ‘‘(A) the functionality of healthcare.gov (or 

13 any subsequent Internet site), including SHOP 

14 exchanges; 

15 ‘‘(B) ensuring that enrollment information 

16 is properly transferred from healthcare.gov (or 

17 any subsequent Internet site) to State Medicaid 

18 agencies; 

19 ‘‘(C) accuracy of enrollee information sub20 mitted through the Exchanges; 

21 ‘‘(D) ensuring the accuracy of advanced 

22 premium tax credits; 

23 ‘‘(E) ensuring the accuracy of payment to 

24 insurers; 


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1 ‘‘(F) enhancement of the consumer experi2 ence when comparing plans, including out-of3 pocket costs, and searching for a specific pro4 vider or drug formulary; 

5 ‘‘(G) overseeing the selection of plans of6 fered on the Federal Exchange, including suffi7 cient network adequacy and transparency re8 quirements; 

9 ‘‘(H) providing recommendations to the 

10 Secretary of the Treasury with respect to the 

11 implementation of section 4980H of the Inter12 nal Revenue Code of 1986 and potential policy 

13 changes with respect to such section and associ14 ated reporting requirements; 

15 ‘‘(I) creating an automated appeals system 

16 for healthcare.gov (or any subsequent Internet 

17 site); 

18 ‘‘(J) overseeing the transition from a State 

19 Exchange to the Federal Exchange; 

20 ‘‘(K) enabling online enrollment in health 

21 insurance plans through the Exchanges for 

22 small businesses and employee choice for em23 ployees of small businesses; 


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1 ‘‘(L) overseeing the Federal contracting re2 lated to healthcare.gov (or any subsequent 

3 Internet site); 

4 ‘‘(M) providing recommendations to the 

5 Office of Personal Management on the over6 sight and administration of the multi-State plan 

7 program; and 

8 ‘‘(N) additional matters, as determined by 

9 the Secretary of Health and Human Services, 

10 the Chief Executive Officer, or President. 

11 ‘‘(3) MEMBERSHIP.—The Board of Directors 

12 shall be comprised of the following: 

13 ‘‘(A) The Secretary of Health and Human 

14 Services. 

15 ‘‘(B) The Administrator of the Centers for 

16 Medicare & Medicaid Services. 

17 ‘‘(C) The Commissioner of the Internal 

18 Revenue Service. 

19 ‘‘(D) The Administrator of the Small Busi20 ness Administration. 

21 ‘‘(E) Three representatives of the private 

22 sector who have demonstrated knowledge in in23 dividual health care coverage, small employer 

24 health care coverage, administering a public or 

25 private health care delivery system, operating 


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1 complex information system technologies, or 

2 promoting health and wellness, appointed by 

3 the Comptroller General of the United States. 

4 ‘‘(4) TERMS.— 

5 ‘‘(A) OFFICERS OF THE FEDERAL GOV6 ERNMENT.—Each member of the Board of Di7 rectors described in subparagraphs (A) through 

8 (D) of paragraph (3) shall serve for a term that 

9 is concurrent with the member’s term as an of10 ficer within the Federal department or agency. 

11 ‘‘(B) OTHER MEMBERS.—Each member of 

12 the board described in paragraph (3)(E) shall 

13 be appointed for a term of 3 years and may be 

14 reappointed for a term of an additional 2 years. 

15 ‘‘(5) CHAIRPERSON.—The Secretary of Health 

16 and Human Services shall serve as Chair of the 

17 Board of Directors. 

18 ‘‘(d) TECHNICAL ADVISORY COMMITTEE.— 

19 ‘‘(1) IN GENERAL.—To assist the Chief Execu20 tive Officer and Board of Directors in carrying out 

21 their duties, the Board of Directors shall establish a 

22 technical advisory committee. 

23 ‘‘(2) MEMBERSHIP.—The technical advisory 

24 committee shall be comprised of the following: 


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1 ‘‘(A) One technical expert from the Cen2 ters for Medicare & Medicaid Administration. 

3 ‘‘(B) One representative of the health in4 surance industry. 

5 ‘‘(C) One representative of health care con6 sumer groups. 

7 ‘‘(D) One representative of the National 

8 Association of Insurance Commissioners. 

9 ‘‘(E) One representative of the State Med10 icaid agencies. 

11 ‘‘(F) One representative from the small 

12 business community. 

13 ‘‘(G) One representative of Federal infor14 mation technology contractors involved in the 

15 operation and development of healthcare.gov (or 

16 any subsequent Internet site). 

17 ‘‘(H) At the discretion of the Chair of the 

18 Board of Directors, up to 2 additional mem19 bers, selected by the Chair and approved by the 

20 Chief Executive Officer. 

21 ‘‘(3) CHAIR.—The Chair of the Board of Direc22 tors shall appoint one member of the technical advi23 sory committee to serve as Chair of such committee. 

24 ‘‘(4) TERMS.—Each member of the technical 

25 advisory committee shall be appointed for a term of 


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1 3 years and may be reappointed for a term of an ad2 ditional 2 years. 

3 ‘‘(e) WORK PLAN AND REPORT.— 

4 ‘‘(1) WORK PLAN.—Not later than 3 months 

5 after the date of enactment of this section, the Chief 

6 Executive Officer, in cooperation with the Board of 

7 Directors, shall develop a work plan with respect to 

8 duties described in subsection (c)(2), indicating the 

9 priority and schedule the Board of Directors will 

10 take in addressing such duties. The work plan shall 

11 be displayed on healthcare.gov (or any subsequent 

12 Internet site). 

13 ‘‘(2) ANNUAL REPORT.—Not later than Feb14 ruary 1 of each year, the Chief Executive Officer, in 

15 consultation with the Board of Directors, shall sub16 mit an annual report to the President and Congress 

17 on the status of the Federal Exchange and related 

18 insurance oversight, including progress made on the 

19 duties of the Chief Executive Officer and Board of 

20 Directors under subsection (c)(2) and remaining 

21 issues to be addressed to enhance the functionality 

22 of healthcare.gov (or any subsequent Internet 

23 site).’’. 

Æ 


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