ENROLL Act of 2019

To amend the Patient Protection and Affordable Care Act to provide for additional requirements with respect to the navigator program, and for other purposes. 1. Short title This Act may be cited as the Expand Navigators’ Resources for Outreach, Learning, and Longevity Act of 2019 ENROLL Act of 2019 2. Providing for additional requirements with respect to the navigator program (a) In general Section 1311(i) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(i) (1) in paragraph (2), by adding at the end the following new subparagraph: (C) Selection of recipients In the case of an Exchange established and operated by the Secretary within a State pursuant to section 1321(c), in awarding grants under paragraph (1), the Exchange shall— (i) select entities to receive such grants based on an entity’s demonstrated capacity to carry out each of the duties specified in paragraph (3); (ii) not take into account whether or not the entity has demonstrated how the entity will provide information to individuals relating to group health plans offered by a group or association of employers described in section 2510.3–5(b) of title 29, Code of Federal Regulations (or any successor regulation), or short-term limited duration insurance (as defined by the Secretary for purposes of section 2791(b)(5) of the Public Health Service Act); and (iii) ensure that, each year, the Exchange awards such a grant to— (I) at least one entity described in this paragraph that is a community and consumer-focused nonprofit group; and (II) at least one entity described in subparagraph (B), which may include another community and consumer-focused nonprofit group in addition to any such group awarded a grant pursuant to subclause (I). In awarding such grants, an Exchange may consider an entity’s record with respect to waste, fraud, and abuse for purposes of maintaining the integrity of such Exchange. ; (2) in paragraph (3)— (A) in subparagraph (C), by inserting after qualified health plans , State medicaid plans under title XIX of the Social Security Act, and State children’s health insurance programs under title XXI of such Act (B) by adding at the end the following flush left sentence: The duties specified in the preceding sentence may be carried out by such a navigator at any time during a year. (3) in paragraph (4)(A)— (A) in the matter preceding clause (i), by striking not (B) in clause (i)— (i) by inserting not be (ii) by striking ; or (C) in clause (ii)— (i) by inserting not receive (ii) by striking the period and inserting a semicolon; and (D) by adding at the end the following new clause: (iii) maintain physical presence in the State of the Exchange so as to allow in-person assistance to consumers. ; and (4) in paragraph (6)— (A) by striking Funding Funding (A) State Exchanges Grants under ; and (B) by adding at the end the following new subparagraph: (B) Federal Exchanges For purposes of carrying out this subsection, with respect to an Exchange established and operated by the Secretary within a State pursuant to section 1321(c), the Secretary shall obligate $100,000,000 out of amounts collected through the user fees on participating health insurance issuers pursuant to section 156.50 of title 45, Code of Federal Regulations (or any successor regulations) for fiscal year 2020 and each subsequent fiscal year. Such amount for a fiscal year shall remain available until expended. . (b) Effective date The amendments made by subsection (a) shall apply with respect to plan years beginning on or after January 1, 2020.

Summary: Expand Navigators' Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019 This bill makes several changes to the navigator program for health insurance exchanges (a program through which entities receive funding to provide education and enrollment assistance). Specifically, the bill addresses certain funding decisions and regulatory actions taken by the Centers for Medicare & Medicaid Services (CMS). For example, the bill increases funding for navigators in federally facilitated exchanges (FFEs) beginning in FY2020. (The CMS decreased annual funding for FFE navigators for the 2017-2018 and 2018-2019 program years.) The bill also counters guidance issued by the CMS regarding navigator criteria by requiring FFE navigators to be chosen without regard to how the entity provides information on association health plans or short-term, limited-duration insurance. The bill also reinstates certain requirements that were removed by the CMS in 2018. Specifically, the bill requires (1) at least two navigators in each FFE, including at least one community and consumer-focused nonprofit group; and (2) that navigators be physically present in the state where the exchange is located.