State Exchange Accountability Act

To amend the Patient Protection and Affordable Care Act to require States with failed American Health Benefit Exchanges to reimburse the Federal Government for amounts provided under grants for the establishment and operation of such Exchanges. 1. Short title This Act may be cited as the State Exchange Accountability Act 2. Reimbursing the Federal Government for failed State Exchange grants Section 1311(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(a) (6) Reimbursement in the case of failed Exchanges (A) In general In the case of a State that has received one or more establishment or early innovator grants under this subsection and which operated a State-based Exchange in program year 2014, if such State subsequently elects to provide solely for the enrollment of its residents in qualified health plans through the Federally Facilitated Exchange, such State shall reimburse the Federal Government for the aggregate amounts provided to the State under such grant or grants. (B) Reimbursement agreements Reimbursement shall be provided to the Federal Government by a State under this paragraph pursuant to the terms of an agreement entered into by the State and the Department of Health and Human Services that, at a minimum, shall require that— (i) such reimbursement be made, in full, within the 10-year period beginning on the date on which the State makes the election described in paragraph (1); and (ii) that the State make an annual payment in an amount equal to 10 percent of the total amount provided to the State under the grant or grants awarded to the State under this subsection. (C) No reduction in amount The Federal Government shall not reduce the amount of the reimbursement required to be provided by a State under this paragraph. (D) Failure to enter into agreement In the case of a State described in subparagraph (A) that fails to enter into an agreement under subparagraph (B), the Secretary shall reduce the amount to be paid to the State under title XIX of the Social Security Act for each of the 10 fiscal years beginning with the first fiscal year that begins after the date of the election described in subparagraph (A) by the State. The amount of each such reduction shall be uniform and shall in the aggregate equal the total amount of the reimbursement required under this paragraph. (E) Deficit reduction Amounts paid by a State under this section shall be placed in the General Fund of the Treasury to be used for deficit reduction. .

Summary: State Exchange Accountability Act - Amends the Patient Protection and Affordable Care Act to require a state to reimburse the federal government for the amount of establishment or early innovator grants the state received to operate a health care exchange if it operated an exchange in 2014 but subsequently elected to provide for enrollment in qualified health plans solely through the federal health care exchange. Requires that: (1) reimbursement be made in full within 10 years of such election, pursuant to an agreement with the Department of Health and Human Services (HHS); and (2) in case of failure to enter such an agreement, the Secretary of HHS shall reduce the state's Medicaid funding for 10 fiscal years in an aggregate amount equal to the reimbursement amount.