I 
113TH CONGRESS 
2D SESSION 
H. R. 4796 
To direct the Secretary of Health and Human Services to conduct outreach 
efforts to provide certain health insurance information to individuals 
enrolled in qualified health plans offered through an Exchange estab-
lished under title I of the Patient Protection and Affordable Care Act 
or State plans under the Medicaid program under title XIX of the 
Social Security Act, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 2, 2014 
Ms. JACKSON LEE (for herself, Ms. CLARKE of New York, Ms. BROWN of 
Florida, Mr. CLAY, Mr. RANGEL, and Ms. NORTON) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To direct the Secretary of Health and Human Services to 
conduct outreach efforts to provide certain health insur-
ance information to individuals enrolled in qualified 
health plans offered through an Exchange established 
under title I of the Patient Protection and Affordable 
Care Act or State plans under the Medicaid program 
under title XIX of the Social Security Act, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Keeping Well by Using 
Your Patient Protection and Affordable Care Act Plan’’. 
SEC. 2. OUTREACH TO CERTAIN INDIVIDUALS ON CERTAIN 
HEALTH INSURANCE INFORMATION. 
(a) IN GENERAL.—Beginning not later than 90 days 
after the date of the enactment of this Act, the Secretary 
of Health and Human Services shall conduct outreach ef-
forts to provide, using the most effective means (as deter-
mined by the Secretary), the health insurance information 
described in subsection (b) to— 
(1) individuals enrolled in qualified health plans 
offered through an Exchange established under title 
I of the Patient Protection and Affordable Care Act 
(Public Law 111–148); and 
(2) individuals enrolled in State plans (or under 
a waiver of such a plan) under the Medicaid pro-
gram under title XIX of the Social Security Act. 
(b) INFORMATION DESCRIBED.—For purposes of 
subsection (a), the information described in this sub-
section is any information, the availability of which the 
Secretary of Health and Human Services determines will 
encourage the utilization of primary care or preventive 
services by the individuals described in such subsection, 
including the following: 
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(1) Information on the extent to which the es-
sential 
health 
benefits 
specified 
in 
section 
1302(b)(1) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18022(b)(1)) are provided by 
a plan described in subsection (a). 
(2) Information on which preventive health 
services are covered under such a plan without the 
application of any cost-sharing (such as a copayment 
or coinsurance), including screenings for certain con-
ditions such as diabetes and high blood pressure, 
vaccinations for adults against influenza, measles, 
mumps, rubella, and other infectious diseases, and 
well-woman visits. 
(3) With respect to qualified health plans de-
scribed in subsection (a)(1), the following informa-
tion presented in a manner that allows for compari-
son of plans within each State: 
(A) Information on the rates of reimburse-
ment recognized under each such qualified 
health plan with respect to items and services 
(as specified by the Secretary) that are fur-
nished to individuals enrolled in such plan by 
health care providers participating in the net-
work of the plan, such as rates of reimburse-
ment applicable to emergency care services, lab-
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oratory tests, diagnostic tests, and physician 
services. 
(B) Information on any cost-sharing re-
quired under each such plan with respect to 
such items and services furnished to such indi-
viduals by such providers and an explanation on 
the extent to which such cost-sharing is based 
on such recognized rates of reimbursement. 
(C) A statement that— 
(i) the rates of reimbursement that 
are collectable by health care providers not 
participating in the network of such a plan 
for furnishing such items and services to 
such individuals may be more than the 
rates of reimbursement recognized under 
such plan for such items and services fur-
nished to such individuals by health care 
providers participating in the network of 
such plan; and 
(ii) any cost-sharing required under 
such a plan with respect to such items and 
services furnished to such individuals by 
health care providers not participating in 
the network of such plan may be more 
than such cost-sharing with respect to such 
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items and services furnished to such indi-
viduals by health care providers partici-
pating in the network of such plan. 
(4) An explanation of basic health insurance 
terms (as determined by the Secretary), including 
deductibles, cost-sharing, copayment, and coinsur-
ance, and the application of such terms to an indi-
vidual enrolled in a plan described in subsection (a), 
illustrated with examples of the application of such 
terms with respect to such individuals under dif-
ferent circumstances and in different health care 
settings. 
(c) REPORT ON OUT-OF-POCKET COSTS.—Not later 
than 180 days after the date of the enactment of this Act, 
with respect to the most recent plan year for which infor-
mation is available, the Secretary of Health and Human 
Services shall submit to the Committee on Energy and 
Commerce of the House of Representatives and the Com-
mittee on Health, Education, Labor, and Pensions of the 
Senate a report that— 
(1) contains information, for each State (includ-
ing the District of Columbia), on the median cost- 
sharing responsibility, with respect to qualified 
health plans offered through an Exchange in such 
State, of health care services— 
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(A) the number of which and types of 
which are determined appropriate by the Sec-
retary to be included in the report; and 
(B) that have been identified by the Sec-
retary as services— 
(i) for which, with respect to such 
plan year, payment may only be made 
under such a plan after satisfaction of the 
deductible applicable under such plan; and 
(ii) for which reimbursement under 
such plan is made most frequently during 
such plan year; and 
(2) describes the best method for making the 
information referred to in paragraph (1) available to 
the public. 
Æ 
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