SEC. 2. PROCEDURES FOR ELIGIBILITY DETERMINATIONS 
UNDER TITLE I OF THE PATIENT PROTEC-
TION AND AFFORDABLE CARE ACT. 
(a) REQUIREMENTS FOR IN-PERSON ATTESTATION 
OF CITIZENSHIP STATUS OR STATUS AS ELIGIBLE LAW-
FUL PERMANENT RESIDENT.—Section 1411 of the Pa-
tient Protection and Affordable Care Act is amended— 
(1) in subsection (a), by striking ‘‘ESTABLISH-
MENT OF PROGRAM.—’’ and all that follows through 
‘‘determining—’’ 
and 
inserting 
‘‘VERIFICATION 
PROCESS.—The Secretary shall ensure that eligi-
bility determinations required by this Act are con-
ducted in accordance with the requirements of this 
section, including requirements for determining—’’; 
(2) in subsection (a)(1), by inserting ‘‘eligible’’ 
before ‘‘alien’’; and 
(3) in subsection (b)(1)— 
(A) by striking ‘‘provide—’’ and inserting 
‘‘appear in person to provide the Exchange with 
the following:’’; and 
(B) by redesignating subparagraph (B) as 
subparagraph (C), by striking ‘‘and’’ at the end 
of subparagraph (A), and by inserting after 
subparagraph (A) the following: 
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‘‘(B) a sworn statement, under penalty of 
perjury, specifically attesting to the fact that 
the enrollee is either— 
‘‘(i) a citizen or national of the United 
States; or 
‘‘(ii) an alien who meets the require-
ments under under subsection (a)(1) for 
eligibility for coverage under a qualified 
health plan offered through an Exchange; 
and’’. 
(b) REQUIREMENTS FOR ESTABLISHMENT OF STA-
TUS.— 
(1) IN GENERAL.—Section 1411(b)(2) of such 
Act is amended by striking subparagraphs (A) and 
(B) and inserting the following: 
‘‘(A) EVIDENCE OF CITIZENSHIP OR NA-
TIONALITY.—In the case of an enrollee whose 
eligibility is based on attestation of citizenship 
of the enrollee, satisfactory evidence, provided 
by the applicant, of citizenship or nationality 
(within the meaning of section 1903(x) of the 
Social Security Act (42 U.S.C. 1396b)). 
‘‘(B) EVIDENCE OF SATISFACTORY IMMI-
GRATION STATUS.—In the case of an enrollee 
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whose eligibility is based on attestation of the 
enrollee’s immigration status— 
‘‘(i) such information as is necessary 
for the applicant to demonstrate that the 
enrollee is in ‘‘satisfactory immigration 
status’’ as defined and in accordance with 
the Systematic Alien Verification for Enti-
tlements (SAVE) program established by 
section 1137 of the Social Security Act (42 
U.S.C. 1320b–7), and 
‘‘(ii) such other additional identifying 
information as the Secretary, in consulta-
tion with the Secretary of Homeland Secu-
rity, may require in order for the applicant 
to demonstrate satisfactory immigration 
status of the enrollee.’’. 
(2) VERIFICATION
OF
ELIGIBILITY
BY
EX-
CHANGE THROUGH DOCUMENTATION.— 
(A) ELIGIBILITY
VERIFICATION
BY
EX-
CHANGE.—Section 1411(c) of such Act is 
amended— 
(i) by striking the subsection heading 
and inserting ‘‘VERIFICATION
OF ELIGI-
BILITY
THROUGH
DOCUMENTATION.—’’; 
and 
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(ii) by striking paragraphs (1) and (2) 
and inserting the following: 
‘‘(1) IN GENERAL.—Each Exchange shall con-
duct eligibility verification, using the information 
provided by an applicant under subsection (b), in ac-
cordance with this subsection. 
‘‘(2) VERIFICATION OF CITIZENSHIP OR IMMI-
GRATION STATUS.— 
‘‘(A) VERIFICATION OF ATTESTATION OF 
CITIZENSHIP.—Each Exchange shall verify, 
based on satisfactory documentary evidence of 
citizenship or nationality provided in accordance 
with subsection (b)(2)(A), the eligibility for en-
rollment of each individual who has been at-
tested by an applicant, as required by sub-
section (b)(1)(B), to be a citizen or national of 
the United States. 
‘‘(B) VERIFICATION OF ATTESTATION OF 
ELIGIBLE
IMMIGRATION
STATUS.—Each Ex-
change shall verify, based on evidence provided 
pursuant to subsection (b)(2)(B), the eligibility 
for enrollment of each individual who has been 
attested by an applicant, as required by sub-
section (b)(1)(B), to be an alien who is eligible 
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for coverage under a qualified health plan of-
fered through an Exchange.’’. 
(B) DOCUMENTATION PROVIDED WITH AP-
PLICATION.—Section 1411(b)(1)(C) of such Act 
(as redesignated under subsection (a)(3)(A)) is 
amended by inserting ‘‘and documentation 
thereof in accordance with this section’’ before 
the period. 
(3) ELIMINATION OF SECRETARIAL AUTHORITY 
TO
MAKE
MODIFICATIONS
TO
METHODS
FOR 
VERIFICATION.—Section 1411(c)(4) of such Act is 
amended— 
(A) by striking ‘‘METHODS.—’’ and all 
that follows through ‘‘The Secretary, in con-
sultation’’ and inserting ‘‘METHODS.—The Sec-
retary, in consultation’’; 
(B) by striking subparagraph (B); and 
(C) by redesignating clauses (i) and (ii) as 
subparagraphs (A) and (B), respectively. 
(4) CONFORMING AMENDMENTS RELATING TO 
REQUIREMENTS FOR SECRETARIAL VERIFICATION.— 
(A) IN GENERAL.—Section 1411 of such 
Act is amended by striking subsection (d) and 
redesignating subsections (e) through (i) as 
subsections (d) through (h), respectively. 
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(B) ADDITIONAL
CONFORMING
AMEND-
MENTS.—Subsection (d) of such section 1411 
(as redesignated by subparagraph (A)) is 
amended— 
(i) in paragraph (1), by striking the 
last sentence; and 
(ii) in subparagraphs (A) and (B) of 
paragraph (2), by striking ‘‘subsections (c) 
and (d)’’ each place it appears and insert-
ing ‘‘subsection (c)’’. 
(5) TREATMENT OF INCONSISTENCIES IN AC-
CORDANCE
WITH
EXISTING
SECONDARY 
VERIFICATION
PROCESS.—Section 1411(d)(3) of 
such Act (as redesignated by paragraph (4)(A)) is 
amended by striking ‘‘under section 1902(ee) of the 
Social Security Act (as in effect on January 1, 
2010)’’ and inserting ‘‘in accordance with the sec-
ondary verification process established consistent 
with section 1137 of the Social Security Act (as in 
effect as of January 1, 2009)’’. 
SEC. 3. EFFECTIVE DATE. 
The amendments made by this Act shall apply as if 
included in the enactment of the Patient Protection and 
Affordable Care Act. 
Æ 
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