I 
116TH CONGRESS 
1ST SESSION H. R. 1425 
To amend the Patient Protection and Affordable Care Act to provide for 
a Improve Health Insurance Affordability Fund to provide for certain 
reinsurance payments to lower premiums in the individual health insur-
ance market. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 28, 2019 
Mrs. CRAIG (for herself and Mr. PETERS) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Patient Protection and Affordable Care Act 
to provide for a Improve Health Insurance Affordability 
Fund to provide for certain reinsurance payments to 
lower premiums in the individual health insurance mar-
ket. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘State Health Care Pre-
mium Reduction Act’’. 
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SEC. 2. IMPROVE HEALTH INSURANCE AFFORDABILITY 
FUND. 
Subtitle D of title I of the Patient Protection and 
Affordable Care Act is amended by inserting after part 
5 (42 U.S.C. 18061 et seq.) the following new part: 
‘‘PART 6—IMPROVE HEALTH INSURANCE 
AFFORDABILITY FUND 
‘‘SEC. 1351. ESTABLISHMENT OF PROGRAM. 
‘‘There is hereby established the ‘Improve Health In-
surance Affordability Fund’ to be administered by the Sec-
retary of Health and Human Services, acting through the 
Administrator of the Centers for Medicare & Medicaid 
Services (in this section referred to as the ‘Adminis-
trator’), to provide funding, in accordance with this title, 
to the 50 States and the District of Columbia (each re-
ferred to in this section as a ‘State’) beginning on January 
1, 2020, for the purposes described in section 1352. 
‘‘SEC. 1352. USE OF FUNDS. 
‘‘(a) IN GENERAL.—A State shall use the funds allo-
cated to the State under this part for one of the following 
purposes: 
‘‘(1) To provide reinsurance payments to health 
insurance issuers with respect to individuals enrolled 
under individual health insurance coverage (other 
than through a plan described in subsection (b)) of-
fered by such issuers. 
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‘‘(2) To provide assistance (other than through 
payments described in paragraph (1)) to reduce out- 
of-pocket costs, such as copayments, coinsurance, 
premiums, and deductibles, of individuals enrolled 
under qualified health plans offered on the indi-
vidual market through an Exchange. 
‘‘(b) EXCLUSION OF CERTAIN GRANDFATHERED AND 
TRANSITIONAL PLANS.—For purposes of subsection (a), 
a plan described in this subsection is the following: 
‘‘(1) A grandfathered health plan (as defined in 
section 1251). 
‘‘(2) A plan (commonly referred to as a ‘transi-
tional plan’) continued under the letter issued by the 
Centers for Medicare & Medicaid Services on No-
vember 14, 2013, to the State Insurance Commis-
sioners outlining a transitional policy for coverage in 
the individual and small group markets to which sec-
tion 1251 does not apply, and under the extension 
of the transitional policy for such coverage set forth 
in the Insurance Standards Bulletin Series guidance 
issued by the Centers for Medicare & Medicaid Serv-
ices on March 5, 2014, February 29, 2016, Feb-
ruary 13, 2017, and April 9, 2018, or under any 
subsequent extensions thereof. 
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