I 
116TH CONGRESS 
2D SESSION 
H. R. 6518 
To direct the Secretary of Health and Human Services to establish a program 
of risk corridors for health insurance issuers offering health insurance 
coverage in the individual or small group market for certain plan years. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 17, 2020 
Mr. PETERS (for himself and Ms. CRAIG) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To direct the Secretary of Health and Human Services to 
establish a program of risk corridors for health insurance 
issuers offering health insurance coverage in the indi-
vidual or small group market for certain plan years. 
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 ‘‘Stop Health Premium 
Spikes Act of 2020’’. 
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SEC. 2. ESTABLISHING A PROGRAM OF RISK CORRIDORS 
FOR HEALTH INSURANCE ISSUERS OFFERING 
HEALTH INSURANCE COVERAGE IN THE INDI-
VIDUAL OR SMALL GROUP MARKET FOR CER-
TAIN PLAN YEARS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall establish and administer a program of risk 
corridors for plan years 2020 and 2021 under which the 
Secretary shall make payments to health insurance issuers 
offering health insurance coverage in the individual or 
small group market based on the ratio of the allowable 
costs of the coverage to the aggregate premiums of the 
coverage. 
(b) PAYMENT METHODOLOGY.—The Secretary shall 
provide under the program established under subsection 
(a) that if the allowable costs for a health insurance issuer 
offering health insurance coverage in the individual or 
small group market for any plan year are more than 105 
percent of the target amount, the Secretary shall pay to 
the issuer an amount equal to 75 percent of the allowable 
costs in excess of 105 percent of the target amount. 
(c) INFORMATION COLLECTION.—The Secretary shall 
establish a process under which information is collected 
from health insurance issuers offering health insurance 
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coverage in the individual or small group market for pur-
poses of carrying out this section. 
(d) DEFINITIONS.— 
(1) ALLOWABLE COSTS.— 
(A) IN GENERAL.—The amount of allow-
able costs of a health insurance issuer offering 
health insurance coverage in the individual or 
small group market for any year is an amount 
equal to the total costs (other than administra-
tive costs) of such issuer in providing benefits 
covered by such coverage. 
(B) 
CERTAIN
REDUCTIONS.—Allowable 
costs shall be reduced by any— 
(i) risk adjustment payments received 
under section 1341 of the Patient Protec-
tion and Affordable Care Act (42 U.S.C. 
18061); and 
(ii) reinsurance payments received 
pursuant to a waiver approved under sec-
tion 1332 of such Act (42 U.S.C. 18052). 
(2) ADDITIONAL TERMS.—For purposes of this 
section, the terms ‘‘health insurance issuer’’, ‘‘health 
insurance coverage’’, ‘‘individual market’’, and 
‘‘small group market’’ have the meanings given such 
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