SEC. 4. CONSISTENCY IN HEALTH INSURANCE COVERAGE 
FOR INDIVIDUALS WITH FEDERALLY AU-
THORIZED 
PRESENCE, 
INCLUDING 
DE-
FERRED ACTION. 
(a) IN GENERAL.—For purposes of eligibility under 
any of the provisions described in subsection (b), all indi-
viduals granted federally authorized presence in the 
United States shall be considered to be lawfully present 
in the United States. 
(b) PROVISIONS DESCRIBED.—The provisions de-
scribed in this subsection are the following: 
(1) EXCHANGE ELIGIBILITY.—Section 1411 of 
the Patient Protection and Affordable Care Act (42 
U.S.C. 18031). 
(2) REDUCED
COST-SHARING
ELIGIBILITY.— 
Section 1402 of the Patient Protection and Afford-
able Care Act (42 U.S.C. 18071). 
(3) PREMIUM
SUBSIDY
ELIGIBILITY.—Section 
36B of the Internal Revenue Code of 1986 (26 
U.S.C. 36B). 
(4) MEDICAID AND CHIP ELIGIBILITY.—Titles 
XIX and XXI of the Social Security Act, including 
under section 1903(v) of such Act (42 U.S.C. 
1396b(v)). 
(c) EFFECTIVE DATE.— 
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(1) IN GENERAL.—Subsection (a) shall take ef-
fect on the date of enactment of this Act. 
(2) TRANSITION
THROUGH
SPECIAL
ENROLL-
MENT
PERIOD.—In the case of an individual de-
scribed in subsection (a) who, before the first day of 
the first annual open enrollment period under sub-
paragraph (B) of section 1311(c)(6) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 
18031(c)(6)) beginning after the date of enactment 
of this Act, is granted federally authorized presence 
in the United States and who, as a result of such 
subsection, qualifies for a subsidy under a provision 
described in paragraph (2) or (3) of subsection (b), 
the Secretary of Health and Human Services shall 
establish a special enrollment period under subpara-
graph (C) of such section 1311(c)(6) during which 
such individual may enroll in qualified health plans 
through Exchanges under title I of the Patient Pro-
tection and Affordable Care Act and qualify for such 
a subsidy. For such an individual who has been 
granted federally authorized presence in the United 
States as of the date of enactment of this Act, such 
special enrollment period shall begin not later than 
90 days after such date of enactment. Nothing in 
this paragraph shall be construed as affecting the 
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authority of the Secretary to establish additional 
special enrollment periods under such subparagraph 
(C). 
SEC. 5. REMOVING CITIZENSHIP AND IMMIGRATION BAR-
RIERS TO ACCESS TO AFFORDABLE HEALTH 
CARE UNDER THE ACA. 
(a) IN GENERAL.— 
(1) PREMIUM TAX CREDITS.—Section 36B of 
the Internal Revenue Code of 1986 is amended— 
(A) in subsection (c)(1)(B)— 
(i) by amending the heading to read 
as follows: ‘‘SPECIAL RULE FOR CERTAIN 
INDIVIDUALS
INELIGIBLE
FOR
MEDICAID 
DUE TO STATUS’’; and 
(ii) by amending clause (ii) to read as 
follows: 
‘‘(ii) the taxpayer is a noncitizen who 
is not eligible for the Medicaid program 
under title XIX of the Social Security Act 
by reason of the individual’s immigration 
status,’’. 
(B) by striking subsection (e). 
(2) COST-SHARING REDUCTIONS.—Section 1402 
of the Patient Protection and Affordable Care Act 
(42 U.S.C. 18071) is amended by striking sub-
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section (e) and redesignating subsection (f) as sub-
section (e). 
(3) BASIC
HEALTH
PROGRAM
ELIGIBILITY.— 
Section 1331(e)(1)(B) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18051(e)(1)(B)) is 
amended by striking ‘‘lawfully present in the United 
States,’’. 
(4) RESTRICTIONS ON FEDERAL PAYMENTS.— 
Section 1412 of the Patient Protection and Afford-
able Care Act (42 U.S.C. 18082) is amended by 
striking subsection (d) and redesignating subsection 
(e) as subsection (d). 
(5) REQUIREMENT TO MAINTAIN MINIMUM ES-
SENTIAL
COVERAGE.—Subsection (d) of section 
5000A of the Internal Revenue Code of 1986 is 
amended by striking paragraph (3) and by redesig-
nating paragraph (4) as paragraph (3). 
(b) CONFORMING AMENDMENTS.— 
(1) ESTABLISHMENT
OF
PROGRAM.—Section 
1411(a) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18081(a)) is amended by strik-
ing paragraph (1) and redesignating paragraphs (2), 
(3), and (4) as paragraphs (1), (2), and (3), respec-
tively. 
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(2) QUALIFIED INDIVIDUALS.—Section 1312(f) 
of the Patient Protection and Affordable Care Act 
(42 U.S.C. 18032(f)) is amended— 
(A) in the heading, by striking ‘‘; ACCESS 
LIMITED
TO CITIZENS
AND LAWFUL RESI-
DENTS’’; and 
(B) by striking paragraph (3). 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to years, plan years, and taxable 
years, as applicable, beginning after December 31, 2021. 
SEC. 6. PRESERVING ACCESS TO COVERAGE. 
(a) IN GENERAL.—Nothing in this Act, including the 
amendments made by this Act, shall prevent lawfully 
present noncitizens who are ineligible for full benefits 
under the Medicaid program under title XIX of the Social 
Security Act from securing a credit for which such lawfully 
present noncitizens would be eligible under section 
36B(c)(1)(B) of the Internal Revenue Code of 1986 and 
under the Medicaid provisions for lawfully present nonciti-
zens, as in effect on the date prior to the date of enact-
ment of this Act. 
(b) DEFINITION.—For purposes of subsection (a), 
the term ‘‘full benefits’’ means, with respect to an indi-
vidual and State, medical assistance for all services cov-
ered under the State plan under title XIX of the Social 
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Security Act that is not less in amount, duration, or scope, 
or is determined by the Secretary of Health and Human 
Services to be substantially equivalent to the medical as-
sistance available for an individual described in section 
1902(a)(10)(A)(i) of the Social Security Act (42 U.S.C. 
1396a(a)(10)(A)(i)). 
Æ 
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