I 
113TH CONGRESS 
1ST SESSION H. R. 3489 
To amend section 1341 of the Patient Protection and Affordable Care Act 
to repeal the funding mechanism for the transitional reinsurance program 
in the individual market, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 14, 2013 
Mr. TIBERI (for himself, Mr. LIPINSKI, Mr. BOUSTANY, Mr. SCHOCK, Mr. 
BRADY of Texas, Ms. JENKINS, Mr. SAM JOHNSON of Texas, Mr. 
REICHERT, Mr. GRIFFIN of Arkansas, Mr. MCINTYRE, Mr. TURNER, 
Mrs. BLACK, and Mr. MURPHY of Florida) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
A BILL 
To amend section 1341 of the Patient Protection and Afford-
able Care Act to repeal the funding mechanism for the 
transitional reinsurance program in the individual mar-
ket, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. FINDINGS; PURPOSE. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) According to the most recent United States 
Census, employer-based health insurance is the larg-
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est source of health insurance coverage in the 
United States. Of those employed, 70 percent receive 
employment-based health insurance. Of unemployed 
Americans, 30 percent receive employer-sponsored 
health insurance. 
(2) Despite the large percentages of coverage, 
as health care costs climb, the percentage of Ameri-
cans who receive health insurance through employers 
has fallen significantly over the last decade—from 
70 percent nationwide in 2000 to 60 percent in 
2011, according to a report by the Robert Wood 
Johnson Foundation. 
(3) According to recent surveys done by the Na-
tional Business Group on Health and the Kaiser 
Family Foundation, most companies continue to 
provide health insurance for employees and wish to 
continue doing so into the future. 
(4) Employers who offer insurance will not con-
tribute additional risk to the health insurance ex-
changes established in the Patient Protection and 
Affordable Care Act (in this Act referred to as 
‘‘PPACA’’). 
(5) The transitional reinsurance program, es-
tablished in section 1341 of PPACA, is intended to 
stabilize risk in the individual health insurance mar-
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ket during the first three years of the health insur-
ance exchanges, as established by that Act. 
(6) PPACA also requires that the Treasury col-
lect a fee for each employer-sponsored covered life in 
order to pay for the transitional reinsurance pro-
gram. 
(7) This fee is a disincentive for employers to 
continue offering coverage to all employees, and does 
not give employers any benefits of the transitional 
reinsurance program. 
(b) PURPOSE.—It is the purpose of this Act to re-
move the current funding mechanism for the transitional 
reinsurance 
program. 
Employer-sponsored 
insurance 
should be supported so that Americans can sustain quality 
health coverage. 
SEC. 2. CHANGES IN FUNDING FOR TRANSITIONAL REIN-
SURANCE PROGRAM IN THE INDIVIDUAL 
MARKET. 
(a) IN GENERAL.—Section 1341(b) of the Patient 
Protection and Affordable Care Act (Public Law 111–148; 
42 U.S.C. 18061(b)) is amended— 
(1) in paragraph (1), by striking ‘‘under 
which—’’ and all that follows and inserting the fol-
lowing: ‘‘under which the applicable reinsurance en-
tity uses amounts appropriated under paragraph 
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(2)(B) to make reinsurance payments to health in-
surance issuers that cover high risk individuals in 
the individual market (excluding grandfathered 
health plans) for any plan year beginning in the 3- 
year period beginning January 1, 2014.’’; 
(2) in paragraph (2)(B), by striking ‘‘PAYMENT 
AMOUNT’’ and all that follows through the end of the 
first sentence and inserting the following: ‘‘AUTHOR-
IZATION
OF
APPROPRIATIONS; 
PAYMENT
FOR-
MULA.—There are hereby authorized to be appro-
priated, based on the best estimates of the NAIC, 
$10,000,000,000 for plan years beginning in 2014, 
$6,000,000,000 for plan years beginning in 2015, 
and $4,000,000,000 for plan years beginning in 
2016 to make reinsurance payments to health insur-
ance issuers described in paragraph (1) that insure 
high-risk individuals consistent with paragraph 
(3).’’; and 
(3) by striking paragraphs (3) and (4) and in-
serting the following: 
‘‘(3) EXTENSION OF FUND AVAILABILITY AND 
TREATMENT OF UNEXPENDED AMOUNTS.— 
‘‘(A) 
EXTENSION
OF
FUND
AVAIL-
ABILITY.—The amounts appropriated for a plan 
year under paragraph (2)(B) shall be allocated 
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among States and used in any of the plan years 
referred to in such paragraph based on the re-
insurance needs of the States and periods in-
volved, as determined by the Secretary. 
‘‘(B) 
TREATMENT
OF
UNEXPENDED 
AMOUNTS.—Amounts appropriated under para-
graph (2)(B) that remain unexpended as of De-
cember 31, 2016, and that are otherwise allo-
cated to a State may be used to make payments 
under any reinsurance program of the State in 
the individual market in effect in the 2-year pe-
riod beginning on January 1, 2017.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect as if included in the enact-
ment of section 1341 of Public Law 111–148. 
Æ 
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