(b) APPROPRIATE COMMITTEES OF CONGRESS.—For 
purposes of this section, the term ‘‘appropriate committees 
of Congress’’ means the Committee on Ways and Means, 
the Committee on Education and the Workforce, the Com-
mittee on Energy and Commerce, and the Small Business 
Committee of the House of Representatives and the Com-
mittee on Finance, the Committee on Health, Education, 
Labor, and Pensions, and the Small Business and Entre-
preneurship Committee of the Senate. 
(c) DEFINITIONS.—For purposes of this Act: 
(1) AFFORDABLE CARE ACT.—The term ‘‘Af-
fordable Care Act’’ means the Patient Protection 
and Affordable Care Act (Public Law 111–148) and 
title I and subtitle B of title II of the Health Care 
and Education Reconciliation Act of 2010 (Public 
Law 111–152). 
(2) SMALL BUSINESS.—The term ‘‘small busi-
ness’’ means an employer with 250 or fewer employ-
ees. 
SEC. 3. STUDY ON IMPACT ON SMALL BUSINESS HEALTH 
INSURANCE. 
(a) STUDY AND REPORT.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of the enactment of this Act, and December 
1 for each of the 4 consecutive years thereafter, the 
VerDate Mar 15 2010 
04:20 May 28, 2014
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4728.IH
H4728
tjames on DSK6SPTVN1PROD with BILLS
Office of the Actuary, Centers for Medicare & Med-
icaid Services, shall conduct a study on the impact 
of the Affordable Care Act on small group health in-
surance costs, including— 
(A) the impact of requirements and bene-
fits pursuant to such Act on the small group 
health insurance market, including community 
rating requirements, minimum actuarial value 
requirements, requirements to provide for es-
sential health benefits described in section 
1302(b) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 18022(b)), require-
ments related to cost-sharing, the prohibition 
on annual and lifetime limits on benefits under 
section 2711 of the Public Health Service Act 
(42 U.S.C. 300gg–11), prohibitions on cost- 
sharing requirements for preventive services, 
and the extension of dependent coverage under 
section 2714 of the Public Health Service Act 
(42 U.S.C. 300gg–14); and 
(B) the impact of new taxes and fees on 
the small group health insurance market costs, 
including the fee imposed under section 9010 of 
the Patient Protection and Affordable Care Act 
(relating to imposition of annual fee on health 
VerDate Mar 15 2010 
01:36 May 28, 2014
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H4728.IH
H4728
tjames on DSK6SPTVN1PROD with BILLS
insurance providers), the transitional reinsur-
ance program contributions, the fees imposed 
under subchapter B of chapter 34 of the Inter-
nal Revenue Code of 1986 (relating to the Pa-
tient Centered Outcome Research Institute 
fees), and Exchange assessments or user fees. 
(2) REPORT.—The Office of the Actuary, Cen-
ters for Medicare & Medicaid Services, in consulta-
tion with the Comptroller General for purposes of 
verifying the methodology, assumptions, validity, and 
reasonableness of the data used by the Actuary, 
shall submit to the appropriate committees of Con-
gress a report on the study conducted under para-
graph (1). 
(b) APPROPRIATE COMMITTEES OF CONGRESS.—For 
purposes of this section, the term ‘‘appropriate committees 
of Congress’’ means the Committee on Ways and Means, 
the Committee on Education and the Workforce, the Com-
mittee on Energy and Commerce, and the Small Business 
Committee of the House of Representatives and the Com-
mittee on Finance, the Committee on Health, Education, 
Labor, and Pensions, and the Small Business and Entre-
preneurship Committee of the Senate. 
VerDate Mar 15 2010 
04:20 May 28, 2014
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H4728.IH
H4728
tjames on DSK6SPTVN1PROD with BILLS
SEC. 4. ONE-YEAR DELAY FOR EMPLOYER MANDATE IN 
CASE OF NEGATIVE IMPACT ON SMALL BUSI-
NESS. 
(a) IN GENERAL.—If the Comptroller General of the 
United States or the Office of the Actuary, Centers for 
Medicare & Medicaid Services, determines in any report 
submitted under section 2 or 3 that the Affordable Care 
Act has caused net employment loss amongst small busi-
nesses or caused small group health insurance costs to 
rise, section 4980H of the Internal Revenue Code of 1986 
shall not apply for months beginning during the 1-year 
period beginning on the date of the submission of such 
report. 
(b) FAILURE TO SUBMIT.—If the Comptroller Gen-
eral of the United States or the Office of the Actuary, 
Centers for Medicare & Medicaid Services, fails to submit 
a report in accordance with the timelines specified in this 
Act, section 4980H of the Internal Revenue Code of 1986 
shall not apply the following calendar year. 
Æ 
VerDate Mar 15 2010 
01:36 May 28, 2014
Jkt 039200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6301
E:\BILLS\H4728.IH
H4728
tjames on DSK6SPTVN1PROD with BILLS