I 
115TH CONGRESS 
2D SESSION 
H. R. 7102 
To amend the Patient Protection and Affordable Care Act to provide for 
additional requirements with respect to the navigator program, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 30, 2018 
Ms. CASTOR of Florida (for herself and Ms. BLUNT ROCHESTER) 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 additional requirements with respect to 
the navigator program, 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. SHORT TITLE. 
This Act may be cited as the ‘‘Expand Navigators’ 
Resources for Outreach, Learning, and Longevity Act of 
2018’’ or the ‘‘ENROLL Act of 2018’’. 
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SEC. 2. PROVIDING FOR ADDITIONAL REQUIREMENTS 
WITH RESPECT TO THE NAVIGATOR PRO-
GRAM. 
(a) IN GENERAL.—Section 1311(i) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18031(i)) 
is amended— 
(1) in paragraph (2), by adding at the end the 
following new subparagraph: 
‘‘(C) 
SELECTION
OF
RECIPIENTS.—In 
awarding grants under paragraph (1), the Ex-
change shall— 
‘‘(i) select entities to receive such 
grants based solely on an entity’s dem-
onstrated capacity to carry out each of the 
duties specified in paragraph (3); 
‘‘(ii) not take into account whether or 
not the entity— 
‘‘(I) has demonstrated how the 
entity will provide information to indi-
viduals relating to group health plans 
offered by a group or association of 
employers 
described 
in 
section 
2510.3–5(b) of title 29, Code of Fed-
eral Regulations (or any successor 
regulation), or short-term limited du-
ration insurance (as defined by the 
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Secretary for purposes of section 
2791(b)(5) of the Public Health Serv-
ice Act); or 
‘‘(II) has developed a plan— 
‘‘(aa) to inform individuals 
of the option not to purchase 
health insurance coverage that 
covers abortion services or how 
individuals may receive a hard-
ship exemption if all qualified 
health plans offered through such 
Exchange provide coverage of 
such services; or 
‘‘(bb) to provide information 
and assistance to individuals with 
respect to prohibitions on the use 
of premium assistance tax credits 
described in section 36B of the 
Internal Revenue Code of 1986 
and cost-sharing reductions de-
scribed in section 1402 from 
being used to cover abortion serv-
ices, the process by which health 
insurance issuers must develop 
premiums for qualified health 
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plans that cover such services, 
and segregation of funds require-
ments for such issuers; and 
‘‘(iii) ensure that, each year, the Ex-
change awards such a grant to— 
‘‘(I) at least one entity described 
in this paragraph that is a community 
and 
consumer-focused 
nonprofit 
group; and 
‘‘(II) at least one entity described 
in subparagraph (B), which may in-
clude another community and con-
sumer-focused nonprofit group in ad-
dition to any such group awarded a 
grant pursuant to subclause (I).’’; 
(2) in paragraph (3)(C), by inserting after 
‘‘qualified health plans’’ the following: ‘‘, State med-
icaid plans under title XIX of the Social Security 
Act, and State children’s health insurance programs 
under title XXI of such Act’’; and 
(3) in paragraph (4)(A)— 
(A) in the matter preceding clause (i), by 
striking ‘‘not’’; 
(B) in clause (i)— 
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(i) by inserting ‘‘not’’ before ‘‘be’’; 
and 
(ii) by striking ‘‘; or’’ and inserting 
‘‘;’’; 
(C) in clause (ii)— 
(i) by inserting ‘‘not’’ before ‘‘re-
ceive’’; and 
(ii) by striking the period and insert-
ing ‘‘;’’; and 
(D) by adding at the end the following new 
clause: 
‘‘(iii) maintain physical presence in 
the State of the Exchange so as to allow 
in-person assistance to consumers.’’. 
(b) EXCHANGES OPERATED BY THE SECRETARY.— 
Section 1321(c) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18041(c)) is amended by adding at 
the end the following new paragraph: 
‘‘(3) NAVIGATOR
PROGRAM
AND
OUTREACH 
AND ENROLLMENT ACTIVITIES.— 
‘‘(A) NAVIGATOR PROGRAM.— 
‘‘(i) IN GENERAL.—In the case of an 
Exchange established or operated by the 
Secretary within a State pursuant to this 
subsection, the Secretary shall establish a 
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program under which such Exchange 
awards grants, with respect to such State, 
to entities that would be described in para-
graph (2) of section 1311(i) to carry out 
the duties that would be described in para-
graph (3) of such section if the references 
in such section 1311(i) to ‘this subsection’ 
and ‘paragraph (1)’ were each instead a 
reference to ‘paragraph (3)(A) of section 
1321(c)’. 
‘‘(ii) APPLICATION
OF
STATE
EX-
CHANGE
NAVIGATOR
PROVISIONS.—For 
purposes of carrying out this subpara-
graph, the provisions of paragraphs (2) 
through (5) of section 1311(i) shall apply 
to the Secretary with respect to an Ex-
change described in clause (i) established 
or operated within a State and the pro-
gram under this subparagraph, with re-
spect to such State, in the same manner as 
such provisions apply to a State with re-
spect to an Exchange described in section 
1311(i) established by the State and the 
program established under such section. 
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‘‘(iii) FUNDING.—For purposes of 
carrying out this subparagraph, the Sec-
retary shall obligate $100,000,000 out of 
amounts collected through the user fees on 
participating health insurance issuers pur-
suant to section 156.50 of title 45, Code of 
Federal Regulations (or any successor reg-
ulations) for each of fiscal year 2019 and 
each subsequent fiscal year. Such amount 
for a fiscal year shall remain available 
until expended. 
‘‘(B) OUTREACH
AND
EDUCATIONAL
AC-
TIVITIES.— 
‘‘(i) IN GENERAL.—In the case of an 
Exchange established or operated by the 
Secretary within a State pursuant to this 
subsection, the Secretary shall carry out 
outreach and educational activities for pur-
poses of informing potential enrollees in 
qualified health plans offered through the 
Exchange of the availability of coverage 
under such plans and financial assistance 
for coverage under such plans. Such out-
reach and educational activities shall be 
provided in a manner that is culturally and 
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linguistically appropriate to the needs of 
the populations being served by the Ex-
change 
(including 
hard-to-reach 
popu-
lations, such as racial and sexual minori-
ties, limited English proficient populations, 
and young adults). 
‘‘(ii) FUNDING.—For purposes of car-
rying out this subparagraph, the Secretary 
shall obligate $100,000,000 out of the 
amounts collected through the user fees on 
participating health insurance issuers pur-
suant to section 156.50 of title 45, Code of 
Federal Regulations (or any successor reg-
ulations) for each of fiscal years 2019 
through 2021. Such amount shall remain 
available without fiscal year limitation 
until expended.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to plan years begin-
ning on or after January 1, 2020. 
Æ 
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