I 
115TH CONGRESS 
1ST SESSION H. R. 3976 
To amend the Patient Protection and Affordable Care Act to allow for 
certain third-party payments. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 5, 2017 
Mr. CRAMER (for himself, Mr. GARAMENDI, Ms. STEFANIK, Mr. LAMBORN, 
Mr. FRANKS of Arizona, Mr. ALLEN, Mr. COOK, Ms. MCSALLY, Mr. 
GOODLATTE, Mr. DESAULNIER, Mr. BRAT, Mr. PETERSON, Mr. GALLA-
GHER, Ms. PINGREE, Mr. HIGGINS of Louisiana, and Mr. DUNCAN of 
Tennessee) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To amend the Patient Protection and Affordable Care Act 
to allow for certain third-party payments. 
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 ‘‘Access to Marketplace 
Insurance Act’’. 
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SEC. 2. PAYMENT OF PREMIUMS BY CERTAIN THIRD PAR-
TIES ON BEHALF OF QUALIFIED INDIVID-
UALS. 
(a) IN GENERAL.—Section 1312 of the Patient Pro-
tection and Affordable Care Act (42 U.S.C. 18032) is 
amended— 
(1) by redesignating subsections (c) through (f) 
as subsections (d) through (g), respectively; and 
(2) by inserting after subsection (b) the fol-
lowing new subsection: 
‘‘(c) PAYMENT OF PREMIUMS BY CERTAIN QUALI-
FIED THIRD PARTIES ON BEHALF OF A QUALIFIED INDI-
VIDUAL.—A qualified individual enrolled in any qualified 
health plan may allow certain third parties to pay any ap-
plicable premium or cost sharing owed by such individual 
to the health insurance issuer issuing such qualified health 
plan, and the health insurance issuer shall accept and 
count toward the annual limitations in section 1302(c) 
such payments made on behalf of qualified individuals, in-
cluding payments from the following: 
‘‘(1) A State or Federal government program, 
including assistance provided under a grant under 
title XXVI of the Public Health Service Act. 
‘‘(2) Indian tribes, tribal organizations, or 
urban Indian organizations. 
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‘‘(3) A program conducted by an organization 
which is— 
‘‘(A) exempt from taxation under section 
501(a) of the Internal Revenue Code of 1986; 
‘‘(B) described in clause (i) or (vi) of sec-
tion 170(b)(1)(A) of such Code; and 
‘‘(C) operated in compliance with applica-
ble Federal laws, including sections 3729 
through 3733 of title 31, United States Code 
(known as the False Claims Act). 
‘‘(d) EDUCATION.—The Secretary is authorized to 
make and enforce such regulations as necessary to assure 
that individuals eligible for the Medicare program under 
part A of title XVIII of the Social Security Act, the Med-
icaid program under title XIX of such Act, or coverage 
under an available Medicare supplemental health insur-
ance policy under section 1882 of such Act receive proper 
education related to all of their coverage options, including 
qualified health plan coverage.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply with respect to premiums and 
cost-sharing paid on or after the date that is 90 days after 
the date of the enactment of this Act. 
Æ 
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