I 
115TH CONGRESS 
1ST SESSION H. R. 3258 
To amend the Patient Protection and Affordable Care Act to improve cost 
sharing subsidies. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 14, 2017 
Mr. RUIZ 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 improve cost sharing subsidies. 
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 ‘‘Marketplace Certainty 
Act’’. 
SEC. 2. ENHANCEMENTS FOR REDUCED COST SHARING. 
(a) MODIFICATION OF AMOUNT.— 
(1) IN
GENERAL.—Section 1402(c)(2) of the 
Patient Protection and Affordable Care Act (42 
U.S.C. 18071(c)(2)) is amended to read as follows: 
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‘‘(2) ADDITIONAL REDUCTION.—The Secretary 
shall establish procedures under which the issuer of 
a qualified health plan to which this section applies 
shall further reduce cost-sharing under the plan in 
a manner sufficient to— 
‘‘(A) in the case of an eligible insured 
whose household income is not less than 100 
percent but not more than 200 percent of the 
poverty line for a family of the size involved, in-
crease the plan’s share of the total allowed 
costs of benefits provided under the plan to 95 
percent of such costs; 
‘‘(B) in the case of an eligible insured 
whose household income is more than 200 per-
cent but not more than 300 percent of the pov-
erty line for a family of the size involved, in-
crease the plan’s share of the total allowed 
costs of benefits provided under the plan to 90 
percent of such costs; and 
‘‘(C) in the case of an eligible insured 
whose household income is more than 300 per-
cent but not more than 400 percent of the pov-
erty line for a family of the size involved, in-
crease the plan’s share of the total allowed 
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costs of benefits provided under the plan to 85 
percent of such costs.’’. 
(2) CONFORMING AMENDMENT.—Clause (i) of 
section 1402(c)(1)(B) of such Act (42 U.S.C. 
18071(c)(1)(B)) is amended to read as follows: 
‘‘(i) IN
GENERAL.—The Secretary 
shall ensure the reduction under this para-
graph shall not result in an increase in the 
plan’s share of the total allowed costs of 
benefits provided under the plan above— 
‘‘(I) 95 percent in the case of an 
eligible insured described in para-
graph (2)(A); 
‘‘(II) 90 percent in the case of an 
eligible insured described in para-
graph (2)(B); and 
‘‘(III) 85 percent in the case of 
an eligible insured described in para-
graph (2)(C).’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply to plan years begin-
ning after December 31, 2017. 
(b) FUNDING.—Section 1402 of the Patient Protec-
tion and Affordable Care Act (42 U.S.C. 18071) is amend-
ed by adding at the end the following new subsection: 
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‘‘(g) FUNDING.—Out of any funds in the Treasury 
not otherwise appropriated, there are appropriated to the 
Secretary such sums as may be necessary for payments 
under this section.’’. 
Æ 
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