I 
115TH CONGRESS 
1ST SESSION H. R. 3311 
To establish an Individual Market Reinsurance fund to provide funding for 
State individual market stabilization reinsurance programs. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 19, 2017 
Mr. LANGEVIN (for himself, Ms. JUDY CHU of California, and Mr. RUIZ) in-
troduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committee on Ways and 
Means, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To establish an Individual Market Reinsurance fund to pro-
vide funding for State individual market stabilization 
reinsurance programs. 
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 ‘‘Individual Health In-
surance Marketplace Improvement Act’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
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(1) Before the passage of the Patient Protec-
tion and Affordable Care Act (Public Law 114–148) 
in 2010, Americans with pre-existing conditions 
faced unfair barriers to accessing health insurance 
coverage and health care costs had risen rapidly for 
decades. 
(2) Since 2010, the rate of uninsured Ameri-
cans has declined to a historic low, with more than 
20,000,000 Americans gaining access to health in-
surance coverage. 
(3) Since 2010, America has experienced the 
slowest growth in the price of health care in over 
five decades. 
(4) Thanks to the Patient Protection and Af-
fordable Care Act (Public Law 114–148), Americans 
can no longer be denied insurance or charged more 
on the basis of their health status, more Americans 
than ever have insurance, and the health care they 
receive is continually improving. 
(5) Starting in 2016, independent, non-partisan 
organizations, including the Congressional Budget 
Office, have determined that the individual health 
insurance markets have stabilized and improved. 
(6) The cost-sharing reduction payments in the 
Patient Protection and Affordable Care Act provide 
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stability in the individual health insurance market, 
lower insurance premiums by nearly 20 percent, and 
encourage competition among health insurers. The 
payments reduce costs for approximately 6,000,000 
people with incomes below 250 percent of the pov-
erty line by an average of about $1,100 per person 
and should be increased to help more Americans. 
(7) Risk mitigation programs, such as the rein-
surance program for the Medicare Part D prescrip-
tion drug benefit program, have provided additional 
stability to the health insurance markets, restrained 
premium growth, and lowered taxpayer costs by 
helping health insurers predict and bear risk associ-
ated with managing health care costs for a popu-
lation. 
(8) From 2014 to 2016, the temporary reinsur-
ance program established under the Affordable Care 
Act helped to stabilize the new insurance market-
places and reduced insurance premiums in the indi-
vidual health insurance market by as much as 10 
percent. 
(9) Throughout his Presidential campaign, the 
President of the United States repeatedly promised 
the American people that his health care plan will 
result in reduced rates of uninsured, lower costs, 
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and higher quality care, stating on January 14, 
2017, that ‘‘We’re going to have insurance for every-
body. There was a philosophy in some circles that if 
you can’t pay for it, you don’t get it. That’s not 
going to happen with us’’; and on January 25, 2017, 
that ‘‘I can assure you, we are going to have a bet-
ter plan, much better health care, much better serv-
ice treatment, a plan where you can have access to 
the doctor that you want and the plan that you 
want. We’re gonna have a much better health care 
plan at much less money’’. 
(10) The goal of any health care legislation 
should be to build on the Affordable Care Act to 
continue expanding coverage and make health care 
more affordable for Americans. Improving afford-
ability and expanding coverage will also broaden the 
individual market risk pool, contributing to lower 
premiums and strengthening market stability. 
SEC. 3. INDIVIDUAL MARKET REINSURANCE FUND. 
(a) ESTABLISHMENT OF FUND.— 
(1) IN GENERAL.—There is established the ‘‘In-
dividual Market Reinsurance Fund’’ to be adminis-
tered by the Secretary to provide funding for an in-
dividual market stabilization reinsurance program in 
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each State that complies with the requirements of 
this section. 
(2) FUNDING.—There is appropriated to the 
Fund, out of any moneys in the Treasury not other-
wise appropriated, such sums as are necessary to 
carry out this section (other than subsection (c)) for 
each calendar year beginning with 2018. Amounts 
appropriated to the Fund shall remain available 
without fiscal or calendar year limitation to carry 
out this section. 
(b) 
INDIVIDUAL
MARKET
REINSURANCE
PRO-
GRAM.— 
(1) USE OF FUNDS.—The Secretary shall use 
amounts in the Fund to establish a reinsurance pro-
gram under which the Secretary shall make reinsur-
ance payments to health insurance issuers with re-
spect to high-cost individuals enrolled in qualified 
health plans offered by such issuers that are not 
grandfathered health plans or transitional health 
plans for any plan year beginning with the 2018 
plan year. This subsection constitutes budget au-
thority in advance of appropriations Acts and rep-
resents the obligation of the Secretary to provide 
payments from the Fund in accordance with this 
subsection. 
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(2) AMOUNT
OF
PAYMENT.—The payment 
made to a health insurance issuer under subsection 
(a) with respect to each high-cost individual enrolled 
in a qualified health plan issued by the issuer that 
is not a grandfathered health plan or a transitional 
health plan shall equal 80 percent of the lesser of— 
(A) the amount (if any) by which the indi-
vidual’s claims incurred during the plan year 
exceeds— 
(i) in case of the 2018, 2019, or 2020 
plan year, $50,000; and 
(ii) in the case of any other plan year, 
$100,000; or 
(B) for plan years described in— 
(i) subparagraph (A)(i), $450,000; 
and 
(ii) subparagraph (A)(ii), $400,000. 
(3) INDEXING.—In the case of plan years be-
ginning after 2018, the dollar amounts that appear 
in subparagraphs (A) and (B) of paragraph (2) shall 
each be increased by an amount equal to— 
(A) such amount; multiplied by 
(B) the premium adjustment percentage 
specified under section 1302(c)(4) of the Af-
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