I 
115TH CONGRESS 
1ST SESSION H. R. 4620 
To amend the Patient Protection and Affordable Care Act to provide 
temporary relief from the annual fee imposed on health insurance providers. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 12, 2017 
Mrs. NOEM (for herself and Ms. SINEMA) introduced the following bill; which 
was referred to the Committee on Energy 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 provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend the Patient Protection and Affordable Care Act 
to provide temporary relief from the annual fee imposed 
on health insurance providers. 
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 ‘‘Protecting Families 
and Small Businesses Act of 2017’’. 
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SEC. 2. RELIEF FROM ANNUAL FEE ON HEALTH INSUR-
ANCE PROVIDERS. 
(a) PARTIAL RELIEF FOR 2018 FOR CERTAIN PRO-
VIDERS.— 
(1) IN GENERAL.—Section 9010 of the Patient 
Protection and Affordable Care Act is amended by 
adding at the end the following new subsection: 
‘‘(k) OPTIONAL RELIEF FOR 2018.— 
‘‘(1) IN GENERAL.—In the case of a covered en-
tity that meets the requirements of paragraph (2), 
the fee described in subsection (a)(1) shall be re-
duced by the sum of the premium rebates provided 
pursuant to paragraph (2). 
‘‘(2) REBATES FOR INDIVIDUALS.—A covered 
entity meets the requirements of this paragraph if 
such entity demonstrates to the satisfaction of the 
Secretary of the Treasury (in consultation with the 
Secretary of Health and Human Services, Adminis-
trator of the Centers for Medicare and Medicaid 
Services, and the National Association of Insurance 
Commissioners, as appropriate) that such entity will 
provide— 
‘‘(A) not later than April 30, 2019, to each 
individual enrolled in calendar year 2018 in a 
qualified rebate plan offered by such entity a 
premium rebate equal to the lesser of— 
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‘‘(i) 2 percent of the net premiums 
written for coverage under such plan for 
such individual for calendar year 2018, or 
‘‘(ii) the amount of the premiums de-
scribed in subparagraph (A) paid by such 
individual, and 
‘‘(B) for individuals who will receive a pre-
mium rebate described in subparagraph (A) 
after September 30, 2018, notice to such indi-
viduals by such date of such premium rebate. 
‘‘(3) QUALIFIED REBATE PLAN.—For purposes 
of this subsection, the term ‘qualified rebate plan’ 
means, with respect to a covered entity, any com-
bination, as elected by the covered entity, of the fol-
lowing categories of health plans: 
‘‘(A) A health plan offered in the indi-
vidual market. 
‘‘(B) A health plan offered in the group 
market. 
‘‘(C) A Medicare Advantage plan under 
part C of title XVIII of the Social Security Act. 
‘‘(D) A prescription drug plan offered 
under part D of such title XVIII. 
‘‘(4) REDUCTION
IN
PREMIUMS
TREATED
AS 
REBATES.—For purposes of this subsection, a reduc-
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tion in premiums owed by an individual for a month 
shall be treated as a premium rebate paid to such 
individual on the first day of such month. 
‘‘(l) MEDICAID MANAGED CARE PLANS REDUCTION 
FOR 2018.—In the case of a medicaid managed care orga-
nization (as defined in section 1903(m)(1)(A) of the Social 
Security Act), the fee described in subsection (a)(1) shall 
be reduced by an amount equal to 2 percent of the net 
premiums written for coverage under a medicaid managed 
care plan (under section 1903(m) or section 1932 of such 
Act) for calendar year 2018.’’. 
(2) CONFORMING AMENDMENT.—Paragraph (1) 
of section 9010(b) of the Patient Protection and Af-
fordable Care Act is amended by striking ‘‘the fee 
under this section’’ and inserting ‘‘the amount deter-
mined under this subsection’’. 
(b) RELIEF FOR 2019.— 
(1) IN GENERAL.—Section 9010(j) of the Pa-
tient Protection and Affordable Care Act is amended 
by striking ‘‘and’’ at the end of paragraph (1), by 
striking the period at the end of paragraph (2) and 
inserting ‘‘, and ending before January 1, 2019, 
and’’, and by adding at the end the following new 
paragraph: 
‘‘(3) beginning after December 31, 2019.’’. 
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