Health Service Act (42 U.S.C. 300jj– 
19(a)). 
(5) SECRETARY
FLEXIBILITY
FOR
BUDGET 
NEUTRAL
REVISIONS
TO
REINSURANCE
PAYMENT 
SPECIFICATIONS.—If the Secretary determines ap-
propriate, the Secretary may substitute higher dollar 
amounts for the dollar amounts specified under sub-
paragraphs (A) and (B) of paragraph (2) (and ad-
justed under paragraph (3), if applicable) if the Sec-
retary certifies that such substitutions, considered 
together, neither increase nor decease the total pro-
jected payments under this subsection. 
(c) OUTREACH AND ENROLLMENT.— 
(1) IN GENERAL.—During the period that be-
gins on January 1, 2018, and ends on December 31, 
2020, the Secretary shall award grants to eligible 
entities for the following purposes: 
(A) OUTREACH
AND
ENROLLMENT.—To 
carry out outreach, public education activities, 
and enrollment activities to raise awareness of 
the availability of, and encourage enrollment in, 
qualified health plans. 
(B) ASSISTING
INDIVIDUALS
TRANSITION 
TO QUALIFIED HEALTH PLANS.—To provide as-
sistance to individuals who are enrolled in 
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health insurance coverage that is not a qualified 
health plan enroll in a qualified health plan. 
(C) ASSISTING
ENROLLMENT
IN
PUBLIC 
HEALTH PROGRAMS.—To facilitate the enroll-
ment of eligible individuals in the Medicare pro-
gram or in a State Medicaid program, as appro-
priate. 
(D) RAISING AWARENESS OF PREMIUM AS-
SISTANCE AND COST-SHARING REDUCTIONS.— 
To distribute fair and impartial information 
concerning enrollment in qualified health plans 
and the availability of premium assistance tax 
credits under section 36B of the Internal Rev-
enue Code of 1986 and cost-sharing reductions 
under section 1402 of the Patient Protection 
and Affordable Care Act, and to assist eligible 
individuals in applying for such tax credits and 
cost-sharing reductions. 
(2) ELIGIBLE ENTITIES DEFINED.— 
(A) IN GENERAL.—In this subsection, the 
term ‘‘eligible entity’’ means— 
(i) a State; or 
(ii) a nonprofit community-based or-
ganization. 
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(B) ENROLLMENT
AGENTS.—Such term 
includes a licensed independent insurance agent 
or broker that has an arrangement with a State 
or nonprofit community-based organization to 
enroll eligible individuals in qualified health 
plans. 
(C) EXCLUSIONS.—Such term does not in-
clude an entity that— 
(i) is a health insurance issuer; or 
(ii) receives any consideration, either 
directly or indirectly, from any health in-
surance issuer in connection with the en-
rollment of any qualified individuals or em-
ployees of a qualified employer in a quali-
fied health plan. 
(3) PRIORITY.—In awarding grants under this 
subsection, the Secretary shall give priority to 
awarding grants to States or eligible entities in 
States that have geographic rating areas at risk of 
having no qualified health plans in the individual 
market. 
(4) FUNDING.—Out of any moneys in the 
Treasury not otherwise appropriated, $500,000,000 
is appropriated to the Secretary for each of calendar 
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years 2018 through 2020, to carry out this sub-
section. 
(d) REPORTS TO CONGRESS.— 
(1) ANNUAL
REPORT.—The Secretary shall 
submit a report to Congress, not later than January 
21, 2019, and each year thereafter, that contains 
the following information for the most recently 
ended year: 
(A) The number and types of plans in each 
State’s individual market, specifying the num-
ber that are qualified health plans, grand-
fathered health plans, or health insurance cov-
erage that is not a qualified health plan. 
(B) The impact of the reinsurance pay-
ments provided under this section on the avail-
ability of coverage, cost of coverage, and cov-
erage options in each State. 
(C) The amount of premiums paid by indi-
viduals in each State by age, family size, geo-
graphic area in the State’s individual market, 
and category of health plan (as described in 
subparagraph (A)). 
(D) The process used to award funds for 
outreach and enrollment activities awarded to 
eligible entities under subsection (c), the 
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amount of such funds awarded, and the activi-
ties carried out with such funds. 
(E) Such other information as the Sec-
retary deems relevant. 
(2) EVALUATION REPORT.—Not later than Jan-
uary 31, 2022, the Secretary shall submit to Con-
gress a report that— 
(A) analyzes the impact of the funds pro-
vided under this section on premiums and en-
rollment in the individual market in all States; 
and 
(B) contains a State-by-State comparison 
of the design of the programs carried out by 
States with funds provided under this section. 
(e) DEFINITIONS.—In this section: 
(1) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of the Department of Health and 
Human Services. 
(2) FUND.—The term ‘‘Fund’’ means the Indi-
vidual Market Reinsurance Fund established under 
subsection (a). 
(3) GRANDFATHERED
HEALTH
PLAN.—The 
term ‘‘grandfathered health plan’’ has the meaning 
given that term in section 1251(e) of the Patient 
Protection and Affordable Care Act. 
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(4) HIGH-COST INDIVIDUAL.—The term ‘‘high- 
cost individual’’ means an individual enrolled in a 
qualified health plan (other than a grandfathered 
health plan or a transitional health plan) who incurs 
claims in excess of $50,000 during a plan year. 
(5) STATE.—The term ‘‘State’’ means each of 
the 50 States and the District of Columbia. 
(6) TRANSITIONAL HEALTH PLAN.—The term 
‘‘transitional health plan’’ means a plan continued 
under the letter issued by the Centers for Medicare 
& Medicaid Services on November 14, 2013, to the 
State Insurance Commissioners outlining a transi-
tional policy for coverage in the individual and small 
group markets to which section 1251 of the Patient 
Protection and Affordable Care Act does not apply, 
and under the extension of the transitional policy for 
such coverage set forth in the Insurance Standards 
Bulletin Series guidance issued by the Centers for 
Medicare & Medicaid Services on March 5, 2014, 
February 29, 2016, and February 13, 2017. 
Æ 
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