I 
115TH CONGRESS 
1ST SESSION H. R. 4200 
To provide for temporary funding for health insurance cost-sharing reduction 
payments and provide targeted tax relief, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 1, 2017 
Mr. BRADY of Texas introduced the following bill; which was referred to the 
Committee on Ways and Means, and in addition to the Committee on En-
ergy and Commerce, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To provide for temporary funding for health insurance cost- 
sharing reduction payments and provide targeted tax re-
lief, and for other purposes. 
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 ‘‘Healthcare Market 
Certainty and Mandate Relief Act of 2017’’. 
SEC. 2. COST-SHARING REDUCTION PAYMENTS. 
(a) IN GENERAL.— 
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(1) APPROPRIATIONS.—There is appropriated 
to the Secretary of Health and Human Services, out 
of any funds in the Treasury not otherwise appro-
priated, such sums as may be necessary for pay-
ments for cost-sharing reductions authorized by sec-
tion 1402 of Public Law 111–148, including through 
advanced payment of such reductions under section 
1412 of such Public Law for plan years 2017, 2018, 
and 2019 (and including for adjustments to any 
prior obligations for such payments). 
(2) 
ADJUSTMENTS.—Notwithstanding 
any 
other provision of this Act, payments and other ac-
tions for adjustments to obligations incurred prior to 
December 31, 2019, may be made through Decem-
ber 31, 2020. 
(3) LIMITATION.—Amounts appropriated under 
paragraph (1) shall not include payment to an issuer 
of a qualified health plan that includes coverage of 
abortion (other than any abortion necessary to save 
the life of the mother or any abortion with respect 
to a pregnancy that is the result of an act of rape 
or incest). 
(b) SPECIAL RULE
FOR PLAN YEAR 2018 PAY-
MENTS.—Section 1402(c) of Public Law 111–148 (42 
U.S.C. 18071(c)) is amended— 
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(1) in paragraph (3)(A), by striking ‘‘An 
issuer’’ and inserting ‘‘Subject to paragraph (6), an 
issuer’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(6) SPECIAL RULE FOR PLAN YEAR 2018 PAY-
MENTS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
make payments under paragraph (3)(A), includ-
ing through advanced payment for cost-sharing 
reduction under section 1412, for plan year 
2018 to an issuer of a qualified health plan 
only, subject to subparagraph (C), if the Sec-
retary determines, based on a certification and 
appropriate documentation from the issuer and 
a certification from State regulators, that the 
premium rates applied under such plan for such 
plan year were based on the assumption of re-
ceiving payments under paragraph (3)(A) for 
such plan year (including by reason of the plan 
being offered in a State in which the State reg-
ulators instructed issuers of health plans in 
such State to make such an assumption). 
‘‘(B) RECOVERY OF PAST PAYMENTS.—If 
the Secretary makes payments to an issuer of 
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a qualified health plan under paragraph (3)(A) 
for plan year 2018 and subsequently determines 
that such issuer increased premium rates for 
that plan year because the issuer expected, or 
was instructed by applicable State regulators to 
expect, that the issuer would not receive such 
payments (or, in the case of such payments 
made to an issuer of a qualified health plan for 
plan year 2018 pursuant to subparagraph (C), 
determines that such issuer did not reduce pre-
mium rates under such plan for such plan year 
to such rates as described in clause (i)(I) of 
such subparagraph) the Secretary may reduce 
payments due to such issuer under paragraph 
(3)(A) for a subsequent plan year by the 
amount paid to such issuer under such para-
graph for plan year 2018. 
‘‘(C) PAYMENTS
ALLOWED
IN
CASE
OF 
ISSUERS IN STATES PROVIDING FOR PREMIUM 
ADJUSTMENT PROCESS.—Notwithstanding sub-
paragraph (A), the Secretary may make pay-
ments under paragraph (3)(A) for plan year 
2018 to an issuer of a qualified health plan not 
otherwise eligible for such payments pursuant 
to subparagraph (A) if— 
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‘‘(i) the qualified health plan is of-
fered in a State for such plan year for 
which the State insurance commissioner 
notifies the Secretary of the Treasury and 
the Secretary of Health and Human Serv-
ices of a process provided for in the State 
under which— 
‘‘(I) issuers of qualified health 
plans in such State choosing to par-
ticipate in such process are required 
to reduce premium rates under such 
plans for plan year 2018 to the rates 
that would have been applied under 
such plans for such plan year had the 
issuers assumed payments for cost- 
sharing reductions under such para-
graph would be received for such plan 
year; and 
‘‘(II) the State submits to the 
Secretaries information to verify that 
the reduction of the premium rate 
under a qualified health plan offered 
by an issuer participating under such 
process satisfies the reduction require-
ment described in subclause (I); and 
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‘‘(ii) the issuer of such qualified 
health plan chooses to participate in such 
process. 
‘‘(D) 
RECONCILIATION
PROCESS.—The 
Secretary of the Treasury and the Secretary of 
Health and Human Services shall adjust the 
methodologies under section 156.430 of title 45, 
Code of Federal Regulations (as in effect on the 
date of enactment of the Healthcare Market 
Certainty and Mandate Relief Act of 2017), as 
may be necessary to correct for any overpay-
ments or underpayments made under this sec-
tion to an issuer in accordance with this para-
graph.’’. 
SEC. 3. MORATORIUM ON INDIVIDUAL MANDATE. 
Section 5000A of the Internal Revenue Code of 1986 
is amended— 
(1) in subsection (a), by striking ‘‘An applica-
ble’’ and inserting ‘‘Except as provided in subsection 
(h), an applicable’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(h) SUSPENSION.—This section shall not apply to 
any month beginning after December 31, 2016, and before 
January 1, 2022.’’. 
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