I 
113TH CONGRESS 
2D SESSION 
H. R. 4196 
To amend the Patient Protection and Affordable Care Act to eliminate Ex-
change cost-sharing subsidies, to amend title XVIII of the Social Security 
Act to create a Medicare Advantage Improvement Fund, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 11, 2014 
Mr. JOHNSON of Ohio introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees 
on Ways and Means and Education and the Workforce, for a period to 
be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To amend the Patient Protection and Affordable Care Act 
to eliminate Exchange cost-sharing subsidies, to amend 
title XVIII of the Social Security Act to create a Medi-
care Advantage Improvement Fund, and for other pur-
poses. 
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 ‘‘Seniors’ Fairness Act 
of 2014’’. 
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SEC. 2. CREATING MEDICARE ADVANTAGE IMPROVEMENT 
FUND. 
Section 1859 of the Social Security Act (42 U.S.C. 
1395w–28) is amended by adding at the end the following 
new subsection: 
‘‘(h) 
MEDICARE
ADVANTAGE
IMPROVEMENT 
FUND.— 
‘‘(1) ESTABLISHMENT.—The Secretary shall es-
tablish under this title a Medicare Advantage Im-
provement Fund (in this subsection referred to as 
the ‘Fund’) which shall be available to make im-
provements under the Medicare Advantage program 
under this part, including by— 
‘‘(A) preventing cost-sharing increases and 
the loss of benefits to individuals enrolled in 
MA plans; and 
‘‘(B) ensuring individuals enrolled in MA 
plans can access a high-quality network of pro-
viders. 
‘‘(2) FUNDING.— 
‘‘(A) IN GENERAL.—There shall be avail-
able to the Fund, for expenditures from the 
Fund during the period of fiscal years 2014 
through 2023, $150,000,000,000. 
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‘‘(B) FUNDING LIMITATION.—Amounts in 
the Fund shall be available to the Secretary 
only pursuant to an appropriations Act.’’. 
SEC. 3. ELIMINATING EXCHANGE COST-SHARING SUB-
SIDIES UNDER PPACA. 
(a) IN GENERAL.—Section 1402 of the Patient Pro-
tection and Affordable Care Act (42 U.S.C. 18071) is 
amended by adding at the end the following new sub-
section: 
‘‘(g) TERMINATION OF REDUCED COST-SHARING BE-
GINNING IN PLAN YEAR 2015.—The provisions of this 
section shall not apply with respect to plan years after 
plan year 2014.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) FAIR LABOR STANDARDS ACT OF 1938.— 
Section 18B(a)(2) of the Fair Labor Standards Act 
of 1938 (29 U.S.C. 218b(a)(2)) is amended— 
(A) by striking ‘‘1986 and’’ and inserting 
‘‘1986 and, in the case of plan year 2014,’’; 
and 
(B) by inserting a comma after ‘‘Care 
Act’’. 
(2) MEDICAID.—Section 1943(b)(1)(C) of the 
Social Security Act (42 U.S.C. 1396w–3(b)(1)(C)) is 
amended by inserting ‘‘(for plan years in which the 
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provisions of such section apply)’’ after ‘‘section 
1402 of the Patient Protection and Affordable Care 
Act’’. 
Æ 
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