Health Care Fairness and Stability Act

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care Fairness and Stability 
Act''.

SEC. 2. SHIFT IN THE COLLECTION OF THE PAYMENT FOR THE TRANSITIONAL 
              REINSURANCE PROGRAM.

    (a) In General.--Section 1341(b) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18061(b)) is amended--
            (1) in paragraph (1)--
                    (A) in subparagraph (A)--
                            (i) by inserting ``beginning on January 1, 
                        2018,'' after ``required to make payments''; 
                        and
                            (ii) by striking ``any plan year beginning 
                        in the 3-year period'' and all that follows 
                        through the end and inserting ``payments made 
                        under subparagraph (C) (as specified in 
                        paragraph (3));'';
                    (B) in subparagraph (B), by striking ``and uses'' 
                and all that follows through the period and inserting 
                ``; and''; and
                    (C) by adding at the end the following:
                    ``(C) the applicable reinsurance entity makes 
                reinsurance payments to health insurance issuers 
                described in subparagraph (A) that cover high risk 
                individuals in the individual market (excluding 
                grandfathered health plans) for any plan year beginning 
                in the 3-year period beginning January 1, 2014, in an 
                aggregate amount of up to the total of the aggregate 
                contribution amounts described in paragraph (3)(B)(iv), 
                subject to paragraph (4).'';
            (2) in paragraph (2), by striking ``paragraph (1)(B)'' and 
        inserting ``paragraph (1)(C)'';
            (3) in paragraph (3)--
                    (A) in subparagraph (A), by striking ``2014'' and 
                inserting ``2018''; and
                    (B) in subparagraph (B)--
                            (i) in clause (ii), by striking 
                        ``administrative'' and inserting 
                        ``operational'';
                            (ii) by redesignating clauses (iii) and 
                        (iv) as clauses (iv) and (v), respectively;
                            (iii) by inserting after clause (ii), the 
                        following:
                            ``(iii) the aggregate contribution amount 
                        for all States shall be based on the total 
                        amount of reinsurance payments made under 
                        paragraph (1)(C);'';
                            (iv) by striking clause (iv), as so 
                        redesignated, and inserting the following:
                            ``(iv) the aggregate contribution amount 
                        collected under clause (iii) shall, without 
                        regard to amounts described in clause (ii), be 
                        limited to $10,000,000,000 based on the plan 
                        years beginning in 2014, $6,000,000,000 based 
                        on the plan years beginning in 2015, and 
                        $4,000,000,000 based on the plan years 
                        beginning in 2016;'';
                            (v) in clause (v), as so redesignated, by 
                        striking ``clause (iii)'' each place that such 
                        term appears and inserting ``clause (iv)''; and
                            (vi) by inserting after clause (v), the 
                        following:
                            ``(vi) in addition to the contribution 
                        amounts under clauses (iii), (iv), and (v), 
                        each issuer's contribution amount--
                                    ``(I) shall reflect its 
                                proportionate share of an additional 
                                $20,300,000 for operational expenses 
                                for reinsurance payments for calendar 
                                year 2014 and for reinsurance 
                                collections for calendar year 2018;
                                    ``(II) shall reflect its 
                                proportionate share of operational 
                                expenses for reinsurance payments for 
                                calendar year 2015 and for reinsurance 
                                collections for calendar year 2019; and
                                    ``(III) shall reflect its 
                                proportionate share of operational 
                                expenses for reinsurance payments for 
                                calendar year 2016 and for reinsurance 
                                collections for calendar year 2020; and
                            ``(vii) collection of the contribution 
                        amounts provided for in clauses (ii) through 
                        (vi) shall be initiated--
                                    ``(I) for calendar year 2014, not 
                                earlier than January 1, 2018;
                                    ``(II) for calendar year 2015, not 
                                earlier than January 1, 2019; and
                                    ``(III) for calendar year 2016, not 
                                earlier than January 1, 2020.'';
            (4) in paragraph (4)--
                    (A) in subparagraph (A)--
                            (i) by striking ``contribution amounts 
                        collected for any calendar year'' and inserting 
                        ``amount provided under paragraph (5) for 
                        reinsurance payments described in paragraph 
                        (1)(C)''; and
                            (ii) by striking ``; and'' and inserting a 
                        period;
                    (B) by striking subparagraph (B);
                    (C) by striking ``that--'' and all that follows 
                through ``the contribution'' in subparagraph (A) and 
                inserting ``that the contribution''; and
                    (D) in the flush matter at the end, by striking 
                ``paragraph (3)(B)(iv)'' and inserting the following: 
                ``paragraph (3)(B)(v) and any amounts collected under 
                clause (ii) of paragraph (3)(B) that, when combined 
                with the funding provided for under paragraph (5), 
                exceed the aggregate amount permitted for making the 
                reinsurance payments described in paragraph (1)(C) and 
                to fund the operational expenses of applicable 
                reinsurance entities,''; and
            (5) by adding at the end the following:
            ``(5) Funding.--To carry out this section, there is 
        appropriated, out of any money in the Treasury not otherwise 
        appropriated, an amount equal to the aggregate amount to be 
        collected for plan years beginning in 2014 set forth in 
        paragraph (3)(B)(iv) for reinsurance payments described in 
        paragraph (1)(C), and an amount equal to the contribution 
        amounts set forth in paragraph (3)(B)(vi) to fund operational 
        expenses of applicable reinsurance entities.''.
    (b) Rule of Construction.--Nothing in the amendments made by this 
section shall be construed to increase the amount of payments to be 
collected under subsection (b)(1)(A) or to decrease the amount of the 
reinsurance payments to be made under subsection (b)(1)(C) of section 
1341 of the Patient Protection and Affordable Care Act (42 U.S.C. 
18061).
    (c) Medical Loss Ratio.--The Secretary of Health and Human Services 
shall promulgate regulations or guidance to ensure that health 
insurance issuers reflect changes made in section 1341 of the Patient 
Protection and Affordable Care Act with section 2718 of the Public 
Health Service Act (42 U.S.C. 300gg-18) and sections 1342 and 1312(c) 
of the Patient Protection and Affordable Care Act (42 U.S.C. 18063 and 
18032(c)).

Summary: Health Care Fairness and Stability Act - Amends the Patient Protection and Affordable Care Act (PPACA) to provide a temporary shift in the scheduled collection of payments for the transitional reinsurance program intended to help stabilize premiums for coverage in the individual health insurance markets from 2014 through 2016. Amends PPACA to delay the collection of reinsurance payments from health insurance issuers and third party administrators of certain self-insured group health plans until January 1, 2018. Amends PPACA to change the formula for determining the amount of contributions collected for payments to health insurance issuers that cover high risk individuals in the individual market.  &nbsp;