Title: Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018
Policy area: Taxation

Summary:
This bill modifies the requirements for the premium assistance tax credit and allows all individuals to purchase catastrophic health plans in the individual market.
(Under current law, the premium assistance tax credit is provided to eligible individuals and families to subsidize the purchase of health insurance plans on an exchange established under the Patient Protection and Affordable Care Act.) The bill modifies the credit to:
The bill also modifies the requirements for minimum essential health benefits to allow all individuals purchasing health insurance in the individual market to purchase a lower premium catastrophic plan. (The plans are currently limited to individuals who are under 30 or qualify for a hardship or affordability exemption.)

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6311 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 6311

 To amend the Internal Revenue Code of 1986 and the Patient Protection 
 and Affordable Care Act to modify the definition of qualified health 
  plan for purposes of the health insurance premium tax credit and to 
allow individuals purchasing health insurance in the individual market 
                to purchase a lower premium copper plan.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              July 6, 2018

Mr. Roskam (for himself and Mr. Burgess) 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 provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
 To amend the Internal Revenue Code of 1986 and the Patient Protection 
 and Affordable Care Act to modify the definition of qualified health 
  plan for purposes of the health insurance premium tax credit and to 
allow individuals purchasing health insurance in the individual market 
                to purchase a lower premium copper plan.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. MODIFICATION OF DEFINITION OF QUALIFIED HEALTH PLAN.

    (a) In General.--Section 36B(c)(3)(A) of the Internal Revenue Code 
of 1986 is amended--
            (1) by inserting ``(determined without regard to 
        subparagraphs (A), (C)(ii), and (C)(iv) of paragraph (1) 
        thereof and without regard to whether the plan is offered on an 
        Exchange)'' after ``1301(a) of the Patient Protection and 
        Affordable Care Act'', and
            (2) by striking ``shall not include'' and all that follows 
        and inserting ``shall not include any health plan that--
                            ``(i) is a grandfathered health plan or a 
                        grandmothered health plan, or
                            ``(ii) includes coverage for abortions 
                        (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) Definition of Grandmothered Health Plan.--Section 36B(c)(3) of 
such Code is amended by adding at the end the following new 
subparagraph:
                    ``(C) Grandmothered health plan.--
                            ``(i) In general.--The term `grandmothered 
                        health plan' means health insurance coverage 
                        which is offered in the individual health 
                        insurance market as of October 1, 2013, and is 
                        permitted to be offered in such market after 
                        January 1, 2014, as a result of CCIIO guidance.
                            ``(ii) CCIIO guidance defined.--The term 
                        `CCIIO guidance' means the letter issued by the 
                        Centers for Medicare & Medicaid Services on 
                        November 14, 2013, to the State Insurance 
                        Commissioners outlining a transitional policy 
                        for non-grandfathered coverage in the 
                        individual health insurance market, as 
                        subsequently extended and modified (including 
                        by a communication entitled `Insurance 
                        Standards Bulletin Series--INFORMATION--
                        Extension of Transitional Policy through 2019' 
                        issued on April 9, 2018, by the Director of the 
                        Center for Consumer Information and Insurance 
                        Oversight of such Centers).
                            ``(iii) Individual health insurance 
                        market.--The term `individual health insurance 
                        market' means the market for health insurance 
                        coverage (as defined in section 9832(b)) 
                        offered to individuals other than in connection 
                        with a group health plan (within the meaning of 
                        section 5000(b)(1)).''.
    (c) Conforming Amendment Related to Abortion Coverage.--Section 
36B(c)(3) of such Code, as amended by paragraph (2), is amended by 
adding at the end the following new subparagraph:
                    ``(D) Certain rules related to abortion.--
                            ``(i) Option to purchase separate coverage 
                        or plan.--Nothing in subparagraph (A) shall be 
                        construed as prohibiting any individual from 
                        purchasing separate coverage for abortions 
                        described in such subparagraph, or a health 
                        plan that includes such abortions, so long as 
                        no credit is allowed under this section with 
                        respect to the premiums for such coverage or 
                        plan.
                            ``(ii) Option to offer coverage or plan.--
                        Nothing in subparagraph (A) shall restrict any 
                        health insurance issuer offering a health plan 
                        from offering separate coverage for abortions 
                        described in such subparagraph, or a plan that 
                        includes such abortions, so long as premiums 
                        for such separate coverage or plan are not paid 
                        for with any amount attributable to the credit 
                        allowed under this section (or the amount of 
                        any advance payment of the credit under section 
                        1412 of the Patient Protection and Affordable 
                        Care Act).
                            ``(iii) Other treatments.--The treatment of 
                        any infection, injury, disease, or disorder 
                        that has been caused by or exacerbated by the 
                        performance of an abortion shall not be treated 
                        as an abortion for purposes of subparagraph 
                        (A).''.
    (d) Conforming Amendments Related to Off-Exchange Coverage.--
            (1) Advance payment not applicable.--Section 1412 of the 
        Patient Protection and Affordable Care Act is amended by adding 
        at the end the following new subsection:
    ``(f) Exclusion of Off-Exchange Coverage.--Advance payments under 
this section, and advance determinations under section 1411, with 
respect to any credit allowed under section 36B shall not be made with 
respect to any health plan which is not enrolled in through an 
Exchange.''.
            (2) Reporting.--Section 6055(b) of the Internal Revenue 
        Code of 1986 is amended by adding at the end the following new 
        paragraph:
            ``(3) Information relating to off-exchange premium credit 
        eligible coverage.--If minimum essential coverage provided to 
        an individual under subsection (a) consists of a qualified 
        health plan (as defined in section 36B(c)(3)) which is not 
        enrolled in through an Exchange established under title I of 
        the Patient Protection and Affordable Care Act, a return 
        described in this subsection shall include--
                    ``(A) a statement that such plan is a qualified 
                health plan (as defined in section 36B(c)(3)),
                    ``(B) the premiums paid with respect to such 
                coverage,
                    ``(C) the months during which such coverage is 
                provided to the individual,
                    ``(D) the adjusted monthly premium for the 
                applicable second lowest cost silver plan (as defined 
                in section 36B(b)(3)) for each such month with respect 
                to such individual, and
                    ``(E) such other information as the Secretary may 
                prescribe.''.
            (3) Other conforming amendments.--
                    (A) Section 36B(b)(2)(A) of such Code is amended by 
                striking ``and which were enrolled'' and all that 
                follows and inserting ``, or''.
                    (B) Section 36B(b)(3)(B)(i) of such Code is amended 
                by striking ``the same Exchange'' and all that follows 
                and inserting ``the Exchange through which such 
                taxpayer is permitted to obtain coverage, and''.
                    (C) Section 36B(c)(2)(A)(i) of such Code is amended 
                by striking ``that was enrolled in through an Exchange 
                established by the State under section 1311 of the 
                Patient Protection and Affordable Care Act''.
    (e) Effective Date.--
            (1) In general.--Except as otherwise provided in this 
        subsection, the amendments made by this subsection shall apply 
        to taxable years beginning after December 31, 2018.
            (2) Advance payment not applicable to off-exchange 
        coverage.--The amendment made by subsection (d)(1) shall take 
        effect on January 1, 2019.
            (3) Reporting.--The amendment made by subsection (d)(2) 
        shall apply to coverage provided for months beginning after 
        December 31, 2018.

SEC. 2. ALLOWING ALL INDIVIDUALS PURCHASING HEALTH INSURANCE IN THE 
              INDIVIDUAL MARKET THE OPTION TO PURCHASE A LOWER PREMIUM 
              COPPER PLAN.

    (a) In General.--Section 1302(e) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18022(e)) is amended--
            (1) in paragraph (1)--
                    (A) by redesignating clauses (i) and (ii) of 
                subparagraph (B) as subparagraphs (A) and (B), 
                respectively, and adjusting the margins accordingly;
                    (B) by striking ``plan year if--'' and all that 
                follows through ``the plan provides--'' and inserting 
                ``plan year if the plan provides--''; and
                    (C) in subparagraph (A), as redesignated by 
                paragraph (1), by striking ``clause (ii)'' and 
                inserting ``subparagraph (B)'';
            (2) by striking paragraph (2); and
            (3) by redesignating paragraph (3) as paragraph (2).
    (b) Risk Pools.--Section 1312(c)(1) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18032(c)(1)) is amended by inserting 
``and enrollees in catastrophic plans described in section 1302(e)'' 
after ``Exchange''.
    (c) Conforming Amendment.--Section 1312(d)(3)(C) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18032(d)(3)(C)) is 
amended by striking ``, except that in the case of a catastrophic plan 
described in section 1302(e), a qualified individual may enroll in the 
plan only if the individual is eligible to enroll in the plan under 
section 1302(e)(2)''.
    (d) Effective Date.--The amendments made by this section shall 
apply to plan years beginning after December 31, 2018.
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