Title: ENROLL Act of 2019
Policy area: Health

Summary:
Expand Navigators' Resources for Outreach, Learning, and Longevity Act of 2019 or the ENROLL Act of 2019
This bill makes several changes to the navigator program for health insurance exchanges (a program through which entities receive funding to provide education and enrollment assistance). Specifically, the bill addresses certain funding decisions and regulatory actions taken by the Centers for Medicare & Medicaid Services (CMS).
For example, the bill increases funding for navigators in federally facilitated exchanges (FFEs) beginning in FY2020. (The CMS decreased annual funding for FFE navigators for the 2017-2018 and 2018-2019 program years.)
The bill also counters guidance issued by the CMS regarding navigator criteria by requiring FFE navigators to be chosen without regard to how the entity provides information on association health plans or short-term, limited-duration insurance.
The bill also reinstates certain requirements that were removed by the CMS in 2018. Specifically, the bill requires (1) at least two navigators in each FFE, including at least one community and consumer-focused nonprofit group; and (2) that navigators be physically present in the state where the exchange is located.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1905 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                S. 1905

To amend the Patient Protection and Affordable Care Act to provide for 
additional requirements with respect to the navigator program, and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 19, 2019

  Ms. Baldwin (for herself, Mr. Casey, Mrs. Shaheen, Mr. Booker, Mr. 
 Kaine, Ms. Stabenow, Ms. Hirono, Ms. Duckworth, Mr. Merkley, Mr. Van 
Hollen, Ms. Hassan, Mr. King, Mr. Coons, Mr. Menendez, Mr. Peters, Mr. 
 Tester, Ms. Harris, Ms. Smith, Mr. Murphy, Ms. Rosen, Mr. Blumenthal, 
and Ms. Klobuchar) introduced the following bill; which was read twice 
and referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend the Patient Protection and Affordable Care Act to provide for 
additional requirements with respect to the navigator program, and for 
                            other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Expand Navigators' Resources for 
Outreach, Learning, and Longevity Act of 2019'' or the ``ENROLL Act of 
2019''.

SEC. 2. PROVIDING FOR ADDITIONAL REQUIREMENTS WITH RESPECT TO THE 
              NAVIGATOR PROGRAM.

    (a) In General.--Section 1311(i) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18031(i)) is amended--
            (1) in paragraph (2), by adding at the end the following 
        new subparagraph:
                    ``(C) Selection of recipients.--In the case of an 
                Exchange established and operated by the Secretary 
                within a State pursuant to section 1321(c), in awarding 
                grants under paragraph (1), the Exchange shall--
                            ``(i) select entities to receive such 
                        grants based on an entity's demonstrated 
                        capacity to carry out each of the duties 
                        specified in paragraph (3);
                            ``(ii) not take into account whether or not 
                        the entity has demonstrated how the entity will 
                        provide information to individuals relating to 
                        group health plans offered by a group or 
                        association of employers described in section 
                        2510.3-5(b) of title 29, Code of Federal 
                        Regulations (or any successor regulation), or 
                        short-term limited duration insurance (as 
                        defined by the Secretary for purposes of 
                        section 2791(b)(5) of the Public Health Service 
                        Act); and
                            ``(iii) ensure that, each year, the 
                        Exchange awards such a grant to--
                                    ``(I) at least one entity described 
                                in this paragraph that is a community 
                                and consumer-focused nonprofit group; 
                                and
                                    ``(II) at least one entity 
                                described in subparagraph (B), which 
                                may include another community and 
                                consumer-focused nonprofit group in 
                                addition to any such group awarded a 
                                grant pursuant to subclause (I).
                        In awarding such grants, an Exchange may 
                        consider an entity's record with respect to 
                        waste, fraud, and abuse for purposes of 
                        maintaining the integrity of such Exchange.'';
            (2) in paragraph (3)--
                    (A) in subparagraph (C), by inserting after 
                ``qualified health plans'' the following: `` , State 
                medicaid plans under title XIX of the Social Security 
                Act, and State children's health insurance programs 
                under title XXI of such Act''; and
                    (B) by adding at the end the following flush left 
                sentence:
        ``The duties specified in the preceding sentence may be carried 
        out by such a navigator at any time during a year.'';
            (3) in paragraph (4)(A)--
                    (A) in the matter preceding clause (i), by striking 
                ``not'';
                    (B) in clause (i)--
                            (i) by inserting ``not'' before ``be''; and
                            (ii) by striking ``; or'' and inserting a 
                        semicolon;
                    (C) in clause (ii)--
                            (i) by inserting ``not'' before 
                        ``receive''; and
                            (ii) by striking the period and inserting a 
                        semicolon; and
                    (D) by adding at the end the following new clause:
                            ``(iii) maintain physical presence in the 
                        State of the Exchange so as to allow in-person 
                        assistance to consumers.''; and
            (4) in paragraph (6)--
                    (A) by striking ``Funding.--Grants under'' and 
                inserting ``Funding.--
                    ``(A) State exchanges.--Grants under''; and
                    (B) by adding at the end the following new 
                subparagraph:
                    ``(B) Federal exchanges.--For purposes of carrying 
                out this subsection, with respect to an Exchange 
                established and operated by the Secretary within a 
                State pursuant to section 1321(c), the Secretary shall 
                obligate $100,000,000 out of amounts collected through 
                the user fees on participating health insurance issuers 
                pursuant to section 156.50 of title 45, Code of Federal 
                Regulations (or any successor regulations) for fiscal 
                year 2020 and each subsequent fiscal year. Such amount 
                for a fiscal year shall remain available until 
                expended.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to plan years beginning on or after January 1, 2020.
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