Title: SAVE Act
Policy area: Health

Summary:
State Allowance for a Variety of Exchanges Act or the SAVE Act
This bill allows the Department of Health and Human Services to award grants to support the establishment of state-based health insurance exchanges in those states that have not already elected to do so. A state that receives a grant must ensure that the resulting exchange is self-sustaining by 2024.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1385 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 1385

To amend the Patient Protection and Affordable Care Act to preserve the 
 option of States to implement health care marketplaces, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 27, 2019

  Mr. Kim (for himself and Mr. Fitzpatrick) introduced the following 
    bill; which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To amend the Patient Protection and Affordable Care Act to preserve the 
 option of States to implement health care marketplaces, 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 ``State Allowance for a Variety of 
Exchanges Act'' or the ``SAVE Act''.

SEC. 2. PRESERVING STATE OPTION TO IMPLEMENT HEALTH CARE MARKETPLACES.

    (a) In General.--Section 1311 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18031) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (4)(B), by striking ``under this 
                subsection'' and inserting ``under this paragraph or 
                paragraph (1)''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(6) Additional planning and establishment grants.--
                    ``(A) In general.--There shall be appropriated to 
                the Secretary, out of any moneys in the Treasury not 
                otherwise appropriated, $200,000,000 to award grants to 
                eligible States for the uses described in paragraph 
                (3).
                    ``(B) Duration and renewability.--A grant awarded 
                under subparagraph (A) shall be for a period of two 
                years and may not be renewed.
                    ``(C) Limitation.--A grant may not be awarded under 
                subparagraph (A) after December 31, 2022.
                    ``(D) Eligible state defined.--For purposes of this 
                paragraph, the term `eligible State' means a State 
                that, as of the date of the enactment of this 
                paragraph, is not operating an Exchange.''; and
            (2) in subsection (d)(5)(A)--
                    (A) by striking ``In establishing an Exchange under 
                this section'' and inserting ``(i) In general.--In 
                establishing an Exchange under this section (other than 
                in establishing an Exchange pursuant to subsection 
                (a)(6))''; and
                    (B) by adding at the end the following:
                            ``(ii) Additional planning and 
                        establishment grants.--In establishing an 
                        Exchange pursuant to subsection (a)(6), the 
                        State shall ensure that such Exchange is self-
                        sustaining beginning on January 1, 2024, 
                        including allowing the Exchange to charge 
                        assessments or user fees to participating 
                        health insurance issuers, or to otherwise 
                        generate funding, to support its operations.''.
    (b) Clarification Regarding Failure To Establish Exchange or 
Implement Requirements.--Section 1321(c) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18041(c)) is amended--
            (1) in paragraph (1), by striking ``If'' and inserting 
        ``Subject to paragraph (3), if''; and
            (2) by adding at the end the following new paragraph:
            ``(3) Clarification.--This subsection shall not apply in 
        the case of a State that elects to apply the requirements 
        described in subsection (a) and satisfies the requirement 
        described in subsection (b) on or after January 1, 2014.''.
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