Patient Protection and Affordable Care Enhancement Act

Bill: 116-hr-1425
Sponsor: Rep. Craig, Angie [D-MN-2]
Introduced: 2019-02-28 in the House
Policy area: Health
Subjects: Appropriations
Government trust funds
Health care costs and insurance
Health care coverage and access
Health programs administration and funding
State and local finance

Summary:
action_date: 2019-02-28
text: 

State Health Care Premium Reduction Act

 
This bill establishes the Improve Health Insurance Affordability Fund. States must use allocated funds to (1) issue reinsurance payments to health insurers (i.e., reimbursements to protect insurers against exceedingly high claims) for individual health insurance coverage, or (2) provide other assistance to reduce out-of-pocket costs (e.g., copayments, coinsurance, and deductibles) for qualified health plans offered in the individual market. 
 
The Centers for Medicare & Medicaid Services must distribute funding to states in accordance with a specified methodology.

action_date: 2020-03-09
text: 

State Health Care Premium Reduction Act

 
This bill establishes and provides funding for the Improve Health Insurance Affordability Fund. States must use allocated funds to (1) issue reinsurance payments to health insurers (i.e., reimbursements to protect insurers against exceedingly high claims) for individual health insurance coverage, or (2) provide other assistance to reduce out-of-pocket costs (e.g., copayments, coinsurance, and deductibles) for qualified health plans offered in the individual market through an exchange.
 
Reinsurance payments using such funds may not be applied to (1) grandfathered health plans in place on March 23, 2010, (2) non-grandfathered transitional plans meeting specified requirements identified by the Centers for Medicare & Medicaid Services (CMS), or (3) student health insurance plans provided by institutions of higher education.
 
The bill appropriates $10 billion per year for the fund, which the CMS must distribute to states in accordance with a specified methodology based on the estimated amount of reinsurance payments for individuals in a state during the given year, subject to specified deductions. Additionally, states must submit applications explaining how they will use such funds. In the event that a state does not submit an application, the bill directs the CMS to allocate the calculated funding amount to reinsurance programs in that state.

action_date: 2020-06-29
text: 

Patient Protection and Affordable Care Enhancement Act

 
 This bill modifies various health insurance programs related to consumer costs for private health insurance plans, Medicaid funding and eligibility, and prescription drug pricing. Specifically, the bill increases the amount and income thresholds for the premium assistance tax credit program and expands access to such tax credit for employees with employer-provided family plans that cost in excess of 9.5% of the employee's household income.
 
 Further, the bill provides additional funding for states to establish health insurance exchanges and establishes the Improve Health Insurance Affordability Fund. States must use allocated funds to (1) issue reinsurance payments to health insurers (i.e., reimbursements to protect insurers against exceedingly high claims) for individual health insurance coverage, or (2) provide other assistance to reduce out-of-pocket costs (e.g., copayments, coinsurance, and deductibles) for qualified health plans offered in the individual market through an exchange.
 
 The bill also nullifies a rule that expands short-term, limited-duration health insurance plans. Such plans may offer coverage for only a limited amount of time and are exempt from certain coverage requirements. The bill also nullifies guidance that alters how states may satisfy the criteria for approval of State Innovation Waivers from certain health insurance coverage requirements.
 
 Additionally, the bill directs the Department of Health and Human Services (HHS) to conduct outreach, education, and reporting activities related to enrollment in plans through health insurance exchanges, particularly in areas with disparities in income or health outcomes. It also establishes and funds grants to states to promote enrollment in health insurance coverage and requires health insurance exchanges to establish network adequacy standards. The bill makes recipients of benefits under the Deferred Action for Childhood Arrivals Program eligible for qualified health plans offered through such exchanges.
 
 With respect to Medicaid, the bill increases to 100% the federal share of the cost for states to meet the minimum Medicaid expansion requirements and to cover newly-eligible individuals; the current federal share of such costs is 90%. It also requires states to provide 12 months of continuous coverage to individuals enrolling in Medicaid or the Children's Health Insurance Program (CHIP) and extends postpartum Medicaid and CHIP coverage to 12 months. The bill further reduces federal matching funds for administrative costs and expands reporting requirements for states that have not met specified Medicaid expansion requirements.
 
 Additionally, the bill 
 
 
extends through FY2024 the minimum payment requirements for primary care services;
 
permanently extends CHIP funding and eligibility, enrollment, and quality assurance provisions;
 
increases the permissible family income threshold for children whom states may make eligible for Medicaid and CHIP;
 
extends Medicaid coverage to residents of the Freely Associated States (i.e., Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau); and
 
increases the federal medical assistance percentage for services provided through Indian Health Care Services.
 
 
 The bill also establishes the Fair Drug Pricing Program that directs HHS to negotiate with manufacturers to set the price for selected drugs and biological products. HHS must select certain drugs and biological products that are among the most costly based on spending under Medicare and enter a voluntary negotiation with manufacturers to establish a maximum price for each drug or product. The negotiation must consider, among other factors, the cost of research and development of the selected drug or biological product, the cost of production, national sales data, and information about alternative products.
 
 The bill establishes an excise tax on manufacturers that do not comply with a negotiated fair price agreement in the amount of specified percentages of the sales of such drug or product. The bill also creates a fund to implement the Fair Drug Pricing Program.


Legislative actions:
action_date: 2020-09-08
text: Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 523.
action_date: 2020-08-13
text: Read the first time. Placed on Senate Legislative Calendar under Read the First Time.
action_date: 2020-06-30
text: Received in the Senate.
action_date: 2020-06-29
text: Motion to reconsider laid on the table Agreed to without objection.
action_date: 2020-06-29
text: On passage Passed by the Yeas and Nays: 234 - 179 (Roll no. 124). (text: CR H2599-2614)
action_date: 2020-06-29
text: Passed/agreed to in House: On passage Passed by the Yeas and Nays: 234 - 179 (Roll no. 124).
action_date: 2020-06-29
text: On motion to recommit with instructions Failed by the Yeas and Nays: 187 - 223 (Roll no. 123).
action_date: 2020-06-29
text: Considered as unfinished business. (consideration: CR H2664-2665)
action_date: 2020-06-29
text: POSTPONED PROCEEDINGS - At the conclusion of debate on the motion to recommit with instructions, the Chair put the question on the motion and by voice vote, announced that the noes had prevailed. Mr. Walden demanded the yeas and nays and the Chair postponed further consideration on the motion to recommit until a time to be announced.
action_date: 2020-06-29
text: The previous question on the motion to recommit with instructions was ordered without objection.
action_date: 2020-06-29
text: Floor summary: DEBATE - The House proceeded with 10 minutes of debate on the Walden motion to recommit with instructions. The instructions contained in the motion seek to require the bill to be reported back to the House with an amendment to prevent the bill from taking effect unless the Secretary of Health and Human Services certifies that no provision of the bill would adversely affect research related to any drug intended to treat or prevent the virus that causes COVID-19.
action_date: 2020-06-29
text: Mr. Walden moved to recommit with instructions to the Committee on Energy and Commerce. (text: CR H2642-2643)
action_date: 2020-06-29
text: The previous question was ordered pursuant to the rule.
action_date: 2020-06-29
text: DEBATE - The House proceeded with three hours of debate on H.R. 1425.
action_date: 2020-06-29
text: Rule provides for consideration of H.R. 1425, H.R. 5332, H.R. 7120, H.R. 7301 and H.J. Res. 90. The resolution provides that the provisions of section 125(c) of the Uruguay Round Agreements Act shall not apply during the remainder of the 116th Congress and the resolution amends H.Res. 967, agreed to on May 15, 2020.
action_date: 2020-06-29
text: Considered under the provisions of rule H. Res. 1017. (consideration: CR H2599-2644)
action_date: 2020-06-24
text: Rules Committee Resolution H. Res. 1017 Reported to House. Rule provides for consideration of H.R. 1425, H.R. 5332, H.R. 7120, H.R. 7301 and H.J. Res. 90. The resolution provides that the provisions of section 125(c) of the Uruguay Round Agreements Act shall not apply during the remainder of the 116th Congress and the resolution amends H.Res. 967, agreed to on May 15, 2020.
action_date: 2020-03-09
text: Placed on the Union Calendar, Calendar No. 334.
action_date: 2020-03-09
text: Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 116-414.
action_date: 2020-03-09
text: Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 116-414.
action_date: 2019-04-04
text: Ordered to be Reported (Amended) by the Yeas and Nays: 30 - 22.
action_date: 2019-04-03
text: Committee Consideration and Mark-up Session Held.
action_date: 2019-03-27
text: Forwarded by Subcommittee to Full Committee (Amended) by the Yeas and Nays: 18 - 13 .
action_date: 2019-03-27
text: Subcommittee Consideration and Mark-up Session Held.
action_date: 2019-03-01
text: Referred to the Subcommittee on Health.
action_date: 2019-02-28
text: Referred to the House Committee on Energy and Commerce.
action_date: 2019-02-28
text: Introduced in House
action_date: 2019-02-28
text: Introduced in House