I 114th CONGRESS 1st Session H. R. 3659 IN THE HOUSE OF REPRESENTATIVES September 30, 2015 Mr. Gutiérrez (for himself and Ms. Judy Chu of California ) 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 Patient Protection and Affordable Care Act to remove citizenship and immigration barriers to access the Exchanges under such Act.

1. Short title This Act may be cited as the Exchange Inclusion for a Healthy America Act of 2015 . 2. Removing citizenship and immigration barriers to access to affordable health care under the ACA (a) In general (1) Premium tax credits Section 36B of the Internal Revenue Code of 1986 is amended— (A) in subsection (c)(1)(B)— (i) by amending the subparagraph heading to read as follows: Special rule for certain individuals ineligible for medicaid due to status ; and (ii) in clause (ii), by striking lawfully present in the United States, but and inserting who ; and (B) by striking subsection (e). (2) Cost-sharing reductions Section 1402 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18071 ) is amended by striking subsection (e). (3) Preexisting condition insurance plan Section 1101(d) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18001(d) ) is amended by striking paragraph (1) and redesignating paragraphs (2) and (3) as paragraphs (1) and (2), respectively. (4) Basic health program eligibility Section 1331(e)(1)(B) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18051(e)(1)(B) ) is amended by striking lawfully present in the United States, . (5) Restrictions on federal payments Section 1412 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18082 ) is amended by striking subsection (d). (6) Requirement to maintain minimum essential coverage Subsection (d) of section 5000A of the Internal Revenue Code of 1986 is amended by striking paragraph (3) and by redesignating paragraph (4) as paragraph (3). (b) Conforming amendments (1) Establishment of program Section 1411(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18081(a) ) is amended by striking paragraph (1) and redesignating paragraphs (2), (3), and (4) as paragraphs (1), (2), and (3), respectively. (2) Qualified individuals Section 1312(f) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18032(f) ) is amended— (A) in the subsection heading, by striking the semicolon and all that follows through residents ; and (B) by striking paragraph (3). (c) Rule of construction Nothing in this Act shall be construed as affecting the application of paragraph (a)(3) of section 155.305 of title 45, Code of Federal Regulations (relating to residency requirements for eligibility for enrollment in the Exchanges), or of paragraph (f)(4) of such section (relating to tax filing requirements for advance payments of the premium tax credit) or any successor to either such paragraph. (d) Effective date The amendments made by this section shall apply to years, plan years, and taxable years, as applicable, beginning after December 31, 2015. 3. Treatment of individuals granted deferred action (a) In general For purposes of eligibility under any of the provisions referred to in subsection (c), notwithstanding paragraph (8) of section 152.2 of title 45, Code of Federal Regulations, individuals described in subsection (b) shall be considered lawfully present in the United States. (b) Individuals described For purposes of subsection (a), the individuals described in this subsection are the following: (1) An individual with deferred action under the Department of Homeland Security’s deferred action for childhood arrivals process, as described in the Secretary of Homeland Security’s June 15, 2012, memorandum. (2) An individual with deferred action under the Department of Homeland Security’s deferred action process for expanded deferred action for childhood arrivals and parents of United States citizens and lawful permanent residents, as described in the Secretary of Homeland Security’s November 20, 2014, memorandum. (c) Provisions described For purposes of subsection (a), the provisions described in this subsection are the following: (1) Exchange eligibility Section 1311 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031 ). (2) Reduced cost-sharing eligibility Section 1402 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18071 ). (3) Premium subsidy eligibility Section 36B of the Internal Revenue Code of 1986.