[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1886 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                S. 1886

 To ensure that individuals who attempted to, or who are enrolled in, 
 qualified health plans offered through an Exchange have continuity of 
  coverage and to require Exchanges to make coverage under qualified 
              health plans retroactive to January 1, 2014.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           December 20, 2013

  Mr. Merkley (for himself, Mrs. Shaheen, Mr. Udall of Colorado, Mr. 
 King, Ms. Heitkamp, and Ms. Landrieu) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To ensure that individuals who attempted to, or who are enrolled in, 
 qualified health plans offered through an Exchange have continuity of 
  coverage and to require Exchanges to make coverage under qualified 
              health plans retroactive to January 1, 2014.

    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 ``Coverage Protection Act''.

SEC. 2. AUTHORITY TO PROVIDE TIMELY COVERAGE FOR INDIVIDUALS WHO WERE 
              UNABLE TO ENROLL IN A QUALIFIED HEALTH PLAN.

    (a) In General.--In the case of an individual who enrolls in a 
qualified health plan offered through an Exchange established under 
title I of the Patient Protection and Affordable Care Act (Public Law 
111-148) before February 1, 2014, the Secretary of Health and Human 
Services shall require that the issuer of the plan treat such 
individual as enrolled in such plan as of December 23, 2013, if the 
following conditions are met:
            (1) Attempted timely enrollment.--The individual submits, 
        not later than January 31, 2014, an attestation (in such form 
        and manner as the Secretary may require) that the individual--
                    (A) made reasonable, good-faith attempts, but was 
                unable, to successfully enroll in such a plan through 
                an Exchange before December 23, 2013; or
                    (B) was initially determined through healthcare.gov 
                to be eligible to enroll in a Medicaid plan under title 
                XIX of the Social Security Act but is not eligible to 
                so enroll in such a Medicaid plan and, because of such 
                incorrect eligibility determination, was subsequently 
                unable to enroll in a qualified health plan before 
                December 23, 2013.
            (2) Payment of premiums.--The individual pays to the health 
        insurance issuer issuing the qualified health plan in which 
        such individual is enrolled (either directly or through the 
        Exchange) any applicable premiums owed by such individual for 
        enrollment in the plan taking into account the amount of any 
        premium assistance made available under section 36B of the 
        Internal Revenue Code of 1986.
    (b) Application for Purposes of Premium Assistance, Reduced Cost-
Sharing, and Individual Responsibility.--Coverage provided under a 
qualified health plan for January and February of 2014 under subsection 
(a) shall be counted as coverage under such a plan by or through an 
Exchange for such months for all purposes, including the following:
            (1) Premium assistance.--Section 36B of the Internal 
        Revenue Code of 1986.
            (2) Cost-sharing reductions.--Section 1402 of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18071).
            (3) Individual responsibility requirement.--Section 5000A 
        of the Internal Revenue Code of 1986.

SEC. 3. RETROACTIVE COVERAGE AND PREMIUM ASSISTANCE.

    Section 1311(c) of the Patient Protection and Affordable Care Act 
(42 U.S.C. 18031(c)) is amended by adding at the end the following:
            ``(7) State option to make initial coverage retroactive.--
                    ``(A) In general.--Notwithstanding any other 
                provision of law, the Secretary shall permit a State, 
                at the option of the State, to make coverage under a 
                qualified health plan retroactive to January 1, 2014, 
                with respect to an individual who enrolls in such plan 
                through the State Exchange (or the Federal Exchange in 
                the case of a State that has not established a State 
                Exchange) during the period established by the State 
                under subparagraph (B). Any health care items or 
                services provided to such enrollee in January of 2014 
                shall be covered retroactively under the plan as if the 
                enrollee had been enrolled on January 1 of such year.
                    ``(B) Period.--The period established under this 
                subparagraph shall be the period beginning on December 
                23, 2013, and ending on a date determined by the State, 
                but in no event later than January 31, 2014, except 
                that a State that has an enrollment deadline that is 
                prior to December 23, 2013, may modify the period under 
                this subparagraph to encompass such deadline.
                    ``(C) Tax credits and cost sharing assistance.--If 
                an individual is determined to be eligible for a tax 
                credit under section 36B of the Internal Revenue Code 
                of 1986 or cost-sharing assistance under section 1402, 
                but such determination has not been verified by the 
                date on which the individual enrolls in the qualified 
                health plan involved, the credit and assistance shall 
                be applied on a retroactive basis to January 1, 2014, 
                and the initial premium payment amount shall be offset 
                to include such credit and assistance amounts for such 
                month.''.

SEC. 4. TRANSITIONAL USE OF RECEIPT OF INSURANCE PAYMENT AS ALTERNATIVE 
              TO HEALTH INSURANCE CARD FOR EXCHANGE PLANS.

    (a) In General.--The Secretary of Health and Human Services shall 
require a health insurance issuer that offers a qualified health plan 
through an Exchange under title I of the Patient Protection and 
Affordable Care Act (Public Law 111-148)--
            (1) to allow in-network providers in such plan to treat, 
        for purposes of coverage under the plan, a receipt of payment 
        of premiums by an individual enrolled under the plan for 
        January or February 2014 who has not received a health 
        insurance card from the issuer in the same manner as if such 
        receipt were such a health insurance card issued to such 
        individual by the issuer for services furnished during such 
        month; and
            (2) to notify such in-network providers of the policy under 
        paragraph (1).
    (b) Rule of Construction.--Nothing in this section shall be 
construed as precluding a health care provider from directly seeking to 
verify the status of the enrollment of an individual in a qualified 
health plan offered through an Exchange by contacting the Exchange or 
the issuer of such plan.
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