[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2712 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 2712

    To streamline the employer reporting process and strengthen the 
eligibility verification process for the health care premium tax credit 
           and cost-sharing subsidy, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 10, 2015

Mrs. Black (for herself and Mr. Thompson of California) introduced the 
following bill; which was referred to the Committee on Ways and Means, 
 and in addition to the Committee on Energy and Commerce, 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 streamline the employer reporting process and strengthen the 
eligibility verification process for the health care premium tax credit 
           and cost-sharing subsidy, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Commonsense 
Reporting and Verification Act of 2015''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Prospective reporting system.
Sec. 4. Protection of dependent privacy.
Sec. 5. Electronic statements.
Sec. 6. GAO studies.
Sec. 7. Eligibility verification process for ACA subsidies.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The Department of the Treasury and the Internal Revenue 
        Service should work together with other relevant departments 
        and agencies to identify and implement methods to minimize 
        compliance burdens on businesses, insurance carriers, and 
        individuals under provisions of the Patient Protection and 
        Affordable Care Act.
            (2) Such collaboration should strike an appropriate balance 
        between sufficient reporting to enforce the law and protecting 
        the privacy of individuals.

SEC. 3. PROSPECTIVE REPORTING SYSTEM.

    (a) In General.--Not later than 180 days after the enactment of 
this Act, the Secretary of the Treasury, in consultation with the 
Secretary of Health and Human Services, the Secretary of Labor, and the 
Administrator of the Small Business Administration, shall implement a 
voluntary prospective reporting system meeting the requirements of 
subsection (b). Such system shall be established not later than 
September 2, 2016, and shall be available for use by employers with 
respect to plan years beginning after December 31, 2015.
    (b) Requirements.--The system created under subsection (a) shall be 
maintained by the Secretary of the Treasury and shall include--
            (1) a process whereby employers may voluntarily report--
                    (A) the name and employer identification number of 
                the employer;
                    (B) a certification of--
                            (i) whether coverage meeting the definition 
                        of minimum essential coverage in section 
                        5000A(f) of the Internal Revenue Code of 1986 
                        is offered to the full-time employees;
                            (ii) whether such coverage is offered to 
                        dependents of such employees;
                            (iii) whether such coverage is offered to 
                        spouses of such employees;
                            (iv) whether such coverage is offered to 
                        part-time employees;
                            (v) whether such coverage meets the minimum 
                        value requirement of section 36B(c)(2)(C)(ii) 
                        of such Code; and
                            (vi) whether such coverage satisfies the 
                        requirements to qualify for one of the 
                        affordability safe harbors promulgated by the 
                        Secretary of the Treasury for purposes of 
                        section 4980H of such Code;
                    (C) the months during the prospective reporting 
                period that such coverage is available to full time 
                employees of the employer; and
                    (D) whether any waiting periods apply with respect 
                to such coverage;
        to be reported not later than 60 days before the start of the 
        open enrollment period under section 1311(c)(6)(B) of the 
        Patient Protection and Affordable Care Act with respect to each 
        such calendar year;
            (2) a process to ensure that Exchanges, the Federal 
        Marketplace Data Services Hub, and the Internal Revenue Service 
        can securely and confidentially access the information 
        described in paragraph (1) as necessary to carry out their 
        respective missions, and to provide to the Secretary of Health 
        and Human Services additional information relating to 
        eligibility determinations for advance payment of the premium 
        tax credits under section 36B of such Code and the cost-sharing 
        subsidies under section 1402 of the Patient Protection and 
        Affordable Care Act (Public Law 111-148);
            (3) a process to allow the appropriate agency described in 
        subsection (a) to follow up with employers in order to obtain 
        additional necessary information relating to an employee's 
        eligibility for such advance payment or such cost-sharing 
        subsidies, and to allow an employee to receive notification of 
        any problem in verifying such eligibility; and
            (4) a process to allow employers using the system to 
        provide timely updates to the Federal Marketplace Data Services 
        Hub regarding any cancellation of coverage or significant 
        change in availability of coverage for participating employees.
    (c) Exemption From Reporting Requirement Under Internal Revenue 
Code of 1986.--If, through the system created under subsection (a), an 
employer provides prospective reporting for a calendar year in which a 
plan year ends that meets the requirements of subsection (b)(1)--
            (1) such employer shall be treated as satisfying the return 
        requirements of subsections (a) and (b) of section 6056 of the 
        Internal Revenue Code of 1986 for the calendar year in which 
        such plan year ends; and
            (2) such employer shall be treated as satisfying the 
        requirements of section 6056(c) of such Code for the calendar 
        year in which such plan year ends if the employer furnishes the 
        statement described in such section to the Internal Revenue 
        Service and to those employees of the employer for whom the 
        employer has received a notice under section 1411(e)(4)(B)(iii) 
        of the Patient Protection and Affordable Care Act (42 U.S.C. 
        18081) from the Exchange (established under section 1311 or 
        1321 of the Patient Protection and Affordable Care Act (42 
        U.S.C. 18031, 18041)) that the employee, or the spouse or 
        dependent of the employee, has enrolled in a qualified health 
        plan (as defined in section 1301 of such Act (42 U.S.C. 18021)) 
        through the Exchange or been deemed eligible for an advance 
        payment of premium tax credits under section 36B of such Code 
        or cost-sharing subsidies under section 1402 of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18071).
    (d) Third-Party Filing.--Employers may use third parties to 
complete the filing described in subsection (b)(1). Use of such a third 
party to complete the filing does not affect an employer's liability 
under sections 6055 or 6056 of the Internal Revenue Code of 1986.
    (e) Employer Notification of Employee Enrollments.--Each Exchange 
established under title I of the Patient Protection and Affordable Care 
Act shall provide notice to each employer at the time an employee (or 
dependent of an employee) is enrolled under a qualified health plan 
through the Exchange.

SEC. 4. PROTECTION OF DEPENDENT PRIVACY.

    (a) In General.--Section 6055(b) of the Internal Revenue Code of 
1986 is amended by adding at the end the following new paragraph:
            ``(3) TINs not collected or maintained.--For purposes of 
        subparagraph (B)(i), in the case of an individual other than 
        the primary insured, if, before January 1, 2014, the health 
        insurance issuer or the employer did not collect or maintain 
        information on the TINs of such individuals (other than for 
        purposes of this section), the individual's name and date of 
        birth may be substituted for the name and TIN.''.
    (b) Effective Date.--The amendment made by this section shall apply 
to returns the due date for which is after the date that is 60 days 
after the date of the enactment of this Act.

SEC. 5. ELECTRONIC STATEMENTS.

    (a) In General.--Section 6056(c) of the Internal Revenue Code of 
1986 is amended by adding at the end the following new paragraph:
            ``(3) Electronic delivery.--An individual shall be deemed 
        to have consented to receive the statement under this section 
        in electronic form if such individual has consented at any 
        prior time, to the person who is the employer of the individual 
        during the calendar year or the preceding plan year to which 
        the statement relates, to receive such statement in electronic 
        form. The preceding sentence shall not apply if the individual 
        refuses consent in writing with respect to the statement under 
        this section.''.
    (b) Statements Relating to Health Insurance Coverage.--Section 
6055(c) of such Code, as amended by this Act, is amended by adding at 
the end the following new paragraph:
            ``(4) Electronic delivery.--An individual shall be deemed 
        to have consented to receive the statement under this 
        subsection in electronic form if such individual has consented 
        at any prior time to receive in electronic form any private 
        health information (such as electronic health records) 
        furnished to such individual by the person required to make 
        such statement, unless the individual refuses such consent in 
        writing.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to statements the due date for which is after December 31, 2015.

SEC. 6. GAO STUDIES.

    (a) Study of First Years of Employer Reporting.--
            (1) In general.--The Comptroller General of the United 
        States shall conduct a study that evaluates, with respect to 
        the period beginning on January 1, 2014, and ending on December 
        31, 2016--
                    (A) the notification of employers by Exchanges 
                established under title I of the Patient Protection and 
                Affordable Care Act (Public Law 111-148) that a full-
                time employee of the employer has been determined 
                eligible for advance payment of premium tax credits 
                under section 36B of the Internal Revenue Code of 1986 
                or cost-sharing subsidies under section 1402 of such 
                Act (42 U.S.C. 18071), including information 
                regarding--
                            (i) the data elements included in the 
                        employer notification;
                            (ii) the process by which the notification 
                        forms were developed and sent to employers, 
                        including whether the process provided for a 
                        formal notice and comment period;
                            (iii) whether employers report that such 
                        notifications provided sufficient and relevant 
                        information for them to make appropriate 
                        decisions about whether to utilize the appeals 
                        process;
                            (iv) the total number of notifications sent 
                        to employers and the timeline of when such 
                        notifications were sent;
                            (v) differences in the notification process 
                        between the marketplace facilitated by the 
                        Federal Government and the State-Based 
                        Marketplaces; and
                            (vi) challenges that have arisen in the 
                        notification process, and recommendations to 
                        address these challenges; and
                    (B) the extent to which the Secretary of Health and 
                Human Services has established a separate appeals 
                process for employers who received such a notification 
                to challenge the eligibility determination, as required 
                by section 1411(f)(2) of the Patient Protection and 
                Affordable Care Act (42 U.S..C. 18081(f)(2)).
            (2) Report.--Not later than 1 year after the date of the 
        enactment of this Act, the Comptroller General shall submit to 
        the Committees on Finance and Health, Education, Labor, and 
        Pensions of the Senate and the Committees on Ways and Means, 
        Energy and Commerce, and Education and the Workforce of the 
        House of Representatives a report on the results of the study 
        conducted under paragraph (1).
    (b) Study of Prospective Reporting System.--
            (1) In general.--The Comptroller General of the United 
        States shall conduct a study that evaluates, with respect to 
        the period beginning on January 1, 2017, and ending on December 
        31, 2017, the functionality of the prospective reporting system 
        established under section 3, including the accuracy of 
        information collected, the number of employers electing to 
        report under such system, and any challenges that have arisen 
        in implementing such system.
            (2) Report.--Not later than July 1, 2018, the Comptroller 
        General shall submit to the Committees on Finance and Health, 
        Education, Labor, and Pensions of the Senate and the Committees 
        on Ways and Means, Energy and Commerce, and Education and the 
        Workforce of the House of Representatives a report on the 
        results of the study conducted under paragraph (1).

SEC. 7. ELIGIBILITY VERIFICATION PROCESS FOR ACA SUBSIDIES.

    (a) In General.--Except as specified in subsection (b), a 
marketplace (as defined in subsection (d)) may automatically reenroll 
an individual into a qualified health plan (as defined for purposes of 
title I of the Patient Protection and Affordable Care Act) so long as 
the marketplace--
            (1) redetermines on an annual basis the eligibility of the 
        individual for any advanced premium tax credit or a cost-
        sharing reduction pursuant to section 1412 of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18082); and
            (2) takes into account, in making such redeterminations, 
        annual changes in premiums and in the Federal poverty level as 
        well as the most recent income data available with respect to 
        the individual involved.
    (b) Reenrollment Limitations.--If a marketplace does not follow the 
processes specified under the section with respect to an individual, 
then the marketplace may not automatically reenroll the individual into 
a qualified health plan with an advanced premium tax credit or a cost-
sharing reduction until the individual provides current income 
information to the marketplace so that eligibility for a credit or 
reduction can be redetermined.
    (c) Comprehensive Guidance Based on Current Guidance.--The 
provisions of this section are intended to generally reflect and be 
consistent with the guidance on annual eligibility redeterminations and 
reenrollments for marketplace coverage issued by the Centers for 
Medicare and Medicaid Services on April 22, 2015. In carrying out this 
section, the Secretary shall apply rules (whether through guidance or 
otherwise) regarding the annual eligibility redeterminations and 
reenrollments for coverage and for tax credits and cost-sharing 
reduction for individuals through a marketplace that are consistent 
with this section and are at least as comprehensive as the guidance 
(issued on April 22, 2015) applied for coverage for 2016. Such guidance 
shall include provisions that ensure that--
            (1) enrollees eligible to be automatically reenrolled in a 
        qualified health plan and to continue provision of such a tax 
        credit or cost-sharing reduction shall maintain on file with 
        the marketplace (or otherwise provide to the marketplace) an 
        authorization for disclosure of information verifying 
        eligibility for such a credit or cost-sharing reduction;
            (2) the marketplace annually requests updated income 
        information to verify such eligibility; and
            (3) enrollees are provided timely and appropriate notices 
        of the rules regarding annual redeterminations and 
        reenrollments.
    (d) Marketplace Defined.--In this section, the term ``marketplace'' 
means State Based Exchanges and the Federally Facilitated Exchange 
established under sections 1311 and 1321 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18031, 18041), respectively.
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