[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 42 Introduced in Senate (IS)]

114th CONGRESS
  1st Session
                                 S. 42

   To require the Secretary of Health and Human Services to address 
certain inconsistencies between the self-attested information provided 
by an applicant in enrolling in a health plan on an Exchange and being 
determined eligible for premium tax credits and cost-sharing reductions 
    or in being determined to be eligible for enrollment in a State 
 Medicaid plan or a State child health plan under the State Children's 
Health Insurance Program and the data received through the Federal Data 
                Services Hub or from other data sources.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 7, 2015

  Mr. Vitter introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
   To require the Secretary of Health and Human Services to address 
certain inconsistencies between the self-attested information provided 
by an applicant in enrolling in a health plan on an Exchange and being 
determined eligible for premium tax credits and cost-sharing reductions 
    or in being determined to be eligible for enrollment in a State 
 Medicaid plan or a State child health plan under the State Children's 
Health Insurance Program and the data received through the Federal Data 
                Services Hub or from other data sources.

    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 ``Stopping Illegal Obamacare Subsidies 
Act''.

SEC. 2. LIMITATION ON AUTO-ENROLLMENT.

    Notwithstanding any other provision of law, American Health Benefit 
Exchanges shall not provide for automatic enrollment in health plans 
under such exchanges until the Inspector General of the Department of 
Health and Human Services verifies that each State Exchange established 
under section 1311 of the Patient Protection and Affordable Care Act 
(42 U.S.C. 13031) and the Federal Exchange established under section 
1321 of such Act (42 U.S.C. 18041) has resolved the inconsistencies (as 
defined in section 3(a)) outlined in the June 2014 report of such 
Inspector General.

SEC. 3. PROCESS FOR APPLICATIONS WITH INCONSISTENCIES.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall make public 
the steps that the Centers for Medicare & Medicaid Services and the 
Federal Exchange will take to clear any inconsistencies that arose on 
or before the date of enactment of this Act and to ensure that the 
systems used by the Centers for Medicare & Medicaid Services to 
determine or assess eligibility for premium tax credits, cost-sharing 
reductions, Medicaid, and the State Children's Health Insurance Program 
(CHIP) can resolve such inconsistencies not later than 30 days after 
the date of enactment of this Act.
    (b) Methods To Monitor Progress.--Not later than 30 days after the 
date of enactment of this Act, the Secretary shall make public the 
methods that the Centers for Medicare & Medicaid Services use to 
monitor, track, and measure the progress of the Federal Exchange and 
State Exchanges in resolving inconsistencies.
    (c) Suspension of Financial Assistance Programs.--Premium 
assistance tax credits under section 36B of the Internal Revenue Code 
of 1986 and the reduced cost-sharing program under section 1402 of the 
Patient Protection and Affordable Care Act (42 U.S.C. 18071) shall not 
be available for plan year 2015. Such premium tax credit and cost-
sharing programs shall resume only after--
            (1) the Commissioner of the Social Security Administration 
        affirmatively declares that all inconsistencies related to 
        invalid social security numbers have been resolved; and
            (2) the Inspector General of the Department of Health and 
        Human Services determines that all inconsistencies, as defined 
        in section 4(1), have been resolved.
    (d) Requests for Additional Information.--
            (1) In general.--If applicant information provided by an 
        individual seeking to enroll in a qualified health plan on a 
        State or Federal Exchange contains inconsistencies, the 
        Secretary shall request additional information from the 
        individual, and the individual shall have 90 days to provide 
        such information.
            (2) Restrictions during inconsistency period.--During the 
        inconsistency period, an individual may be enrolled in 
        qualified health plan, but may not participate in the premium 
        assistance credit program under section 36B of the Internal 
        Revenue Code of 1986 or the reduced cost-sharing program under 
        section 1402 of the Patient Protection and Affordable Care Act 
        (42 U.S.C. 18071). An individual who cooperates with a request 
        for additional information and whom the Secretary later 
        determines to be eligible for such programs, shall 
        retroactively receive the benefits of such programs that such 
        individual was eligible to receive for the inconsistency 
        period.
            (3) Failure to submit additional information.--If the 
        applicant does not submit additional information requested 
        under subparagraph (A)--
                    (A)(i) the applicant shall be withdrawn from the 
                premium assistance credit program under section 36B of 
                the Internal Revenue Code of 1986 and the reduced cost-
                sharing program under section 1402 of the Patient 
                Protection and Affordable Care Act (42 U.S.C. 18071), 
                as applicable, at the end of the inconsistency period; 
                and
                    (ii) the Secretary shall send notification of such 
                disenrollment to the applicable health insurance 
                issuer; and
                    (B) the applicant shall re-enroll in a qualified 
                health plan with appropriate and accurate information 
                during the next open enrollment period.

SEC. 4. DEFINITIONS.

    In this Act--
            (1) the term ``inconsistencies'' means differences between 
        the self-attested information provided by an applicant in 
        enrolling in a health plan on an Exchange and being determined 
        eligible for premium tax credits and cost-sharing reductions or 
        in being determined to be eligible for enrollment in a State 
        Medicaid plan or a State child health plan under the State 
        Children's Health Insurance Program (CHIP) and the data 
        received through the Federal Data Services Hub or from other 
        data sources, including differences with respect to--
                    (A) citizenship;
                    (B) income;
                    (C) coverage under an eligible employer-sponsored 
                plan;
                    (D) incarceration status; or
                    (E) any other issue that would impact individual's 
                eligibility for financial assistance programs under the 
                Patient Protection and Affordable Care Act (including 
                the amendments made by such Act); and
            (2) the term ``inconsistency period'' means the 90-day 
        period beginning on the date the notice of an inconsistency is 
        sent to the applicant.
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