[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1385 Reported in House (RH)]

<DOC>





                                                  Union Calendar No. 27
116th CONGRESS
  1st Session
                                H. R. 1385

                          [Report No. 116-49]

To amend the Patient Protection and Affordable Care Act to preserve the 
 option of States to implement health care marketplaces, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 27, 2019

  Mr. Kim (for himself and Mr. Fitzpatrick) introduced the following 
    bill; which was referred to the Committee on Energy and Commerce

                              May 3, 2019

  Additional sponsors: Ms. Schakowsky, Mrs. Watson Coleman, Ms. Blunt 
 Rochester, Mr. Pallone, Mr. Rush, Mrs. Dingell, Mr. Ruiz, Ms. Eshoo, 
  Mr. Kennedy, Ms. Matsui, Mr. Van Drew, Ms. Clarke of New York, Ms. 
      Houlahan, Ms. Scanlon, Ms. McCollum, and Ms. Mucarsel-Powell

                              May 3, 2019

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
    [For text of introduced bill, see copy of bill as introduced on 
                           February 27, 2019]


_______________________________________________________________________

                                 A BILL


 
To amend the Patient Protection and Affordable Care Act to preserve the 
 option of States to implement health care marketplaces, 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.

    This Act may be cited as the ``State Allowance for a Variety of 
Exchanges Act'' or the ``SAVE Act''.

SEC. 2. PRESERVING STATE OPTION TO IMPLEMENT HEALTH CARE MARKETPLACES.

    (a) In General.--Section 1311 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18031) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (4)(B), by striking ``under this 
                subsection'' and inserting ``under this paragraph or 
                paragraph (1)''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(6) Additional planning and establishment grants.--
                    ``(A) In general.--There shall be appropriated to 
                the Secretary, out of any moneys in the Treasury not 
                otherwise appropriated, $200,000,000 to award grants to 
                eligible States for the uses described in paragraph 
                (3).
                    ``(B) Duration and renewability.--A grant awarded 
                under subparagraph (A) shall be for a period of two 
                years and may not be renewed.
                    ``(C) Limitation.--A grant may not be awarded under 
                subparagraph (A) after December 31, 2022.
                    ``(D) Eligible state defined.--For purposes of this 
                paragraph, the term `eligible State' means a State 
                that, as of the date of the enactment of this 
                paragraph, is not operating an Exchange (other than an 
                Exchange described in section 155.200(f) of title 45, 
                Code of Federal Regulations).''; and
            (2) in subsection (d)(5)(A)--
                    (A) by striking ``operations.--In establishing an 
                Exchange under this section'' and inserting 
                ``operations.--
                            ``(i) In general.--In establishing an 
                        Exchange under this section (other than in 
                        establishing an Exchange pursuant to a grant 
                        awarded under subsection (a)(6))''; and
                    (B) by adding at the end the following:
                            ``(ii) Additional planning and 
                        establishment grants.--In establishing an 
                        Exchange pursuant to a grant awarded under 
                        subsection (a)(6), the State shall ensure that 
                        such Exchange is self-sustaining beginning on 
                        January 1, 2024, including allowing the 
                        Exchange to charge assessments or user fees to 
                        participating health insurance issuers, or to 
                        otherwise generate funding, to support its 
                        operations.''.
    (b) Clarification Regarding Failure To Establish Exchange or 
Implement Requirements.--Section 1321(c) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18041(c)) is amended--
            (1) in paragraph (1), by striking ``If'' and inserting 
        ``Subject to paragraph (3), if''; and
            (2) by adding at the end the following new paragraph:
            ``(3) Clarification.--This subsection shall not apply in 
        the case of a State that elects to apply the requirements 
        described in subsection (a) and satisfies the requirement 
        described in subsection (b) on or after January 1, 2014.''.
                                                  Union Calendar No. 27

116th CONGRESS

  1st Session

                               H. R. 1385

                          [Report No. 116-49]

_______________________________________________________________________

                                 A BILL

To amend the Patient Protection and Affordable Care Act to preserve the 
 option of States to implement health care marketplaces, and for other 
                               purposes.

_______________________________________________________________________

                              May 3, 2019

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed