Modifications to exemption from requirement to maintain health coverage

(a)

Exemption for individuals in areas with fewer than 2 issuers offering plans on an exchange

Section 5000A(e) of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph:

(6)

Individuals in areas with fewer than 2 issuers offering plans on an exchange

(A)

In general

Any applicable individual for any period during a calendar year if there are fewer than 2 health insurance issuers offering qualified health plans on an Exchange for such period in the county in which the applicable individual resides.(B)

Aggregation rules

For purposes of subparagraph (A), all health insurance issuers treated as a single employer under subsection (a) or (b) of section 52, or subsection (m) or (o) of section 414, shall be treated as a single health insurance issuer.

(b)

Effective date

The amendments made by this section shall apply to months beginning after the date of the enactment of this Act.

Health insurance coverage for certain congressional staff and members of the executive branch

Section 1312(d)(3)(D) of the Patient Protection and Affordable Care Act (42 U.S.C. 18032(d)(3)(D)) is amended—(1)by striking the subparagraph heading and inserting the following:

(D)

Members of Congress, congressional staff, and political appointees in the exchange

;

(2)in clause (i), in the matter preceding subclause (I)—(A)by striking and congressional staff with and inserting , congressional staff, the President, the Vice President, and political appointees with; and(B)by striking or congressional staff shall and inserting , congressional staff, the President, the Vice President, or a political appointee shall;(3)in clause (ii)—(A)in subclause (II), by inserting after Congress, the following: of a committee of Congress, or of a leadership office of Congress,; and(B)by adding at the end the following:

(III)

Political appointee

The term political appointee means any individual who—(aa)is employed in a position described under sections 5312 through 5316 of title 5, United States Code (relating to the Executive Schedule);(bb)is a limited term appointee, limited emergency appointee, or noncareer appointee in the Senior Executive Service, as defined under paragraphs (5), (6), and (7), respectively, of section 3132(a) of title 5, United States Code; or(cc)is employed in a position in the executive branch of the Government of a confidential or policy-determining character under schedule C of subpart C of part 213 of title 5 of the Code of Federal Regulations.

; and

(4)by adding at the end the following:

(iii)

Government contribution

No Government contribution under section 8906 of title 5, United States Code, shall be provided on behalf of an individual who is a Member of Congress, a congressional staff member, the President, the Vice President, or a political appointee for coverage under this paragraph.(iv)

Limitation on amount of tax credit or cost sharing

An individual enrolling in health insurance coverage pursuant to this paragraph shall not be eligible to receive a tax credit under section 36B of the Internal Revenue Code of 1986 or reduced cost sharing under section 1402 of this Act in an amount that exceeds the total amount for which a similarly situated individual (who is not so enrolled) would be entitled to receive under such sections.(v)

Limitation on discretion for designation of staff

Notwithstanding any other provision of law, a Member of Congress shall not have discretion in determinations with respect to which employees employed by the office of such Member are eligible to enroll for coverage through an Exchange.(vi)

Clarification

The terms small employer (as defined under section 1304(b)(2)) and qualified employers (as defined under subsection (f)) do not include the Congress, with respect to enrollments in an Exchange and a SHOP Exchange.