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<dc:title>117 S1623 IS: State Allowance for a Variety of Exchanges Act of 2021</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2021-05-13</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>117th CONGRESS</congress><session>1st Session</session><legis-num>S. 1623</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20210513">May 13, 2021</action-date><action-desc><sponsor name-id="S306">Mr. Menendez</sponsor> (for himself, <cosponsor name-id="S370">Mr. Booker</cosponsor>, and <cosponsor name-id="S309">Mr. Casey</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To amend title I of the Patient Protection and Affordable Care Act to provide for additional grants for States to conduct activities related to establishing American Health Benefit Exchanges.</official-title></form><legis-body style="OLC" display-enacting-clause="yes-display-enacting-clause" id="H7F170D2566AA4D40BD67833942614D6F"><section section-type="section-one" id="H2CA6A2460D55435CA6D214AB35866703"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>State Allowance for a Variety of Exchanges Act of 2021</short-title></quote> or the <quote><short-title>SAVE Act of 2021</short-title></quote>.</text></section><section id="H9E0EF042295A459783007D98E3EB50B8"><enum>2.</enum><header>Preserving State option to implement health care Marketplaces</header><subsection id="H8AB88F124BE84AA6AD5FFA0318E41990"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1311 of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/18031">42 U.S.C. 18031</external-xref>) is amended—</text><paragraph id="HB3519FA04DC341E1A66E570D9AA6AA56"><enum>(1)</enum><text>in subsection (a)—</text><subparagraph id="H0C9365F18CD14EFC9FF97DDAA64AF870"><enum>(A)</enum><text>in paragraph (4)(B), by striking <quote>under this subsection</quote> and inserting <quote>under this paragraph or paragraph (1)</quote>; and</text></subparagraph><subparagraph id="H174C15A4B6B04E9D8CB26E41838F4DEE"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H9998FFE2451241B49911163D66CEFEEA"><paragraph id="HD0FFD40AFA4F48B4B94362682ECCD54D"><enum>(6)</enum><header>Additional planning and establishment grants</header><subparagraph id="HD7BF501AFD15463D9F5ADA16147AE538"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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).</text></subparagraph><subparagraph id="H11C5B674813C49698473D55027252D45"><enum>(B)</enum><header>Duration and renewability</header><text>A grant awarded under subparagraph (A) shall be for a period of 2 years and may not be renewed.</text></subparagraph><subparagraph id="H124681636F774157A68D41E63D7F98F1"><enum>(C)</enum><header>Limitation</header><text display-inline="yes-display-inline">A grant may not be awarded under subparagraph (A) after December 31, 2024.</text></subparagraph><subparagraph commented="no" id="H71E978D33AC54007A21AA4C5EFAC4C1C"><enum>(D)</enum><header>Eligible State defined</header><text display-inline="yes-display-inline">For purposes of this paragraph, the term <term>eligible State</term> means a State that, as of January 1, 2019, was not operating an Exchange (other than an Exchange described in section 155.200(f) of title 45, Code of Federal Regulations, as in effect on such date).</text></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph><paragraph id="H1DD2C4713C0041D182A091E2B94E4809"><enum>(2)</enum><text>in subsection (d)(5)(A)—</text><subparagraph id="H70B32557B90A4C3DB255BF8D1B72A16A"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote><header-in-text level="subparagraph" style="OLC">operations.—</header-in-text>In establishing an Exchange under this section</quote> and inserting</text><quoted-block style="OLC" display-inline="yes-display-inline" id="HA6C955B9151C438783BBB34280CC51A8"><text><header-in-text level="subparagraph" style="OLC">operations.—</header-in-text></text><clause id="H206ADE6DE9FF4F438075E7B6E0544F4E"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">In establishing an Exchange under this section (other than in establishing an Exchange with respect to which a grant is awarded under subsection (a)(6))</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph><subparagraph id="H2B60E3AD6B0B4DFE9626B800160E5B3A"><enum>(B)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H5118140C738F44C889DC1849AC8799D4"><clause id="HF0834D7B457440488EDBED7873DB9DD3"><enum>(ii)</enum><header>Additional planning and establishment grants</header><text display-inline="yes-display-inline">In establishing an Exchange with respect to which a grant is awarded under subsection (a)(6), the State shall ensure that such Exchange is self-sustaining beginning on January 1, 2026, including allowing the Exchange to charge assessments or user fees to participating health insurance issuers, or to otherwise generate funding, to support its operations.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection><subsection commented="no" id="HD2A644B5B46D4BE9866C5CA8BD33CABB"><enum>(b)</enum><header>Clarification regarding failure To establish Exchange or implement requirements</header><text display-inline="yes-display-inline">Section 1321(c) of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/18041">42 U.S.C. 18041(c)</external-xref>) is amended—</text><paragraph commented="no" id="H0B7153C5BFC44D8BBA6270620512F8E3"><enum>(1)</enum><text>in paragraph (1), by striking <quote>If</quote> and inserting <quote>Subject to paragraph (3), if</quote>; and</text></paragraph><paragraph commented="no" id="H928C5D03FACB4D8B8A8615881BF08CBE"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="H18D512B9A8784EC7879DB5F57CC05767"><paragraph commented="no" id="H627FEC146652492D81AC335B77521041"><enum>(3)</enum><header>Clarification</header><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section></legis-body></bill> 

