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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-OTT21187-63C-SG-9TM"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>117 S499 IS: Improving Health Insurance Affordability Act of 2021</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2021-03-01</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. 499</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20210301">March 1, 2021</action-date><action-desc><sponsor name-id="S324">Mrs. Shaheen</sponsor> (for herself, <cosponsor name-id="S309">Mr. Casey</cosponsor>, <cosponsor name-id="S330">Mr. Bennet</cosponsor>, <cosponsor name-id="S388">Ms. Hassan</cosponsor>, <cosponsor name-id="S354">Ms. Baldwin</cosponsor>, <cosponsor name-id="S341">Mr. Blumenthal</cosponsor>, <cosponsor name-id="S259">Mr. Reed</cosponsor>, <cosponsor name-id="S385">Ms. Cortez Masto</cosponsor>, <cosponsor name-id="S284">Ms. Stabenow</cosponsor>, <cosponsor name-id="S394">Ms. Smith</cosponsor>, <cosponsor name-id="S314">Mr. Tester</cosponsor>, <cosponsor name-id="S364">Mr. Murphy</cosponsor>, <cosponsor name-id="S308">Mr. Cardin</cosponsor>, <cosponsor name-id="S402">Ms. Rosen</cosponsor>, <cosponsor name-id="S311">Ms. Klobuchar</cosponsor>, and <cosponsor name-id="S362">Mr. Kaine</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSFI00">Committee on Finance</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To amend the Internal Revenue Code of 1986 to expand eligibility for the refundable credit for coverage under a qualified health plan, to improve cost-sharing subsidies under the Patient Protection and Affordable Care Act, and for other purposes.</official-title></form><legis-body display-enacting-clause="yes-display-enacting-clause"><section section-type="section-one" id="id6D6F2360A412447C97C46C195F8BFAB5"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Improving Health Insurance Affordability Act of 2021</short-title></quote>.</text></section><section section-type="subsequent-section" id="id3EFD33B1174F4FBDAEACD52A3760A2F4"><enum>2.</enum><header>Increase in eligibility for credit</header><subsection id="id2518259FFAD14B8285E10E5A30591851"><enum>(a)</enum><header>In general</header><text>Subparagraph (A) of <external-xref legal-doc="usc" parsable-cite="usc/26/36B">section 36B(c)(1)</external-xref> of the Internal Revenue Code of 1986 is amended by striking <quote>but does not exceed 400 percent</quote> . </text></subsection><subsection id="idCB386A87620F4362993DFB2366DF9C1C"><enum>(b)</enum><header>Applicable percentages</header><paragraph id="id21CDA79EA7594305A423E0E9FFF1C4DF"><enum>(1)</enum><header>In general</header><text>Subparagraph (A) of <external-xref legal-doc="usc" parsable-cite="usc/26/36B">section 36B(b)(3)</external-xref> of the Internal Revenue Code of 1986 as follows the table headings is amended to read as follows:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id734AD5C22DC74907881B8D610AB3DF13"><subparagraph id="idA71BA7F24A154313A623AAD9D910F79B"><enum>(A)</enum><header>Applicable percentage</header><text>The applicable percentage for any taxable year shall be the percentage such that the applicable percentage for any taxpayer whose household income is within an income tier specified in the following table shall increase, on a sliding scale in a linear manner, from the initial premium percentage to the final premium percentage specified in such table for such income tier:</text><table table-type="" table-template-name="Generic: 1 text, 2 num" align-to-level="section" frame="topbot" colsep="1" rowsep="0" blank-lines-before="1" line-rules="hor-ver" rule-weights="4.4.4.0.0.0"><tgroup cols="3" grid-typeface="1.1" rowsep="0" thead-tbody-ldg-size="10.10.12"><colspec coldef="txt" colname="column1" min-data-value="180" colwidth="209pts"></colspec><colspec coldef="fig" colname="column2" min-data-value="10" colwidth="90pts"></colspec><colspec coldef="fig" colname="column3" min-data-value="10" rowsep="0" colwidth="89pts"></colspec><thead><row><entry morerows="0" namest="column1" colname="column1">In the case of household income<linebreak></linebreak> (expressed as a percent of poverty line)<linebreak></linebreak> within the following
 income tier:</entry><entry morerows="0" namest="column2" colname="column2">The initial premium percentage is—</entry><entry morerows="0" namest="column3" colname="column3">The final premium percentage is—</entry></row></thead><tbody><row><entry align="left" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="1" colname="column1">Up to 150 percent</entry><entry align="right" rowsep="0" colname="column2">0</entry><entry align="right" rowsep="0" colname="column3">0</entry></row><row><entry align="left" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="1" colname="column1">150 percent up to 200 percent</entry><entry align="right" rowsep="0" colname="column2">0</entry><entry align="right" rowsep="0" colname="column3">2.0</entry></row><row><entry align="left" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="1" colname="column1">200 percent up to 250 percent</entry><entry align="right" rowsep="0" colname="column2">2.0</entry><entry align="right" rowsep="0" colname="column3">4.0</entry></row><row><entry align="left" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="1" colname="column1">250 percent up to 300 percent</entry><entry align="right" rowsep="0" colname="column2">4.0</entry><entry align="right" rowsep="0" colname="column3">6.0</entry></row><row><entry align="left" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="1" colname="column1">300 percent up to 400 percent</entry><entry align="right" rowsep="0" colname="column2">6.0</entry><entry align="right" rowsep="0" colname="column3">8.5</entry></row><row><entry align="left" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="1" colname="column1">400 percent and up</entry><entry align="right" rowsep="0" colname="column2">8.5</entry><entry align="right" rowsep="0" colname="column3">8.5.</entry></row></tbody></tgroup></table></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph><paragraph id="id86489D50508C40A68F394823E1212D42"><enum>(2)</enum><header>Conforming amendments relating to affordability of coverage</header><subparagraph id="idFED52794C8304A9B95A2ACD475C71F85"><enum>(A)</enum><text>Subparagraph (C) of section 36B(c)(2) of such Code is amended by striking clause (iv).</text></subparagraph><subparagraph id="id658EA512E9854C1C9183F45929BD7FCC"><enum>(B)</enum><text>Paragraph (4) of section 36B(c) of such Code is amended by striking subparagraph (F).</text></subparagraph></paragraph></subsection><subsection id="id81C63C0CF6514D0BA0BD1A7EA5B8C30B"><enum>(c)</enum><header>Limitation on recapture</header><text>Clause (i) of <external-xref legal-doc="usc" parsable-cite="usc/26/36B">section 36B(f)(2)(B)</external-xref> of the Internal Revenue Code of 1986 is amended—</text><paragraph id="id6C8BA20FCDC9460B81ABF4CE1BC1509E"><enum>(1)</enum><text>by striking <quote>400 percent</quote> and inserting <quote>800 percent</quote>;</text></paragraph><paragraph id="id2B04E7925A8C4013BAEFA86561D484A5"><enum>(2)</enum><text>by striking the period at the end of the last row of the table; and</text></paragraph><paragraph id="id2C42F610AE2F497AB43C23FA9BD557D7"><enum>(3)</enum><text>by adding at the end of the table the following new rows:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idF8469703379449988BF6D2E0169F2642"><table blank-lines-before="1" align-to-level="section" colsep="1" frame="topbot" line-rules="hor-ver" rowsep="0" rule-weights="4.4.4.0.0.0" table-template-name="Generic: 1 text, 2 num" table-type=""><tgroup cols="2" grid-typeface="1.1" rowsep="0" thead-tbody-ldg-size="10.10.12"><colspec coldef="txt" colname="column1" colwidth="269pts" min-data-value="180"></colspec><colspec coldef="fig" colname="column2" colwidth="56pts" min-data-value="10"></colspec><tbody><row><entry align="left" colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="1">At least 400 percent but less than 600 percent</entry><entry align="right" colname="column2" rowsep="0">$3,500</entry></row><row><entry align="left" colname="column1" rowsep="0" stub-definition="txt-ldr" stub-hierarchy="1"> At least 600 percent but less than 800 percent</entry><entry align="right" colname="column2" rowsep="0">$4,500.</entry></row></tbody></tgroup></table><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="id2FA6EB19677248028AA76CDAC5FB9822"><enum>(d)</enum><header>Premium cost standard</header><paragraph id="idB391BEFC84C44D9AB382C7FD24A4DBFC"><enum>(1)</enum><header>In general</header><text>The following provisions of <external-xref legal-doc="usc" parsable-cite="usc/26/36B">section 36B</external-xref> of the Internal Revenue Code of 1986 are each amended by striking <quote>silver</quote> each place it appears and inserting <quote>gold</quote>:</text><subparagraph id="idE339FAE6ADB642189D200F33CF2ED67B"><enum>(A)</enum><text>Paragraphs (2)(B)(i), (3)(B), and (3)(C) of subsection (b).</text></subparagraph><subparagraph id="id32F1379D08494CC1BD8B22BC6BBFDC52"><enum>(B)</enum><text>The heading of subparagraph (B) of subsection (b)(3).</text></subparagraph><subparagraph id="id52F8053D9BA34DAD8524CE9F3F65DF30"><enum>(C)</enum><text>Subsection (c)(4)(C)(i)(I).</text></subparagraph></paragraph><paragraph id="id489524C00C86446FB2DA2657A0E7CF2F"><enum>(2)</enum><header>Conforming amendments to reduced cost-sharing</header><text>Section 1402(b)(1) of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/18071">42 U.S.C. 18071(b)(1)</external-xref>) is amended by striking <quote>silver</quote> and inserting <quote>gold</quote>.</text></paragraph></subsection><subsection id="idBD74D482EE384B16836FB7968337D835"><enum>(e)</enum><header>Effective date</header><text>The amendments made by this section shall apply to taxable years beginning after December 31, 2021.</text></subsection></section><section id="idC9E5EABF6FF04C6896A6E77D0A49B793"><enum>3.</enum><header>Enhancements for reduced cost-sharing</header><subsection id="id816D1004423D40149FDCA43AF6762B36"><enum>(a)</enum><header>Modification of amount</header><paragraph id="id5E373D22E7274209BAE0EE4F261B5766"><enum>(1)</enum><header>In general</header><text>Section 1402(c)(2) of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/18071">42 U.S.C. 18071(c)(2)</external-xref>) is amended—</text><subparagraph id="idA17492E6F21D495FB7240A5542748E6B"><enum>(A)</enum><text>by striking <quote>150 percent</quote> in subparagraph (A) and inserting <quote>200 percent</quote>,</text></subparagraph><subparagraph id="idC3481CEE9EF24913ACE900FE8E19DF91"><enum>(B)</enum><text>by striking <quote>94 percent</quote> in subparagraph (A) and inserting <quote>95 percent</quote>,</text></subparagraph><subparagraph id="id7802E65812C74D24A15DF8097A4B9B06"><enum>(C)</enum><text>by striking <quote>150 percent but not more than 200 percent</quote> in subparagraph (B) and inserting <quote>200 percent but not more than 300 percent</quote>,</text></subparagraph><subparagraph id="idB3B9FA1A60BD4492B035676823C3B798"><enum>(D)</enum><text>by striking <quote>87 percent</quote> in subparagraph (B) and inserting <quote>90 percent</quote>,</text></subparagraph><subparagraph id="id77873138FD8E4D709CBC04F2426DC42A"><enum>(E)</enum><text>by striking <quote>200 percent</quote> in subparagraph (C) and inserting <quote>300 percent</quote>,</text></subparagraph><subparagraph id="id4E37C984712142FA8CF7D19692371677"><enum>(F)</enum><text>by striking <quote>250 percent</quote> in subparagraph (C) and inserting <quote>400 percent</quote>, and</text></subparagraph><subparagraph id="idB34E9A7584164AA4B61A55042D6825C5"><enum>(G)</enum><text>by striking <quote>73 percent</quote> in subparagraph (C) and inserting <quote>85 percent</quote>.</text></subparagraph></paragraph><paragraph commented="no" id="id4EA1A49A96F34F559C542C05D9DAFDBF"><enum>(2)</enum><header>Conforming amendment</header><text>Clause (i) of section 1402(c)(1)(B) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/18071">42 U.S.C. 18071(c)(1)(B)</external-xref>) is amended to read as follows:</text><quoted-block display-inline="no-display-inline" id="id8BC881AB950E40BA8EFC352DB6B93414" style="OLC"><clause commented="no" id="idbc20dd7b15f24de3b7f505f4ea6ea1c0"><enum>(i)</enum><header>In general</header><text>The Secretary shall ensure the reduction under this paragraph shall not result in an increase in the plan’s share of the total allowed costs of benefits provided under the plan above—</text><subclause commented="no" id="ideeb8874526ff4c788c70c9d96156f669"><enum>(I)</enum><text>95 percent in the case of an eligible insured described in paragraph (2)(A); </text></subclause><subclause commented="no" id="id0e172e5a20ca4ee4bf36f2ab28b86dae"><enum>(II)</enum><text>90 percent in the case of an eligible insured described in paragraph (2)(B); and</text></subclause><subclause commented="no" id="id41808E20B3984905807008428D6E7774"><enum>(III)</enum><text>85 percent in the case of an eligible insured described in paragraph (2)(C).</text></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph><paragraph id="id2C1879DECC234620B25FCE0528234B5C"><enum>(3)</enum><header>Effective date</header><text>The amendments made by this subsection shall apply to plan years beginning after December 31, 2021.</text></paragraph></subsection><subsection id="idfa20dce2c1e848d9822b65e24c054aee"><enum>(b)</enum><header>Funding</header><text>Section 1402 of the Patient Protection and Affordable Care Act (<external-xref legal-doc="usc" parsable-cite="usc/42/18071">42 U.S.C. 18071</external-xref>) is amended by adding at the end the following new subsection:</text><quoted-block display-inline="no-display-inline" id="idd902ffbec5c74eed8dfa0f4864c13cb4" style="OLC"><subsection id="id8e29f4068fcb4a8ca386bf36857ce673"><enum>(g)</enum><header>Funding</header><text>Out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary such sums as may be necessary for payments under this section.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section></legis-body></bill>


