[Congressional Record Volume 172, Number 48 (Tuesday, March 17, 2026)]
[Senate]
[Pages S1140-S1141]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 4447. Ms. BLUNT ROCHESTER submitted an amendment intended to be
proposed by her to the bill S. 1383, to establish the Veterans Advisory
Committee on Equal Access, and for other purposes; which was ordered to
lie on the table; as follows:
At the end, add the following:
TITLE II--RESTORING PATIENT PROTECTIONS AND AFFORDABILITY
Subtitle A--Consumer Protections
SEC. 201. RESTORATION OF TEMPORARY ENHANCED PREMIUM CREDITS.
(a) In General.--Clause (iii) of section 36B(b)(3)(A) of
the Internal Revenue Code of 1986 is amended--
(1) by striking ``January 1, 2026'' and inserting ``January
1, 2029'', and
(2) by striking ``2025'' in the heading and inserting
``2028''.
(b) Taxpayers Whose Household Income Exceeds 400 Percent of
the Poverty Line.--Section 36B(c)(1)(E) of the Internal
Revenue Code of 1986 is amended--
(1) by striking ``January 1, 2026'' and inserting ``January
1, 2029'', and
(2) by striking ``2025'' in the heading and inserting
``2028''.
(c) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after December 31,
2025.
SEC. 202. ADDITIONAL OPEN ENROLLMENT PERIOD FOR PLAN YEAR
2026.
With respect to plan year 2026, the Secretary of Health and
Human Services shall require Exchanges to provide an
additional open enrollment period under section 1311(c)(6) of
the Patient Protection and Affordable Care Act (42 U.S.C.
18031(c)(6)) during the period beginning on the date of
enactment of this Act and ending on December 31, 2026.
SEC. 203. RESTORING NAVIGATOR PROGRAM.
(a) Funding.--Section 1311(i)(6) of the Patient Protection
and Affordable Care Act (42 U.S.C. 18031(i)(6)) is amended--
(1) by striking ``Grants under'' and inserting the
following:
``(A) State exchanges.--In the case of an Exchange
established and operated by a State pursuant to subsection
(b), grants under''; and
(2) by adding at the end the following:
``(B) Federal exchanges.--For purposes of carrying out this
subsection with respect to an Exchange established and
operated by the Secretary pursuant to section 1321(c), the
Secretary shall obligate $100,000,000 out of amounts
collected through the user fees on participating health
insurance issuers pursuant to section 156.50 of title 45,
Code of Federal Regulations (or any successor regulations)
for fiscal year 2026. Such amount so obligated for a fiscal
year shall remain available until expended.''.
(b) Standards.--Section 1311(i)(4)(A) of the Patient
Protection and Affordable Care Act (42 U.S.C. 18031(i)(4)(A))
is amended--
(1) in clause (i), by striking ``or'' at the end;
(2) in clause (ii), by striking the period and inserting a
semicolon; and
(3) by adding at the end the following:
``(iii) charge any fees to applicants or enrollees; or
``(iv) request any form of remuneration from or on behalf
of any applicant or enrollee.''.
SEC. 204. REPEAL OF DISALLOWANCE OF PREMIUM TAX CREDIT IN
CASE OF CERTAIN COVERAGE ENROLLED IN DURING
SPECIAL ENROLLMENT PERIOD.
(a) In General.--Section 36B(c)(3)(A) of the Internal
Revenue Code of 1986, as amended by Public Law 119-21, is
amended by striking clause (iii).
(b) Effective Date.--The amendment made by this section
shall apply with respect to plan years beginning after
December 31, 2025.
Subtitle B--Health Plan Accountability
SEC. 211. MINIMUM NOTICE REQUIREMENTS FOR PLAN YEAR 2025
ENROLLEES.
The Secretary of Health and Human Services shall require
each health insurance issuer that offered a qualified health
plan through a Federal or State Exchange for plan year 2025
to notify, not later than 15 days after the date of enactment
of this Act, all individuals enrolled in such plan for any
month during plan year 2025 of--
(1) changes to eligibility for premium assistance credits,
and to the premium assistance credit amounts, under section
36B of the Internal Revenue Code of 1986 that first take
effect with respect to plan year 2026;
(2) the additional open enrollment period for plan year
2026 pursuant to section 202; and
(3) any additional information relating to such eligibility
and enrollment, as the Secretary determines appropriate,
including the website and phone number for the applicable
Federal or State Exchange.
SEC. 212. MINIMUM NOTICE REQUIREMENTS FOR PLAN YEAR 2026
ENROLLEES.
(a) In General.--The Secretary of Health and Human Services
shall require each health insurance issuer that offers a
qualified health plan through a Federal or State Exchange for
plan year 2026 to notify all individuals enrolled in such
plan for plan year 2026 of--
(1) changes to eligibility for premium assistance credits,
and to the premium assistance credit amounts, under section
36B of the Internal Revenue Code of 1986 that first take
effect with respect to plan year 2026;
(2) the additional open enrollment period for plan year
2026 pursuant to section 202; and
(3) any additional information relating to such eligibility
and enrollment, as the Secretary determines appropriate,
including the website and phone number for the applicable
Federal or State Exchange.
(b) Timing.--The notification by a health insurance issuer
under subsection (a) shall be made--
(1) not later than 15 days after the date of enactment of
this Act, with respect to individuals enrolled in such plan
as of the date of enactment of this Act; and
(2) not later than 15 days after an individual's
enrollment, with respect to individuals enrolling, after such
date of enactment, in the plan during the additional open
enrollment period under section 202 for plan year 2026.
SEC. 213. HEALTH INSURANCE ISSUER REPORTING REQUIREMENTS.
(a) Report From Issuer.--Not later than 90 days after the
date of enactment of this Act, each health insurance issuer
that is subject to the reporting requirements under sections
201 and 202 shall submit to the Secretary of Health and Human
Services a report attesting to compliance with the
requirements under sections 201 and 202.
(b) Consolidated Report to Congress.--Not later than 120
days after the date of enactment of this Act, the Secretary
of Health and Human Services shall submit to the Committee on
Finance and the Committee on Health, Education, Labor, and
Pensions of the Senate and the Committee on Ways and Means,
the Committee on Energy and Commerce, and the Committee on
Education and Workforce of the House of Representatives a
report that consolidates the reports submitted by issuers
under subsection (a).
SEC. 214. ENFORCEMENT.
(a) In General.--Consistent with the process set forth in
subsections (d) and (e) of section 156.805 of title 45, Code
of Federal Regulations (or successor regulations), the
Secretary of Health and Human Services may impose a civil
monetary penalty upon any health insurance issuer who fails
to comply with the notification requirements under section
201 or 202 or the reporting requirements under section 203.
[[Page S1141]]
(b) Penalty Amounts.--
(1) Violations regarding notice to enrollees.--In the case
of a violation of section 201 or 202, such penalty shall be
in the amount equal to $1,000 for each individual enrolled in
a plan for plan year 2025 or 2026 who did not receive a
notice as required under section 201 or 202, as applicable,
for each day between the date on which such notice was due
and the date on which the notice is provided.
(2) Reporting violations.--In the case of a violation of
section 203, such penalty shall be in the amount of $1,000
per day for each individual enrolled in health insurance
coverage with respect to which the report is required, for
each day between the date on which the report under section
302 was due and the date on which the report is submitted.
Subtitle C--Eliminating Red Tape
SEC. 221. APPLYING COMMERCIAL MARKET POLICY TO REENROLLMENT
PROCESS.
(a) In General.--Section 36B(c)(5)(A) of the Internal
Revenue Code of 1986, as added by Public Law 119-21, is
amended by striking ``, using applicable enrollment
information that shall be provided or verified by the
applicant,''.
(b) Effective Date.--The amendment made by this section
shall apply to taxable years beginning after December 31,
2027.
SEC. 222. PROTECTION AGAINST BUREAUCRATIC COVERAGE DENIALS.
(a) In General.--Section 1311(c)(6) of the Patient
Protection and Affordable Care Act (42 U.S.C. 18031(c)(6)) is
amended--
(1) in subparagraph (C), by striking ``; and'' and
inserting a semicolon; and
(2) by adding at the end the following:
``(E) special enrollment periods for any individual denied
the advance payment for which the individual applies for one
or more months pending the verification prescribed by section
36B(c)(5)(A) of the Internal Revenue Code of 1986, to permit
enrollment of any such individual following such
verification; and''.
(b) Effective Date.--The amendment made by this section
shall apply with respect to plan years beginning on or after
January 1, 2028.
SEC. 223. AUTOMATIC ENROLLMENT FROM BRONZE TO SILVER LEVEL
QUALIFIED HEALTH PLANS OFFERED ON EXCHANGES.
The Secretary of Health and Human Services shall revise
section 155.335(j) of title 45, Code of Federal Regulations
(or any successor regulation) to ensure that, with respect to
reenrollments for plan years beginning on or after January 1,
2026, a Federal or State Exchange established under subtitle
D of title I of the Patient Protection and Affordable Care
Act (42 U.S.C. 18021 et seq.) may reenroll an individual who
was enrolled in a bronze level qualified health plan in a
silver level qualified health plan (as such terms are defined
in section 1301(a) and described in 1302(d) of such Act (42
U.S.C. 18021(a); 18022(d))).
Subtitle D--Market Stabilization
SEC. 231. RESTORING MARKETPLACE FLEXIBILITY.
(a) In General.--Section 1311(c)(6) of the Patient
Protection and Affordable Care Act (42 U.S.C. 18031(c)(6)),
as amended by section 222(a), is further amended by adding at
the end the following:
``(F) a special enrollment period once per month for any
individual who is eligible for the advance payment of premium
tax credits under section 1412 and whose household income is
not expected to exceed 150 percent of the poverty line for a
family of the size involved.''.
(b) Effective Date.--The amendment made by subsection (a)
shall apply with respect to plan years beginning on or after
January 1, 2026.
SEC. 232. NO HEALTH PLAN GOUGING.
The Secretary of Health and Human Services shall--
(1) revise section 156.140(c) of title 45, Code of Federal
Regulations (or a successor regulation), to provide that, for
plan years beginning on or after January 1, 2026, the
allowable variation in the actuarial value of a health plan
applicable under such section shall be the allowable
variation for such plan applicable under such section for
plan year 2025; and
(2) revise section 156.400 of title 45, Code of Federal
Regulations (or a successor regulation), to provide that, for
plan years beginning on or after January 1, 2026, the term
``de minimis variation for a silver plan variation'' means a
minus 0 percentage point and plus 2 percentage point
allowable actuarial value variation.
SEC. 233. PROTECTING CONTINUITY OF COVERAGE.
(a) In General.--The Secretary of Health and Human Services
shall revise section 155.305(f)(4) of title 45, Code of
Federal Regulations (or a successor regulation) to provide
that an Exchange may determine an enrollee ineligible for an
advance premium tax credit under section 36B of the Internal
Revenue Code of 1986 as described in such section
155.305(f)(4) only after a taxpayer (or a taxpayer's spouse,
if married) has failed to file a Federal income tax return
and reconcile their past advance premium tax credit for 2
consecutive years for which tax data will be utilized for
verification of household income and family size.
(b) Effective Date.--The requirement described in
subsection (a) shall apply with respect to plan years
beginning on or after January 1, 2026.
SEC. 234. PROTECTING ENROLLEES FROM SURPRISE PREMIUM BILLS.
(a) In General.--Section 36B(f)(2) of the Internal Revenue
Code of 1986, as amended by Public Law 119-21, is amended--
(1) by striking ``If the advanced payments'' and inserting
the following:
``(A) In general.--If the advanced payments'', and
(2) by adding at the end the following new subparagraph:
``(B) Limitation on increase.--
``(i) In general.--In the case of a taxpayer whose
household income is less than 400 percent of the poverty line
for the size of the family involved for the taxable year, the
amount of the increase under subparagraph (A) shall in no
event exceed the applicable dollar amount determined in
accordance with the following table (one-half of such amount
in the case of a taxpayer whose tax is determined under
section 1(c) for the taxable year):
------------------------------------------------------------------------
The
``If the household income (expressed as a percentage of the applicable
poverty line) is: dollar
amount is:
------------------------------------------------------------------------
Less than 200%............................................. $600
At least 200% but less than 300%........................... $1,500
At least 300% but less than 400%........................... $2,500.
------------------------------------------------------------------------
``(ii) Indexing of amount.--In the case of any calendar
year beginning after 2014, each of the dollar amounts in the
table contained under clause (i) shall be increased by an
amount equal to--
``(I) such dollar amount, multiplied by
``(II) the cost-of-living adjustment determined under
section 1(f)(3) for the calendar year, determined by
substituting `calendar year 2013' for `calendar year 2016' in
subparagraph (A)(ii) thereof.
If the amount of any increase under clause (i) is not a
multiple of $50, such increase shall be rounded to the next
lowest multiple of $50.''.
(b) Conforming Amendment.--Section 35(g)(12)(B)(ii) of such
Code is amended by striking ``the amount determined under
clause (i) shall be substituted for the amount determined
under section 36B(f)(2)'' and inserting ``then section
36B(f)(2)(B) shall be applied by substituting the amount
determined under clause (i) for the amount determined under
section 36(f)(2)(A)''.
(c) Effective Date.--The amendment made by this section
shall apply to taxable years beginning after December 31,
2025.
SEC. 235. NO ACA AND EMPLOYER COVERAGE PREMIUM SPIKES.
Section 1302(c)(4) of the Patient Protection and Affordable
Care Act (42 U.S.C. 18022(c)(4)) is amended by adding at the
end the following: ``For calendar year 2026 and each
subsequent calendar year, the lower bound of the allowable
premium adjustment percentage for purposes of paragraph
(1)(B)(i) is the lower bound of the premium adjustment
percentage that applied under this paragraph for plan year
2022 using National Health Expenditure Accounts projections
of average per enrollee employer-sponsored insurance
premiums.''.
______