[Congressional Record (Bound Edition), Volume 160 (2014), Part 13]
[Senate]
[Pages 18809-18810]
[From the U.S. Government Publishing Office, www.gpo.gov]




   SUPPORT OF DIVISION M OF THE CONSOLIDATED AND FURTHER CONTINUING 
APPROPRIATIONS ACT, 2015, THE EXPATRIATE HEALTH COVERAGE CLARIFICATION 
                                  ACT

  Mr. CARPER. Madam President, I ask unanimous consent to engage in a 
colloquy with my colleague, Senator Coons.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. CARPER. Madam President, along with my colleague Senator Coons, I 
rise today in support of Division M of the Consolidated and Further 
Continuing Appropriations Act, 2015, the Expatriate Health Coverage 
Clarification Act. I would also like to clarify the intent of this 
bipartisan and technical bill, which was necessary to clearly explain 
how the Affordable Care Act, ACA, should apply to U.S.-issued 
expatriate health insurance plans and to ensure that U.S. health 
insurers who provide expatriate health insurance plans encounter the 
same legal requirements and expectations as foreign expatriate health 
insurers.
  Expatriate health insurance plans are high-quality and comprehensive 
health insurance plans intended for a globally mobile, highly skilled 
and sought-after workforce. Expatriate workers can be found in diverse 
industries and sectors, including corporations such as airlines and oil 
and gas exploration companies, nonprofit organizations, foreign aid 
groups, and contractors in conflict zones supporting or protecting U.S. 
troops and citizens. Expatriate workers often travel between multiple 
countries several times within 1 year or live in foreign countries for 
prolonged periods of time. These expatriate workers and their families 
typically require and depend on comprehensive health care services and 
other supporting services in multiple countries in the course of one 
year. U.S.-issued expatriate plans cover fewer than 500,000 
individuals, which primarily include Americans working overseas.
  My understanding and intent is that the Expatriate Health Coverage 
Clarification Act should make only limited and technical modifications 
to the ACA that apply to U.S. health insurers providing health 
insurance coverage to ``qualified expatriates'' as defined by

[[Page 18810]]

this legislation. These modifications are necessary to ensure that U.S. 
insurance companies offering expatriate health plans can remain 
competitive in the global marketplace for these plans, alongside 
foreign insurers who are not subject to the same ACA requirements. This 
legislation should not affect current labor or immigration laws or 
regulations. I have worked hand-in-hand with Senators Coons, Toomey, 
Rubio, Harkin, Wyden, Alexander, Hatch, and a bipartisan group of our 
House colleagues to ensure that the Expatriate Health Coverage 
Clarification Act is narrowly written to respect, and leave 
undisturbed, our existing immigration laws and regulations.
  Mr. COONS. Madam President, as Senator Carper noted, the Expatriate 
Health Coverage Clarification Act should not reduce the Affordable Care 
Act's health insurance coverage protections based on U.S. workers' 
immigration status, including those employed with nonimmigrant work 
visas. We intend that the definition of ``qualified expatriate'' be 
closely adhered to in the implementation of this legislation by the 
administration, the health insurance companies that seek to offer 
expatriate health plans, and the employers who utilize these plans on 
behalf of their workers who are transferred or assigned both within or 
outside the United States.
  It is my expectation that expatriate health plan enrollment should 
remain relatively constant, accounting for the normal ebbs and flows of 
the demand of and supply for expatriate workers. The provisions of this 
bill apply to the two Federal laws that it seeks to modify--the 
Affordable Care Act and the Health Care and Education Reconciliation 
Act. It is not Congress's intent to affect other Federal law. As 
Senator Carper stated, the legislation would not change existing 
immigration law or regulations--including those that govern benefit 
equivalency between nonimmigrant visa holders and their U.S. 
counterparts. It is also not Congress's intent to impact or diminish in 
any way an employee's rights under title VII of the Civil Rights Act or 
any other antidiscrimination protections or to preempt any relevant 
State law governing employees' rights.
  The Expatriate Health Coverage Clarification Act is a bipartisan, 
technical clarification of health insurance law, intended to place U.S. 
expatriate health insurers on equal footing with their foreign 
counterparts. We look forward to the passage of this bill and are 
grateful for the bipartisan coalition that has worked so constructively 
to find a path forward on this issue.

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