[House Report 113-422]
[From the U.S. Government Publishing Office]


113th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     113-422

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  PROVIDING FOR CONSIDERATION OF THE BILL (H.R. 4414) TO CLARIFY THE 
   TREATMENT UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 
 HEALTH PLANS IN WHICH EXPATRIATES ARE THE PRIMARY ENROLLEES, AND FOR 
                             OTHER PURPOSES

                                _______
                                

   April 28, 2014.--Referred to the House Calendar and ordered to be 
                                printed

                                _______
                                

               Mr. Burgess, from the Committee on Rules, 
                        submitted the following

                              R E P O R T

                       [To accompany H. Res. 555]

    The Committee on Rules, having had under consideration 
House Resolution 555, by a nonrecord vote, report the same to 
the House with the recommendation that the resolution be 
adopted.

                SUMMARY OF PROVISIONS OF THE RESOLUTION

    The resolution provides for consideration of H.R. 4414, the 
Expatriate Health Coverage Clarification Act of 2014, under a 
closed rule. The resolution provides one hour of debate equally 
divided and controlled by the chair and ranking minority member 
of the Committee on Ways and Means. The resolution waives all 
points of order against consideration of the bill. The 
resolution provides that the amendment printed in this report 
shall be considered as adopted and the bill, as amended, shall 
be considered as read. The resolution waives all points of 
order against provisions in the bill, as amended. The 
resolution provides one motion to recommit with or without 
instructions.

                         EXPLANATION OF WAIVERS

    The waiver of all points of order against consideration of 
the bill includes a waiver of section 311 of the Congressional 
Budget Act of 1974, which prohibits consideration of 
legislation that would cause revenues to be less than the level 
of total revenues for the first fiscal year or for the total of 
that first fiscal year and the ensuing fiscal years for which 
allocations are provided.
    Although the resolution waives all points of order against 
provisions in the bill, as amended, the Committee is not aware 
of any points of order. The waiver is prophylactic in nature.

                            COMMITTEE VOTES

    The results of each record vote on an amendment or motion 
to report, together with the names of those voting for and 
against, are printed below:

Rules Committee record vote No. 127

    Motion by Mr. McGovern to report an open rule. Defeated: 3-
7.

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                Majority Members                      Vote               Minority Members               Vote
----------------------------------------------------------------------------------------------------------------
Ms. Foxx........................................          Nay   Ms. Slaughter.....................          Yea
Mr. Bishop of Utah..............................  ............  Mr. McGovern......................          Yea
Mr. Cole........................................          Nay   Mr. Hastings of Florida...........  ............
Mr. Woodall.....................................          Nay   Mr. Polis.........................          Yea
Mr. Nugent......................................          Nay
Mr. Webster.....................................          Nay
Ms. Ros-Lehtinen................................  ............
Mr. Burgess.....................................          Nay
Mr. Sessions, Chairman..........................          Nay
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             SUMMARY OF THE AMENDMENT CONSIDERED AS ADOPTED

    Nunes (CA), Carney (DE): Clarifies that an expatriate 
health plan offered by an employer must be actuarially similar 
or better than a domestic plan offered by the employer that 
meets the minimum value test defined in the Internal revenue 
code section 36B or in the case where the employer does not 
offer a domestic plan, the expatriate plan must at least meet 
minimum value. Clarifies that an expatriate health plan must 
make payments in two or more currencies, and the plans must 
comply with laws that existed prior to the passage of the 
Affordable Care Act. Clarifies that an individual must be 
abroad for at least 6 months in any 12 consecutive months to be 
qualified to enroll in an expatriate plan.

                TEXT OF AMENDMENT CONSIDERED AS ADOPTED

  Page 2, line 7, strike ``2011'' and insert ``2010''.
  Page 5, beginning on line 23, amend subparagraph (D) to read 
as follows:
                  (D) In the case of an expatriate health plan 
                that is a group health plan offered by a plan 
                sponsor that--
                          (i) also offers a qualifying minimum 
                        value domestic group health plan, the 
                        plan sponsor reasonably believes that 
                        the benefits provided by the expatriate 
                        health plan are actuarially similar to, 
                        or better than, the benefits provided 
                        under a qualifying minimum value 
                        domestic group health plan offered by 
                        that plan sponsor; or
                          (ii) does not also offer a qualifying 
                        minimum value domestic group health 
                        plan, the plan sponsor reasonably 
                        believes that the benefits provided by 
                        the expatriate health plan are 
                        actuarially similar to, or better than, 
                        the benefits provided under a 
                        qualifying minimum value domestic group 
                        health plan.
  Page 6, beginning on line 13, amend subparagraph (F) to read 
as follows:
                  (F) The plan or coverage--
                          (i) is issued by an expatriate health 
                        plan issuer, or administered by an 
                        administrator, that maintains, with 
                        respect to such plan or coverage--
                                  (I) network provider 
                                agreements with health care 
                                providers that are outside of 
                                the United States; and
                                  (II) call centers in more 
                                than one country and accepts 
                                calls from customers in 
                                multiple languages; and
                          (ii) offers reimbursements for items 
                        or services under such plan or coverage 
                        in more than two currencies.
  Page 6, after line 22, insert the following:
                  (G) The plan or coverage, and the plan 
                sponsor or expatriate health insurance issuer 
                with respect to such plan or coverage, 
                satisfies the provisions of title XXVII of the 
                Public Health Service Act (42 U.S.C. 300gg et 
                seq.), chapter 100 of the Internal Revenue Code 
                of 1986, and part 7 of subtitle B of title I of 
                the Employee Retirement Income Security Act of 
                1974 (29 U.S.C. 1181 et seq.), which would 
                otherwise apply to such a plan or coverage, and 
                sponsor or issuer, if not for the enactment of 
                the Patient Protection and Affordable Care Act 
                and title I and subtitle B of title II of the 
                Health Care and Education Reconciliation Act of 
                2010.
  Page 7, line 2, insert ``an alien residing outside the United 
States,'' after ``who is''.
  Page 7, line 8, strike ``90 days'' and insert ``180 days''.
  Page 7, beginning on line 9, strike ``12 consecutive months 
of enrollment'' and all that follows through line 12, and 
insert ``12 consecutive months.''
  Page 7, beginning on line 20, amend paragraph (4) to read as 
follows:
          (4) Qualifying minimum value domestic group health 
        plan.--The term ``qualifying minimum value domestic 
        group health plan'' means a group health plan that is 
        offered in the United States that meets the following 
        requirements:
                  (A) Substantially all of the primary 
                enrollees in the plan are not qualified 
                expatriates, with respect to such plan.
                  (B) Substantially all of the benefits 
                provided under the plan are not excepted 
                benefits described in section 9832(c) of the 
                Internal Revenue Code of 1986.
                  (C) The application of section 
                36B(c)(2)(C)(ii) of such Code to such plan 
                would not prevent an employee eligible for 
                coverage under such plan from being treated as 
                eligible for minimum essential coverage for 
                purposes of section 36B(c)(2)(B) of such Code.

                                  
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