To amend the Patient Protection and Affordable Care Act to identify individuals dually enrolled in Medicaid or CHIP and an Exchange.
Sponsored By: Representative Burchett
Introduced
Summary
Prevents duplicate federal subsidies for people enrolled in both Medicaid or CHIP and Marketplace qualified health plans. It would require the Department of Health and Human Services to set up recurring data matches to find people enrolled in both programs and stop Marketplace subsidies for those individuals.
Show full summary
- People and families enrolled in both a Marketplace qualified health plan and a State Medicaid or CHIP plan, including waivers, would be identified and would not receive premium tax credits or cost-sharing reductions.
- The Department of Health and Human Services would compare enrollments using the Public Assistance Reporting Information System or a successor at least quarterly and could notify Exchanges and the Secretary of the Treasury to stop subsidies for identified individuals.
- The match covers title XIX Medicaid and title XXI CHIP enrollments and their waivers, so dual enrollments across Exchanges and those State programs are included.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 1 costs, 0 mixed.
Stops marketplace subsidies for Medicaid or CHIP
If enacted, HHS would set up a program within 60 days to find people signed up for both a marketplace plan and Medicaid or CHIP. The program would use PARIS (or a successor) to compare Exchange qualified health plan records with State Medicaid and CHIP records at least every three months. If someone is identified as enrolled in both, the Secretary would act (for example notify Exchanges and the Treasury) to make sure they do not receive premium tax credits (section 36B) or cost‑sharing reductions (section 1402). If you are found to be dually enrolled, this would likely raise your monthly premiums and out‑of‑pocket costs.
Sponsors & CoSponsors
Sponsor
Burchett
TN • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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