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, Tim [R-TN-2]
Introduced
Summary
Identify people who are enrolled in both Medicaid or CHIP and an ACA Exchange and stop them from getting Exchange premium tax credits or cost‑sharing reductions. This bill would require the Secretary to set up a recurring data‑matching program that links Exchange enrollments with State Medicaid and CHIP enrollments using the Public Assistance Reporting Information System or a successor system.
Show full summary
- Families and individuals: If an individual is found to be enrolled in both a qualified health plan through an Exchange and Medicaid or CHIP, the bill would bar that person from receiving premium tax credits under section 36B of the Internal Revenue Code or cost‑sharing reductions under section 1402 of the Affordable Care Act.
- State Medicaid and CHIP programs: Enrollment records from State plans and waivers would be included in the matches, so traditional Medicaid, CHIP, and waiver enrollees can be identified.
- Exchanges and federal tax authorities: The Secretary would be required to notify applicable Exchanges and the Secretary of the Treasury and direct actions to prevent subsidy payments for people flagged by the matches. The matches must run at least quarterly and the program would have to be established within 60 days of enactment.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 1 costs, 0 mixed.
Stop duplicate Medicaid and marketplace subsidies
If enacted, the bill would require the federal government to set up a data match within 60 days. The program would run at least every three months. It would compare people in Exchange qualified health plans with people in Medicaid or CHIP, including waivers. If someone is found in both, the government would stop premium tax credits (IRC 36B) and cost‑sharing reductions (ACA 1402). The Secretary could notify Exchanges and the Treasury to enforce the stop. The subsidy stop would begin when the match is identified.
Sponsors & CoSponsors
Sponsor
Burchett, Tim [R-TN-2]
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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