S.Amdt. 3654

1. Adds SEC. 1006. SUNSET IF PREMIUMS INCREASE TOO RAPIDLY at the end of subtitle A of title I

   Adds a section

   In H.R. 4872 · Placed on Calendar Senate

   (b) Funding.--There is appropriated to the Fund, out of any funds in the Treasury not otherwise appropriated, $1,000,000,000 for Federal administrative expenses to carry out such Act (and the amendments made by such Acts).

   Inserted: SEC. 1006. SUNSET IF PREMIUMS INCREASE TOO RAPIDLY.

   Inserted: (a) In General.--The following requirements of the Patient Protection and Affordable Care Act shall not apply to health insurance coverage and group health plans offered in the individual or group market within a State during plan years beginning after the sunset date with respect to that market:

   Inserted: (1) Any requirement under section 1301 of such Act, section 2707 of the Public Health Service Act, or any other provision of, or amendment made by, such Act that a health plan provide an essential health benefits package described in section 1302(a) of such Act, including any requirement that the plan provide--

   Inserted: (A) for essential health benefits described in section 1302(b) of such Act;

   Inserted: (B) in the case of a plan offered in the group market, an annual limitation on the plan's deductible described in section 1302(c)(2) of such Act; and

   Inserted: (C) a level of coverage described in section 1302(d) of such Act.

   Inserted: (2) The requirements of section 2701 of the Public Health Service Act (relating to limits on premiums).

   Inserted: (b) Coordination With Qualified Health Plans and Premium Tax Credits and Cost-Sharing Reductions.--In the case of a State to which subsection (a) applies, the Secretary of health and Human Services shall establish procedures for establishing which health plans shall be treated as qualified health plans for purposes of the Exchanges established within such State. Such procedures shall ensure that the aggregate amount of premium tax credits under section 36B of the Internal Revenue Code of 1986 and cost-sharing reductions under section 1402 of the Patient Protection and Affordable Care Act with respect to qualified health plans in the individual market within such State does not exceed the aggregate amount of such credits and reductions that would have been allowed if subsection (a) did not apply to such State.

   Inserted: (c) Sunset Date.--For purposes of this section--

   Inserted: (1) In general.--The term "sunset date" means, with respect to the individual or group market within a State, the first date on which the applicable State authority determines under paragraph (2) that the percentage increase in average annual premiums within such market for a calendar year over the preceding calendar year exceeds the percentage increase for such period in the Consumer Price Index for all urban consumers published by the Department of Labor.

   Inserted: (2) Determination.--The applicable State authority shall for each calendar year after 2013 make the determination described in paragraph (1).

   Inserted: (3) Applicable state authority.--The term "applicable State authority" has the meaning given such term by section 2791(d)(1) of the Public Health Service Act.

   Original wording

   At the end of subtitle A of title I, add the following:

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As printed