To amend the Patient Protection and Affordable Care Act to identify individuals dually enrolled in Medicaid or CHIP and an Exchange. | ChamberLight
Bills · HR 6516
IN COMMITTEE· 119TH CONGRESS
House BillHR 6516Health
To amend the Patient Protection and Affordable Care Act to identify individuals dually enrolled in Medicaid or CHIP and an Exchange.
INTRO DEC 9· LAST ACTION DEC 9
READING
2MIN
COSPONSORS
0
READER REACTIONS0 TOTAL
NO VOTES YET · BE THE FIRST
Introduced only
LEGISLATIVE PROGRESS
STEP 2 / 8
Introduced
In Committee
Reported
Passed House
Passed Senate
Conference
To President
Became Law
WHAT THE BILL DOES
AI-written
This bill matters because it addresses a potential overlap in government health insurance spending. Currently, some individuals might be eligible for and enrolled in both Medicaid/CHIP (which often has very low or no costs) and an ACA Exchange plan for which they receive federal financial assistance. This can lead to inefficient use of taxpayer money, as the government might effectively be subsidizing two forms of health coverage for the same individual when one is sufficient.
If this bill becomes law, it could lead to savings in federal spending by preventing duplicate subsidies. It would also clarify coverage for individuals and ensure that government resources for health care are directed more efficiently. If it doesn't pass, the current system would continue, allowing for the possibility of individuals receiving financial assistance for both types of health coverage.
KEY PROVISIONS
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PROVISION 01
Requires the Secretary of HHS to establish a program to identify individuals dually enrolled in Medicaid or CHIP and an ACA Exchange health plan.
This sets up the mechanism to find people who might be getting duplicate government health coverage assistance.
PROVISION 02
Mandates that this data comparison program operate on a recurring basis, at least quarterly, using the Public Assistance Reporting Information System (PARIS).
Ensures a continuous and consistent effort to identify dual enrollments using an existing federal system.
PROVISION 03
Directs the Secretary to take actions, such as notifying Exchanges and the Treasury, to stop premium tax credits and cost-sharing reductions for identified dually enrolled individuals.
This is the enforcement mechanism that stops the financial assistance for duplicate coverage.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
This bill matters because it addresses a potential overlap in government health insurance spending. Currently, some individuals might be eligible for and enrolled in both Medicaid/CHIP (which often has very low or no costs) and an ACA Exchange plan for which they receive federal financial assistance. This can lead to inefficient use of taxpayer money, as the government might effectively be subsidizing two forms of health coverage for the same individual when one is sufficient.
If this bill becomes law, it could lead to savings in federal spending by preventing duplicate subsidies. It would also clarify coverage for individuals and ensure that government resources for health care are directed more efficiently. If it doesn't pass, the current system would continue, allowing for the possibility of individuals receiving financial assistance for both types of health coverage.
KEY PROVISIONS
AI-extracted
high
Requires the Secretary of HHS to establish a program to identify individuals dually enrolled in Medicaid or CHIP and an ACA Exchange health plan.
This sets up the mechanism to find people who might be getting duplicate government health coverage assistance.
med
Mandates that this data comparison program operate on a recurring basis, at least quarterly, using the Public Assistance Reporting Information System (PARIS).
Ensures a continuous and consistent effort to identify dual enrollments using an existing federal system.
high
Directs the Secretary to take actions, such as notifying Exchanges and the Treasury, to stop premium tax credits and cost-sharing reductions for identified dually enrolled individuals.
This is the enforcement mechanism that stops the financial assistance for duplicate coverage.
Not later than 60 days after the date of enactment.
The Secretary of HHS must establish the dual enrollment identification program.
Not less frequently than quarterly.
The dual enrollment identification program must compare data on a recurring basis.
GLOSSARY
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Medicaid
A joint federal and state program that helps with medical costs for some people with limited income and resources.
CHIP
The Children's Health Insurance Program, which provides low-cost health coverage to children in families who earn too much money to qualify for Medicaid but cannot afford private insurance.
Exchange
An online marketplace where individuals and small businesses can shop for and buy health insurance plans, often with financial help from the government (also known as a 'marketplace').
Qualified Health Plan
A health insurance plan that meets the requirements of the Affordable Care Act and is offered on an ACA Exchange.
Premium Tax Credits
Government payments that help eligible individuals and families afford health insurance premiums purchased through an ACA Exchange.
Cost-Sharing Reductions
Discounts that reduce the amount individuals have to pay for deductibles, copayments, and coinsurance when they get care, available to eligible individuals who enroll in certain plans through an ACA Exchange.
Public Assistance Reporting Information System (PARIS)
ACTION TIMELINE
2 EVENTS
DEC 9, 25
Introduced in House
INTROREFERRAL
DEC 9, 25
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
A system used by federal and state agencies to compare data on individuals receiving public assistance benefits, helping to identify potential fraud, waste, or abuse.
