[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2688 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 2688
To improve healthcare-related, tax-preferred savings accounts and to
provide for cooperative governing of individual and group health
insurance coverage across State lines, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 15, 2013
Mr. Ross introduced the following bill; which was referred to the
Committee on Ways and Means, and in addition to the Committee on Energy
and Commerce, 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 BILL
To improve healthcare-related, tax-preferred savings accounts and to
provide for cooperative governing of individual and group health
insurance coverage across State lines, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Providing
Accountability and Transparency to Incentivize Economically Necessary
Transitions in Health Care Act of 2013'' or the ``PATIENT's Health Care
Act of 2013''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--HEALTHCARE-RELATED SAVINGS ACCOUNTS
Sec. 101. Deduction of premiums for high deductible health plans.
Sec. 102. Repeal of high deductible health plan requirement.
Sec. 103. Increase in deductible HSA contribution limitations.
Sec. 104. Medicare eligible individuals eligible to contribute to HSA.
Sec. 105. HSA rollover to Medicare Advantage MSA.
Sec. 106. One-time transfer of flexible spending arrangement balance to
health savings account in case of
separation from employment.
Sec. 107. Payment of high deductible health plan premiums from HSA.
Sec. 108. Repeal of disqualification of expenses for over-the-counter
drugs under certain accounts and
arrangements.
Sec. 109. Payment of long-term care premiums from health flexible
spending arrangement.
Sec. 110. Allowing MSA and HSA rollover to adult child of account
holder.
Sec. 111. Disposition of unused health benefits in cafeteria plans and
flexible spending arrangements.
Sec. 112. Permitting beneficiary contributions to Medicare Advantage
MSA.
Sec. 113. Child health savings account.
TITLE II--HEALTH INSURANCE PROVISIONS
Sec. 201. Cooperative governing of individual and group health
insurance coverage.
Sec. 202. Reauthorization of the Preexisting Condition Insurance Plan
(PCIP) Program.
TITLE I--HEALTHCARE-RELATED SAVINGS ACCOUNTS
SEC. 101. DEDUCTION OF PREMIUMS FOR HIGH DEDUCTIBLE HEALTH PLANS.
(a) In General.--Part VII of subchapter B of chapter 1 of the
Internal Revenue Code of 1986 is amended by redesignating section 224
as section 225 and by inserting after section 223 the following new
section:
``SEC. 224. PREMIUMS FOR HIGH DEDUCTIBLE HEALTH PLANS.
``(a) Deduction Allowed.--In the case of an individual, there shall
be allowed as a deduction for the taxable year the aggregate amount
paid by such individual as premiums under a high deductible health plan
with respect to months during such year for which such individual is an
eligible individual with respect to such health plan.
``(b) Definitions.--For purposes of this section--
``(1) Eligible individual.--
``(A) In general.--The term `eligible individual'
means, with respect to any month, any individual if--
``(i) such individual is covered under a
high deductible health plan as of the 1st day
of such month, and
``(ii) such individual is not, while
covered under a high deductible health plan,
covered under any health plan--
``(I) which is not a high
deductible health plan, and
``(II) which provides coverage for
any benefit which is covered under the
high deductible health plan.
``(B) Certain coverage disregarded.--Subparagraph
(A)(ii) shall be applied without regard to--
``(i) coverage for any benefit provided by
permitted insurance,
``(ii) coverage (whether through insurance
or otherwise) for accidents, disability, dental
care, vision care, or long-term care, and
``(iii) coverage under a health flexible
spending arrangement during any period
immediately following the end of a plan year of
such arrangement during which unused benefits
or contributions remaining at the end of such
plan year may be paid or reimbursed to plan
participants for qualified benefit expenses
incurred during such period if--
``(I) the balance in such
arrangement at the end of such plan
year is zero, or
``(II) the individual is making a
qualified HSA distribution (as defined
in section 106(e)) in an amount equal
to the remaining balance in such
arrangement as of the end of such plan
year, in accordance with rules
prescribed by the Secretary.
``(2) High deductible health plan.--
``(A) In general.--The term `high deductible health
plan' means a health plan--
``(i) which has an annual deductible which
is not less than--
``(I) $1,000 for self-only
coverage, and
``(II) twice the dollar amount in
subclause (I) for family coverage, and
``(ii) the sum of the annual deductible and
the other annual out-of-pocket expenses
required to be paid under the plan (other than
for premiums) for covered benefits does not
exceed--
``(I) $5,000 for self-only
coverage, and
``(II) twice the dollar amount in
subclause (I) for family coverage.
``(B) Exclusion of certain plans.--Such term does
not include a health plan if substantially all of its
coverage is described in paragraph (1)(B).
``(C) Safe harbor for absence of preventive care
deductible.--A plan shall not fail to be treated as a
high deductible health plan by reason of failing to
have a deductible for preventive care (within the
meaning of section 1871 of the Social Security Act,
except as otherwise provided by the Secretary).
``(D) Special rule for annual out-of-pocket
limitation for network plans.--In the case of a plan
using a network of providers, such plan shall not fail
to be treated as a high deductible health plan by
reason of having an out-of-pocket limitation for
services provided outside of such network which exceeds
the applicable limitation under subparagraph (A)(ii).
``(3) Permitted insurance.--The term `permitted insurance'
means--
``(A) insurance if substantially all of the
coverage provided under such insurance relates to--
``(i) liabilities incurred under workers'
compensation laws,
``(ii) tort liabilities,
``(iii) liabilities relating to ownership
or use of property, or
``(iv) such other similar liabilities as
the Secretary may specify by regulations,
``(B) insurance for a specified disease or illness,
and
``(C) insurance paying a fixed amount per day (or
other period) of hospitalization.
``(4) Family coverage.--The term `family coverage' means
any coverage other than self-only coverage.
``(c) Special Rules.--
``(1) Deduction allowable for only 1 plan.--For purposes of
this section, in the case of an individual covered by more than
1 high deductible health plan for any month, the individual may
only take into account amounts paid for 1 of such plans for
such month.
``(2) Employer provided coverage.--
``(A) In general.--No deduction shall be allowed to
an individual under subsection (a) for any amount paid
for coverage under a high deductible health plan for a
month if that individual participates in any coverage
for such month that is excluded (in whole or in part)
from the gross income of the individual or the
individual's spouse under section 106.
``(B) Cafeteria plans, etc.--Employer contributions
to a cafeteria plan or a flexible spending or similar
arrangement which are excluded from gross income under
section 106 shall be treated for purposes of this
section as paid by the employer.
``(3) Contributions to health savings account required.--A
deduction shall not be allowed under subsection (a) for a
taxable year with respect to such individual if such individual
is not allowed a deduction under section 223 for such taxable
year.
``(4) Medical and health savings accounts.--Subsection (a)
shall not apply with respect to any amount which is paid or
distributed out of an Archer MSA or a health savings account
which is not included in gross income under section 220(f) or
223(f), as the case may be.
``(5) Coordination with deduction for health insurance of
self-employed individuals.--The amount taken into account by
the taxpayer in computing the deduction under section 162(l)
shall not be taken into account under this section.
``(6) Coordination with medical expense deduction.--The
amount taken into account by the taxpayer in computing the
deduction under this section shall not be taken into account
under section 213.''.
(b) Deduction Allowed Whether or Not Individual Itemizes Other
Deductions.--Subsection (a) of section 62 of such Code is amended by
inserting after paragraph (21) the following new paragraph:
``(22) Premiums for high deductible health plans.--The
deduction allowed by section 224.''.
(c) Clerical Amendment.--The table of sections for part VII of
subchapter B of chapter 1 of such Code is amended by striking the last
item and inserting the following new items:
``Sec. 224. Premiums for high deductible health plans.
``Sec. 225. Cross reference.''.
(d) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2013.
SEC. 102. REPEAL OF HIGH DEDUCTIBLE HEALTH PLAN REQUIREMENT.
(a) In General.--Subsection (a) of section 223 of such Code is
amended to read as follows:
``(a) Deduction Allowed.--In the case of an individual, there shall
be allowed as a deduction for a taxable year an amount equal to the
aggregate amount paid in cash during such taxable year by or on behalf
of such individual to a health savings account of such individual.''.
(b) Conforming Amendments.--
(1) Section 223 of such Code is amended by striking
subsection (c) and redesignating subsections (d) through (h) as
subsections (c) through (g), respectively.
(2) Section 223(b) of such Code is amended by striking
paragraph (8).
(3) Subparagraph (A) of section 223(c)(1) of such Code (as
redesignated by paragraph (1)) is amended--
(A) by striking ``subsection (f)(5)'' and inserting
``subsection (e)(5)'', and
(B) in clause (ii)--
(i) by striking ``the sum of--'' and all
that follows and inserting ``the dollar amount
in effect under subsection (b)(1).''.
(4) Section 223(f)(1) of such Code (as redesignated by
paragraph (1)) is amended by striking ``Each dollar amount in
subsections (b)(2) and (c)(2)(A)'' and inserting ``In the case
of a taxable year beginning after December 31, 2010, each
dollar amount in subsection (b)(1)''.
(5) Section 26(b)(U) of such Code is amended by striking
``section 223(f)(4)'' and inserting ``section 223(e)(4)''.
(6) Sections 35(g)(3), 220(f)(5)(A), 848(e)(1)(v),
4973(a)(5), and 6051(a)(12) of such Code are each amended by
striking ``section 223(d)'' each place it appears and inserting
``section 223(c)''.
(7) Section 106(d)(1) of such Code is amended--
(A) by striking ``who is an eligible individual (as
defined in section 223(c)(1))'', and
(B) by striking ``section 223(d)'' and inserting
``section 223(c)''.
(8) Section 408(d)(9) of such Code is amended--
(A) in subparagraph (A) by striking ``who is an
eligible individual (as defined in section 223(c))
and'', and
(B) in subparagraph (C) by striking ``computed on
the basis of the type of coverage under the high
deductible health plan covering the individual at the
time of the qualified HSA funding distribution''.
(9) Section 877A(g)(6) of such Code is amended by striking
``223(f)(4)'' and inserting ``223(e)(4)''.
(10) Section 4973(g) of such Code is amended--
(A) by striking ``section 223(d)'' and inserting
``section 223(c)'',
(B) in paragraph (2), by striking ``section
223(f)(2)'' and inserting ``section 223(e)(2)'', and
(C) by striking ``section 223(f)(3)'' and inserting
``section 223(e)(3)''.
(11) Section 4975 of such Code is amended--
(A) in subsection (c)(6)--
(i) by striking ``section 223(d)'' and
inserting ``section 223(c)'', and
(ii) by striking ``section 223(e)(2)'' and
inserting ``section 223(d)(2)'', and
(B) in subsection (e)(1)(E), by striking ``section
223(d)'' and inserting ``section 223(c)''.
(12) Section 6693(a)(2)(C) of such Code is amended by
striking ``section 223(h)'' and inserting ``section 223(g)''.
(c) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2011.
SEC. 103. INCREASE IN DEDUCTIBLE HSA CONTRIBUTION LIMITATIONS.
(a) In General.--Paragraph (1) of section 223(b) of the Internal
Revenue Code of 1986 is amended by striking ``the sum of the monthly''
and all that follows through ``eligible individual'' and inserting
``$10,000 ($20,000 in the case of a joint return)''.
(b) Additional Contributions.--Paragraph (3) of section 223(b) is
amended to read as follows:
``(3) Additional contributions for individuals between 55
and 65.--In the case of an individual who has attained the age
of 55, but has not attained the age of 66, before the close of
the taxable year, the limitation under paragraph (1) shall be
increased by $10,000.''.
(c) Conforming Amendments.--
(1) Section 223(b) of such Code, as amended by this Act, is
amended by striking paragraphs (2) and (5) and by redesignating
paragraphs (3), (4), (6), and (7) as paragraphs (2), (3), (4),
and (5), respectively.
(2) Section 223(c)(1)(A)(ii) of such Code (as redesignated
by this Act) is amended by striking ``the sum of--'' and all
that follows and inserting ``the dollar amount in effect under
subsection (b)(1).''.
(3) Section 223(f)(1) of such Code (as redesignated by this
Act) is amended by striking ``Each dollar amount in subsections
(b)(2) and (c)(2)(A)'' and inserting ``In the case of a taxable
year beginning after December 31, 2013, each dollar amount in
subsection (b)(1)''.
(4) Paragraph (3) of section 223(b) of such Code (as
redesignated by paragraph (1)) is amended by striking the last
sentence.
(d) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2013.
SEC. 104. MEDICARE ELIGIBLE INDIVIDUALS ELIGIBLE TO CONTRIBUTE TO HSA.
(a) Subsection (b) of section 223 of the Internal Revenue Code of
1986, as amended by this Act, is amended by striking paragraph (4).
(b) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2013.
SEC. 105. HSA ROLLOVER TO MEDICARE ADVANTAGE MSA.
(a) In General.--Paragraph (2) of section 138(b) of the Internal
Revenue Code of 1986 is amended by striking ``or'' at the end of
subparagraph (A), by adding ``or'' at the end of subparagraph (C), and
by adding at the end the following new subparagraph:
``(C) a HSA rollover contribution described in
subsection (c)(5),''.
(b) HSA Rollover Contribution.--Subsection (c) of section 138 of
such Code is amended by adding at the end the following new paragraph:
``(5) Rollover contribution.--An amount is described in
this paragraph as a rollover contribution if it meets the
requirements of subparagraphs (A) and (B).
``(A) In general.--The requirements of this
subparagraph are met in the case of an amount paid or
distributed from a health savings account to the
account beneficiary to the extent the amount received
is paid into a Medicare Advantage MSA of such
beneficiary not later than the 60th day after the day
on which the beneficiary receives the payment or
distribution.
``(B) Limitation.--This paragraph shall not apply
to any amount described in subparagraph (A) received by
an individual from a health savings account if, at any
time during the 1-year period ending on the day of such
receipt, such individual received any other amount
described in subparagraph (A) from a health savings
account which was not includible in the individual's
gross income because of the application of section
223(e)(5)(A).''.
(c) Conforming Amendment.--Subparagraph (A) of section 223(e)(5) of
such Code, as amended by this Act, is amended by inserting ``or
Medicare Advantage MSA'' after ``into a health savings account''.
(d) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2013.
SEC. 106. ONE-TIME TRANSFER OF FLEXIBLE SPENDING ARRANGEMENT BALANCE TO
HEALTH SAVINGS ACCOUNT IN CASE OF SEPARATION FROM
EMPLOYMENT.
(a) In General.--Section 125 of the Internal Revenue Code of 1986
is amended by redesignating subsection (j) as subsection (k) and by
inserting after subsection (i) the following new subsection:
``(j) One-Time Transfer of Remaining Balance in Health Flexible
Spending Arrangement After Separation From Employment.--
``(1) In general.--For purposes of this title, a plan shall
not fail to be treated as a health flexible spending
arrangement solely because a participant may, in connection
with separation from employment with the employer, direct
amounts in the participant's account under such arrangement to
be contributed on behalf of the participant to a health savings
account (as defined in section 223(c)) maintained for the
benefit of the participant.''.
(b) Conforming Amendment.--Section 223(c)(1)(A) of such Code, as
amended by this Act, is amended by striking ``or section 220(f)(5)''
and inserting ``, section 125(j), or section 220(f)(5)''.
(c) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2013.
SEC. 107. PAYMENT OF HIGH DEDUCTIBLE HEALTH PLAN PREMIUMS FROM HSA.
(a) In General.--Subparagraph (B) of section 223(c)(2) of such
Code, as amended by this Act, is amended by inserting ``other than a
high deductible plan (as defined in section 224(b)(2))'' before the
period at the end.
(b) Effective Date.--The amendment made by this section shall apply
to taxable years beginning after December 31, 2013.
SEC. 108. REPEAL OF DISQUALIFICATION OF EXPENSES FOR OVER-THE-COUNTER
DRUGS UNDER CERTAIN ACCOUNTS AND ARRANGEMENTS.
(a) HSAs.--Subparagraph (A) of section 223(c)(2) of the Internal
Revenue Code of 1986, as amended by this Act, is amended by striking
the last sentence.
(b) Archer MSAs.--Subparagraph (A) of section 220(d)(2) of such
Code is amended by striking the last sentence.
(c) Health Flexible Spending Arrangements and Health Reimbursement
Arrangements.--Section 106 of such Code is amended by striking
subsection (f).
(d) Effective Date.--The amendments made by this section shall
apply to expenses incurred after December 31, 2013.
SEC. 109. PAYMENT OF LONG-TERM CARE PREMIUMS FROM HEALTH FLEXIBLE
SPENDING ARRANGEMENT.
(a) In General.--Section 125 of the Internal Revenue Code of 1986,
as amended by this Act, is amended by inserting after subsection (h)
the following new subsection:
``(i) Payment of Long-Term Care Premiums From Health Flexible
Spending Arrangement.--
``(1) In general.--No payment for insurance may be made
from a health flexible spending arrangement.
``(2) Long-term care insurance.--Paragraph (1) shall not
apply to any expense for coverage under a qualified long-term
care insurance contract (as defined in section 7702B(b)).''.
(b) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2013.
SEC. 110. ALLOWING MSA AND HSA ROLLOVER TO ADULT CHILD OF ACCOUNT
HOLDER.
(a) MSAs.--
(1) In general.--Subparagraph (A) of section 220(f)(8) of
the Internal Revenue Code of 1986 (relating to treatment after
death of account holder) is amended--
(A) by inserting ``or adult child'' after
``surviving spouse'',
(B) by inserting ``or adult child, as the case may
be,'' after ``the spouse'', and
(C) by inserting ``or adult child'' after
``spouse'' in the heading thereof.
(2) Adult child defined.--Paragraph (8) of section 220(f)
of such Code is amended by adding at the end the following new
subparagraph:
``(C) Adult child.--For purposes of this paragraph,
the term `adult child' means an individual--
``(i) who is a child of the deceased
individual, and
``(ii) with respect to whom a deduction
under section 151 would not be allowable to
another taxpayer for a taxable year beginning
in the calendar year in which such individual's
taxable year begins.''.
(b) HSAs.--
(1) In general.--Subparagraph (A) of section 223(e)(8) of
such Code, as amended by this Act, is amended--
(A) by inserting ``or adult child'' after
``surviving spouse'',
(B) by inserting ``or adult child, as the case may
be,'' after ``the spouse'', and
(C) by inserting ``or adult child'' after
``spouse'' in the heading thereof.
(2) Adult child defined.--Paragraph (8) of section 223(e)
of such Code, as amended by this Act, is amended by adding at
the end the following new subparagraph:
``(C) Adult child.--For purposes of this paragraph,
the term `adult child' has the meaning given such term
by section 220(f)(8)(C).''.
(c) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2013.
SEC. 111. DISPOSITION OF UNUSED HEALTH BENEFITS IN CAFETERIA PLANS AND
FLEXIBLE SPENDING ARRANGEMENTS.
(a) In General.--Section 125 of the Internal Revenue Code of 1986
is amended by redesignating subsections (k) and (l) as subsections (l)
and (m), respectively, and by inserting after subsection (j) the
following:
``(k) Carryforwards or Payments of Certain Unused Health
Benefits.--
``(1) In general.--For purposes of this title, a plan or
other arrangement shall not fail to be treated as a cafeteria
plan solely because qualified benefits under such plan include
a health flexible spending arrangement under which not more
than $500 of unused health benefits may be--
``(A) carried forward to the succeeding plan year
of such health flexible spending arrangement, or
``(B) paid to or on behalf of an employee as
compensation as of the end of such plan year or upon
the termination of, or failure to re-enroll in, such
plan or arrangement.
``(2) Distribution of unused health benefits on behalf of
employee.--For purposes of paragraph (1)(B), unused health
benefits paid as compensation on behalf of an employee by the
employer shall be--
``(A) includible in gross income and wages of the
employee, whether or not a deduction for such payment
is allowable under this title to the employee, and
``(B) excludable from--
``(i) gross income to the extent provided
under section 402(e), 457(a) (with respect to
contributions to an eligible deferred
compensation plan (as defined in section
457(b)) of an eligible employer described in
section 457(e)(1)(A)), or 220, and
``(ii) wages to the extent otherwise
provided for amounts so excludable.
``(3) Unused health benefits.--For purposes of this
subsection, the term `unused health benefits' means the excess
of--
``(A) the maximum amount of reimbursement allowable
during a plan year under a health flexible spending
arrangement, over
``(B) the actual amount of reimbursement during
such year under such arrangement.''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to taxable years beginning after December 31, 2013.
SEC. 112. PERMITTING BENEFICIARY CONTRIBUTIONS TO MEDICARE ADVANTAGE
MSA.
(a) In General.--Subsection (b) of section 138 of such Code is
amended by striking paragraph (2) and by redesignating paragraphs (3)
and (4) as paragraphs (2) and (3), respectively.
(b) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2013.
SEC. 113. CHILD HEALTH SAVINGS ACCOUNT.
(a) In General.--Section 223 of the Internal Revenue Code of 1986,
as amended by this Act, is amended by adding at the end the following
new subsection:
``(h) Child Health Savings Accounts.--
``(1) In general.--In the case of an individual, in
addition to any deduction allowed under subsection (a) for any
taxable year, there shall be allowed as a deduction under this
section an amount equal to the aggregate amount paid in cash by
the taxpayer during the taxable year to a child health savings
account of a child of the taxpayer.
``(2) Limitation.--The amount taken into account under
paragraph (1) with respect to each child of the taxpayer for
the taxable year shall not exceed an amount equal to $3,000.
``(3) Child health savings account.--For purposes of this
subsection, the term `child health savings account' means a
health savings account designated as a child health savings
account and established for the benefit of a child of a
taxpayer, but only if--
``(A) such account was established for the benefit
of the child before the child attains the age of 5, and
``(B) under the written governing instrument
creating the trust, no contribution will be accepted to
the extent such contribution, when added to previous
contributions to the trust for the calendar year,
exceeds the dollar amount in effect under paragraph
(2).
``(4) Treatment of account before age 18.--For purposes of
this section, except as otherwise provided in this subsection,
a child health savings account established for the benefit of
the child of a taxpayer shall be treated as a health savings
account of the taxpayer until the child attains the age of 18,
after which such account shall be treated as a health savings
account of the child.
``(5) Distributions.--
``(A) In general.--In the case of a child health
savings account established under this section for the
benefit of a child of a taxpayer--
``(i) Before age 18.--Any amount paid or
distributed out of such account before the
child has attained the age of 18, shall be
included in the gross income of the taxpayer,
and subparagraph (A) of subsection (f) shall
apply (relating to additional tax on
distributions not used for qualified medical
expenses).
``(ii) Age 18 and older.--Any amount paid
or distributed out of such account after the
child has attained the age of 18 may only be
treated as used to pay qualified medical
expenses to the extent such child is not
covered as a dependent under insurance (other
than permitted insurance) of a parent.
``(B) Exceptions for disability or death of
child.--If the child becomes disabled within the
meaning of section 72(m)(7) or dies--
``(i) subparagraph (A) shall not apply to
any subsequent payment or distribution, and
``(ii) the taxpayer may rollover the amount
in such account to an individual retirement
plan of the taxpayer, to any health savings
account of the taxpayer, or to any child health
savings account of any other child of the
taxpayer.
``(C) Health insurance may be purchased from
account.--Subparagraph (B) of subsection (d)(2) shall
not apply to any health savings account originally
established as a child health savings account.
``(6) Regulations.--The Secretary shall prescribe such
regulations as may be necessary to carry out the purposes of
this subsection, including rules for determining application of
this subsection in the case of legal guardians and in the case
of parents of a child who file separately, are separated, or
are not married.''.
(b) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2013.
TITLE II--HEALTH INSURANCE PROVISIONS
SEC. 201. COOPERATIVE GOVERNING OF INDIVIDUAL AND GROUP HEALTH
INSURANCE COVERAGE.
(a) In General.--Title XXVII of the Public Health Service Act (42
U.S.C. 300gg et seq.) is amended by adding at the end the following new
part:
``PART D--COOPERATIVE GOVERNING OF INDIVIDUAL AND GROUP HEALTH
INSURANCE COVERAGE
``SEC. 2795. DEFINITIONS.
``In this part:
``(1) Primary state.--The term `primary State' means, with
respect to individual or group health insurance coverage
offered by a health insurance issuer, the State designated by
the issuer as the State whose covered laws shall govern the
health insurance issuer in the sale of such coverage under this
part. An issuer, with respect to a particular policy, may only
designate one such State as its primary State with respect to
all such coverage it offers. Such an issuer may not change the
designated primary State with respect to individual or group
health insurance coverage once the policy is issued, except
that such a change may be made upon renewal of the policy. With
respect to such designated State, the issuer is deemed to be
doing business in that State.
``(2) Secondary state.--The term `secondary State' means,
with respect to individual or group health insurance coverage
offered by a health insurance issuer, any State that is not the
primary State. In the case of a health insurance issuer that is
selling a policy in, or to a resident of, a secondary State,
the issuer is deemed to be doing business in that secondary
State.
``(3) Health insurance issuer.--The term `health insurance
issuer' has the meaning given such term in section 2791(b)(2),
except that such an issuer must be licensed in the primary
State and be qualified to sell individual health insurance
coverage in that State.
``(4) Individual health insurance coverage.--The term
`individual health insurance coverage' means health insurance
coverage offered in the individual market, as defined in
section 2791(e)(1).
``(5) Group health insurance coverage.--The term `group
health insurance coverage' has the meaning given such term in
2791(b)(4).
``(6) Applicable state authority.--The term `applicable
State authority' means, with respect to a health insurance
issuer in a State, the State insurance commissioner or official
or officials designated by the State to enforce the
requirements of this title for the State with respect to the
issuer.
``(7) Hazardous financial condition.--The term `hazardous
financial condition' means that, based on its present or
reasonably anticipated financial condition, a health insurance
issuer is unlikely to be able--
``(A) to meet obligations to policyholders with
respect to known claims and reasonably anticipated
claims; or
``(B) to pay other obligations in the normal course
of business.
``(8) Covered laws.--
``(A) In general.--The term `covered laws' means
the laws, rules, regulations, agreements, and orders
governing the insurance business pertaining to--
``(i) individual or group health insurance
coverage issued by a health insurance issuer;
``(ii) the offer, sale, rating (including
medical underwriting), renewal, and issuance of
individual or group health insurance coverage
to an individual;
``(iii) the provision to an individual in
relation to individual or group health
insurance coverage of health care and insurance
related services;
``(iv) the provision to an individual in
relation to individual or group health
insurance coverage of management, operations,
and investment activities of a health insurance
issuer; and
``(v) the provision to an individual in
relation to individual or group health
insurance coverage of loss control and claims
administration for a health insurance issuer
with respect to liability for which the issuer
provides insurance.
``(B) Exception.--Such term does not include any
law, rule, regulation, agreement, or order governing
the use of care or cost management techniques,
including any requirement related to provider
contracting, network access or adequacy, health care
data collection, or quality assurance.
``(9) State.--The term `State' means the 50 States and
includes the District of Columbia, Puerto Rico, the Virgin
Islands, Guam, American Samoa, and the Northern Mariana
Islands.
``(10) Unfair claims settlement practices.--The term
`unfair claims settlement practices' means only the following
practices:
``(A) Knowingly misrepresenting to claimants and
insured individuals relevant facts or policy provisions
relating to coverage at issue.
``(B) Failing to acknowledge with reasonable
promptness pertinent communications with respect to
claims arising under policies.
``(C) Failing to adopt and implement reasonable
standards for the prompt investigation and settlement
of claims arising under policies.
``(D) Failing to effectuate prompt, fair, and
equitable settlement of claims submitted in which
liability has become reasonably clear.
``(E) Refusing to pay claims without conducting a
reasonable investigation.
``(F) Failing to affirm or deny coverage of claims
within a reasonable period of time after having
completed an investigation related to those claims.
``(G) A pattern or practice of compelling insured
individuals or their beneficiaries to institute suits
to recover amounts due under its policies by offering
substantially less than the amounts ultimately
recovered in suits brought by them.
``(H) A pattern or practice of attempting to settle
or settling claims for less than the amount that a
reasonable person would believe the insured individual
or his or her beneficiary was entitled by reference to
written or printed advertising material accompanying or
made part of an application.
``(I) Attempting to settle or settling claims on
the basis of an application that was materially altered
without notice to, or knowledge or consent of, the
insured.
``(J) Failing to provide forms necessary to present
claims within 15 calendar days of a request with
reasonable explanations regarding their use.
``(K) Attempting to cancel a policy in less time
than that prescribed in the policy or by the law of the
primary State.
``(11) Fraud and abuse.--The term `fraud and abuse' means
an act or omission committed by a person who, knowingly and
with intent to defraud, commits, or conceals any material
information concerning, one or more of the following:
``(A) Presenting, causing to be presented or
preparing with knowledge or belief that it will be
presented to or by an insurer, a reinsurer, broker or
its agent, false information as part of, in support of
or concerning a fact material to one or more of the
following:
``(i) An application for the issuance or
renewal of an insurance policy or reinsurance
contract.
``(ii) The rating of an insurance policy or
reinsurance contract.
``(iii) A claim for payment or benefit
pursuant to an insurance policy or reinsurance
contract.
``(iv) Premiums paid on an insurance policy
or reinsurance contract.
``(v) Payments made in accordance with the
terms of an insurance policy or reinsurance
contract.
``(vi) A document filed with the
commissioner or the chief insurance regulatory
official of another jurisdiction.
``(vii) The financial condition of an
insurer or reinsurer.
``(viii) The formation, acquisition,
merger, reconsolidation, dissolution or
withdrawal from one or more lines of insurance
or reinsurance in all or part of a State by an
insurer or reinsurer.
``(ix) The issuance of written evidence of
insurance.
``(x) The reinstatement of an insurance
policy.
``(B) Solicitation or acceptance of new or renewal
insurance risks on behalf of an insurer reinsurer or
other person engaged in the business of insurance by a
person who knows or should know that the insurer or
other person responsible for the risk is insolvent at
the time of the transaction.
``(C) Transaction of the business of insurance in
violation of laws requiring a license, certificate of
authority or other legal authority for the transaction
of the business of insurance.
``(D) Attempt to commit, aiding or abetting in the
commission of, or conspiracy to commit the acts or
omissions specified in this paragraph.
``SEC. 2796. APPLICATION OF LAW.
``(a) In General.--The covered laws of the primary State shall
apply to individual and group health insurance coverage offered by a
health insurance issuer in the primary State and in any secondary
State, but only if the coverage and issuer comply with the conditions
of this section with respect to the offering of coverage in any
secondary State and only if the covered laws of the primary State--
``(1) do not apply any age limitations with respect to who
may purchase such coverage that is a high deductible health
plan; and
``(2) do not require such coverage that is a high
deductible health plan to provide for any specific type of
coverage.
``(b) Exemptions From Covered Laws in a Secondary State.--Except as
provided in this section, a health insurance issuer with respect to its
offer, sale, rating (including medical underwriting), renewal, and
issuance of individual or group health insurance coverage in any
secondary State is exempt from any covered laws of the secondary State
(and any rules, regulations, agreements, or orders sought or issued by
such State under or related to such covered laws) to the extent that
such laws would--
``(1) make unlawful, or regulate, directly or indirectly,
the operation of the health insurance issuer operating in the
secondary State, except that any secondary State may require
such an issuer--
``(A) to pay, on a nondiscriminatory basis,
applicable premium and other taxes (including high risk
pool assessments) which are levied on insurers and
surplus lines insurers, brokers, or policyholders under
the laws of the State;
``(B) to register with and designate the State
insurance commissioner as its agent solely for the
purpose of receiving service of legal documents or
process;
``(C) to submit to an examination of its financial
condition by the State insurance commissioner in any
State in which the issuer is doing business to
determine the issuer's financial condition, if--
``(i) the State insurance commissioner of
the primary State has not done an examination
within the period recommended by the National
Association of Insurance Commissioners; and
``(ii) any such examination is conducted in
accordance with the examiners' handbook of the
National Association of Insurance Commissioners
and is coordinated to avoid unjustified
duplication and unjustified repetition;
``(D) to comply with a lawful order issued--
``(i) in a delinquency proceeding commenced
by the State insurance commissioner if there
has been a finding of financial impairment
under subparagraph (C); or
``(ii) in a voluntary dissolution
proceeding;
``(E) to comply with an injunction issued by a
court of competent jurisdiction, upon a petition by the
State insurance commissioner alleging that the issuer
is in hazardous financial condition;
``(F) to participate, on a nondiscriminatory basis,
in any insurance insolvency guaranty association or
similar association to which a health insurance issuer
in the State is required to belong;
``(G) to comply with any State law regarding fraud
and abuse (as defined in section 2795(10)), except that
if the State seeks an injunction regarding the conduct
described in this subparagraph, such injunction must be
obtained from a court of competent jurisdiction;
``(H) to comply with any State law regarding unfair
claims settlement practices (as defined in section
2795(9)); or
``(I) to comply with the applicable requirements
for independent review under section 2798 with respect
to coverage offered in the State;
``(2) require any individual or group health insurance
coverage issued by the issuer to be countersigned by an
insurance agent or broker residing in that secondary State;
``(3) apply any age limitations with respect to who may
purchase such coverage that is a high deductible health plan;
``(4) require such coverage that is a high deductible
health plan to provide for any specific type of coverage; or
``(5) otherwise discriminate against the issuer issuing
insurance in both the primary State and in any secondary State.
``(c) Clear and Conspicuous Disclosure.--A health insurance issuer
shall provide the following notice, in 12-point bold type, in any
insurance coverage offered in a secondary State under this part by such
a health insurance issuer and at renewal of the policy, with the 5
blank spaces therein being appropriately filled with the name of the
health insurance issuer, the name of primary State, the name of the
secondary State, the name of the secondary State, and the name of the
secondary State, respectively, for the coverage concerned: `Notice:
This policy is issued by ____ and is governed by the laws and
regulations of the State of ____, and it has met all the laws of that
State as determined by that State's Department of Insurance. This
policy may be less expensive than others because it is not subject to
all of the insurance laws and regulations of the State of _____,
including coverage of some services or benefits mandated by the law of
the State of _____. Additionally, this policy is not subject to all of
the consumer protection laws or restrictions on rate changes of the
State of _____. As with all insurance products, before purchasing this
policy, you should carefully review the policy and determine what
health care services the policy covers and what benefits it provides,
including any exclusions, limitations, or conditions for such services
or benefits.'.
``(d) Prohibition on Certain Reclassifications and Premium
Increases.--
``(1) In general.--For purposes of this section, a health
insurance issuer that provides individual or group health
insurance coverage to an individual under this part in a
primary or secondary State may not upon renewal--
``(A) move or reclassify the individual insured
under the health insurance coverage from the class such
individual is in at the time of issue of the contract
based on the health status-related factors of the
individual; or
``(B) increase the premiums assessed the individual
for such coverage based on a health status-related
factor or change of a health status-related factor or
the past or prospective claim experience of the insured
individual.
``(2) Construction.--Nothing in paragraph (1) shall be
construed to prohibit a health insurance issuer--
``(A) from terminating or discontinuing coverage or
a class of coverage in accordance with subsections (b)
and (c) of section 2742;
``(B) from raising premium rates for all
policyholders within a class based on claims
experience;
``(C) from changing premiums or offering discounted
premiums to individuals who engage in wellness
activities at intervals prescribed by the issuer, if
such premium changes or incentives--
``(i) are disclosed to the consumer in the
insurance contract;
``(ii) are based on specific wellness
activities that are not applicable to all
individuals; and
``(iii) are not obtainable by all
individuals to whom coverage is offered;
``(D) from reinstating lapsed coverage; or
``(E) from retroactively adjusting the rates
charged an insured individual if the initial rates were
set based on material misrepresentation by the
individual at the time of issue.
``(e) Prior Offering of Policy in Primary State.--A health
insurance issuer may not offer for sale individual or group health
insurance coverage in a secondary State unless that coverage is
currently offered for sale in the primary State.
``(f) Licensing of Agents or Brokers for Health Insurance
Issuers.--Any State may require that a person acting, or offering to
act, as an agent or broker for a health insurance issuer with respect
to the offering of individual or group health insurance coverage obtain
a license from that State, with commissions or other compensation
subject to the provisions of the laws of that State, except that a
State may not impose any qualification or requirement which
discriminates against a nonresident agent or broker.
``(g) Documents for Submission to State Insurance Commissioner.--
Each health insurance issuer issuing individual or group health
insurance coverage in both primary and secondary States shall submit--
``(1) to the insurance commissioner of each State in which
it intends to offer such coverage, before it may offer
individual or group health insurance coverage in such State--
``(A) a copy of the plan of operation or
feasibility study or any similar statement of the
policy being offered and its coverage (which shall
include the name of its primary State and its principal
place of business);
``(B) written notice of any change in its
designation of its primary State; and
``(C) written notice from the issuer of the
issuer's compliance with all the laws of the primary
State; and
``(2) to the insurance commissioner of each secondary State
in which it offers individual or group health insurance
coverage, a copy of the issuer's quarterly financial statement
submitted to the primary State, which statement shall be
certified by an independent public accountant and contain a
statement of opinion on loss and loss adjustment expense
reserves made by--
``(A) a member of the American Academy of
Actuaries; or
``(B) a qualified loss reserve specialist.
``(h) Power of Courts To Enjoin Conduct.--Nothing in this section
shall be construed to affect the authority of any Federal or State
court to enjoin--
``(1) the solicitation or sale of individual or group
health insurance coverage by a health insurance issuer to any
person or group who is not eligible for such insurance; or
``(2) the solicitation or sale of individual or group
health insurance coverage that violates the requirements of the
law of a secondary State which are described in subparagraphs
(A) through (H) of section 2796(b)(1).
``(i) Power of Secondary States To Take Administrative Action.--
Nothing in this section shall be construed to affect the authority of
any State to enjoin conduct in violation of that State's laws described
in section 2796(b)(1).
``(j) State Powers To Enforce State Laws.--
``(1) In general.--Subject to the provisions of subsection
(b)(1)(G) (relating to injunctions) and paragraph (2), nothing
in this section shall be construed to affect the authority of
any State to make use of any of its powers to enforce the laws
of such State with respect to which a health insurance issuer
is not exempt under subsection (b).
``(2) Courts of competent jurisdiction.--If a State seeks
an injunction regarding the conduct described in paragraphs (1)
and (2) of subsection (h), such injunction must be obtained
from a Federal or State court of competent jurisdiction.
``(k) States' Authority To Sue.--Nothing in this section shall
affect the authority of any State to bring action in any Federal or
State court.
``(l) Generally Applicable Laws.--Nothing in this section shall be
construed to affect the applicability of State laws generally
applicable to persons or corporations.
``(m) Guaranteed Availability of Coverage to HIPAA Eligible
Individuals.--To the extent that a health insurance issuer is offering
coverage in a primary State that does not accommodate residents of
secondary States or does not provide a working mechanism for residents
of a secondary State, and the issuer is offering coverage under this
part in such secondary State which has not adopted a qualified high
risk pool as its acceptable alternative mechanism (as defined in
section 2744(c)(2)), the issuer shall, with respect to any individual
or group health insurance coverage offered in a secondary State under
this part, comply with the guaranteed availability requirements for
eligible individuals in section 2741.
``(n) No Mandated Benefit Coverage Requirements.--Notwithstanding
any other provision of law, a health insurance issuer offering
individual or group health insurance coverage in a primary State and in
any secondary State in accordance with this part (and any coverage so
offered) shall not be subject to any Federal law that would otherwise--
``(1) apply any age limitations with respect to who may
purchase such coverage that is a high deductible health plan;
or
``(2) require such coverage that is a high deductible
health plan to provide for any specific type of coverage.
``SEC. 2797. PRIMARY STATE MUST MEET FEDERAL FLOOR BEFORE ISSUER MAY
SELL INTO SECONDARY STATES.
``A health insurance issuer may not offer, sell, or issue
individual or group health insurance coverage in a secondary State if
the State insurance commissioner does not use a risk-based capital
formula for the determination of capital and surplus requirements for
all health insurance issuers.
``SEC. 2798. INDEPENDENT EXTERNAL APPEALS PROCEDURES.
``(a) Right to External Appeal.--A health insurance issuer may not
offer, sell, or issue individual or group health insurance coverage in
a secondary State under the provisions of this title unless--
``(1) both the secondary State and the primary State have
legislation or regulations in place establishing an independent
review process for individuals who are covered by individual
health insurance coverage or group health insurance offered by
a health insurance issuer, respectively, or
``(2) in any case in which the requirements of subparagraph
(A) are not met with respect to the either of such States, the
issuer provides an independent review mechanism substantially
identical (as determined by the applicable State authority of
such State) to that prescribed in the `Health Carrier External
Review Model Act' of the National Association of Insurance
Commissioners for all individuals who purchase insurance
coverage under the terms of this part, except that, under such
mechanism, the review is conducted by an independent medical
reviewer, or a panel of such reviewers, with respect to whom
the requirements of subsection (b) are met.
``(b) Qualifications of Independent Medical Reviewers.--In the case
of any independent review mechanism referred to in subsection (a)(2):
``(1) In general.--In referring a denial of a claim to an
independent medical reviewer, or to any panel of such
reviewers, to conduct independent medical review, the issuer
shall ensure that--
``(A) each independent medical reviewer meets the
qualifications described in paragraphs (2) and (3);
``(B) with respect to each review, each reviewer
meets the requirements of paragraph (4) and the
reviewer, or at least 1 reviewer on the panel, meets
the requirements described in paragraph (5); and
``(C) compensation provided by the issuer to each
reviewer is consistent with paragraph (6).
``(2) Licensure and expertise.--Each independent medical
reviewer shall be a physician (allopathic or osteopathic) or
health care professional who--
``(A) is appropriately credentialed or licensed in
1 or more States to deliver health care services; and
``(B) typically treats the condition, makes the
diagnosis, or provides the type of treatment under
review.
``(3) Independence.--
``(A) In general.--Subject to subparagraph (B),
each independent medical reviewer in a case shall--
``(i) not be a related party (as defined in
paragraph (7));
``(ii) not have a material familial,
financial, or professional relationship with
such a party; and
``(iii) not otherwise have a conflict of
interest with such a party (as determined under
regulations).
``(B) Exception.--Nothing in subparagraph (A) shall
be construed to--
``(i) prohibit an individual, solely on the
basis of affiliation with the issuer, from
serving as an independent medical reviewer if--
``(I) a non-affiliated individual
is not reasonably available;
``(II) the affiliated individual is
not involved in the provision of items
or services in the case under review;
``(III) the fact of such an
affiliation is disclosed to the issuer
and the enrollee (or authorized
representative) and neither party
objects; and
``(IV) the affiliated individual is
not an employee of the issuer and does
not provide services exclusively or
primarily to or on behalf of the
issuer;
``(ii) prohibit an individual who has staff
privileges at the institution where the
treatment involved takes place from serving as
an independent medical reviewer merely on the
basis of such affiliation if the affiliation is
disclosed to the issuer and the enrollee (or
authorized representative), and neither party
objects; or
``(iii) prohibit receipt of compensation by
an independent medical reviewer from an entity
if the compensation is provided consistent with
paragraph (6).
``(4) Practicing health care professional in same field.--
``(A) In general.--In a case involving treatment,
or the provision of items or services--
``(i) by a physician, a reviewer shall be a
practicing physician (allopathic or
osteopathic) of the same or similar specialty,
as a physician who, acting within the
appropriate scope of practice within the State
in which the service is provided or rendered,
typically treats the condition, makes the
diagnosis, or provides the type of treatment
under review; or
``(ii) by a non-physician health care
professional, the reviewer, or at least 1
member of the review panel, shall be a
practicing non-physician health care
professional of the same or similar specialty
as the non-physician health care professional
who, acting within the appropriate scope of
practice within the State in which the service
is provided or rendered, typically treats the
condition, makes the diagnosis, or provides the
type of treatment under review.
``(B) Practicing defined.--For purposes of this
paragraph, the term `practicing' means, with respect to
an individual who is a physician or other health care
professional, that the individual provides health care
services to individual patients on average at least 2
days per week.
``(5) Pediatric expertise.--In the case of an external
review relating to a child, a reviewer shall have expertise
under paragraph (2) in pediatrics.
``(6) Limitations on reviewer compensation.--Compensation
provided by the issuer to an independent medical reviewer in
connection with a review under this section shall--
``(A) not exceed a reasonable level; and
``(B) not be contingent on the decision rendered by
the reviewer.
``(7) Related party defined.--For purposes of this section,
the term `related party' means, with respect to a denial of a
claim under a coverage relating to an enrollee, any of the
following:
``(A) The issuer involved, or any fiduciary,
officer, director, or employee of the issuer.
``(B) The enrollee (or authorized representative).
``(C) The health care professional that provides
the items or services involved in the denial.
``(D) The institution at which the items or
services (or treatment) involved in the denial are
provided.
``(E) The manufacturer of any drug or other item
that is included in the items or services involved in
the denial.
``(F) Any other party determined under any
regulations to have a substantial interest in the
denial involved.
``(8) Definitions.--For purposes of this subsection:
``(A) Enrollee.--The term `enrollee' means, with
respect to health insurance coverage offered by a
health insurance issuer, an individual enrolled with
the issuer to receive such coverage.
``(B) Health care professional.--The term `health
care professional' means an individual who is licensed,
accredited, or certified under State law to provide
specified health care services and who is operating
within the scope of such licensure, accreditation, or
certification.
``SEC. 2799. ENFORCEMENT.
``(a) In General.--Subject to subsection (b), with respect to
specific individual or group health insurance coverage the primary
State for such coverage has sole jurisdiction to enforce the primary
State's covered laws in the primary State and any secondary State.
``(b) Secondary State's Authority.--Nothing in subsection (a) shall
be construed to affect the authority of a secondary State to enforce
its laws as set forth in the exception specified in section 2796(b)(1).
``(c) Court Interpretation.--In reviewing action initiated by the
applicable secondary State authority, the court of competent
jurisdiction shall apply the covered laws of the primary State.
``(d) Notice of Compliance Failure.--In the case of individual
health insurance coverage offered in a secondary State, or group health
insurance coverage offered by a health insurance issuer in a secondary
State, that fails to comply with the covered laws of the primary State,
the applicable State authority of the secondary State may notify the
applicable State authority of the primary State.''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to health insurance coverage offered, issued, or sold after the
date that is one year after the date of the enactment of this Act.
(c) GAO Ongoing Study and Reports.--
(1) Study.--The Comptroller General of the United States
shall conduct an ongoing study concerning the effect of the
amendment made by subsection (a) on--
(A) the number of uninsured and under-insured;
(B) the availability and cost of health insurance
policies for individuals with pre-existing medical
conditions;
(C) the availability and cost of health insurance
policies generally;
(D) the elimination or reduction of different types
of benefits under health insurance policies offered in
different States; and
(E) cases of fraud or abuse relating to health
insurance coverage offered under such amendment and the
resolution of such cases.
(2) Annual reports.--The Comptroller General shall submit
to Congress an annual report, after the end of each of the 5
years following the effective date of the amendment made by
subsection (a), on the ongoing study conducted under paragraph
(1).
SEC. 202. REAUTHORIZATION OF THE PREEXISTING CONDITION INSURANCE PLAN
(PCIP) PROGRAM.
(a) In General.--The PCIP program is hereby reauthorized through
December 31, 2016, and shall continue in effect subject to the
provisions of this section.
(b) Elimination of Requirement for Noncoverage for 6 Months To Be
Eligible Individual.--The condition under paragraph (2) of section
1101(d) of the Patient Protection and Affordable Care Act (42 U.S.C.
18001(d)) shall not apply to the reauthorized PCIP program.
(c) Funding.--
(1) Initial funding.--Initial funding for the reauthorized
PCIP program shall be derived from the following:
(A) Funding that was available in the Patient-
Centered Outcomes Research Institute Trust Fund under
section 9511 of the Internal Revenue Code of 1986 on
the day before the date of the enactment of this Act.
(B) Any unobligated funds in the Prevention and
Public Health Fund (under section 4002 of Public Law
111-148, 42 U.S.C. 300u-11) attributable to fiscal year
2013 as of the day before the date of the enactment of
this Act.
(2) Subsequent funding.--Subsequent funding for the
reauthorized PCIP program shall be derived from any funds that
would otherwise be made available to such Prevention and Public
Health Fund for fiscal years 2014 through 2016.
(3) Transfer.--Funding under the previous paragraphs shall
be transferred to an account within the Department of Health
and Human Services that provided funding, as of the day before
the date of the enactment of this Act, to carry out the PCIP
program.
(d) Definitions.--In this section:
(1) The term ``PCIP program'' means the Preexisting
Condition Insurance Plan (PCIP) Program established as of the
day before the date of the enactment of this Act under section
1101 of Public Law 111-148 (42 U.S.C. 18001).
(2) The term ``reauthorized PCIP program'' means the PCIP
program as reauthorized under this section.
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