Sec. 302. Requiring Marketplace outreach, educational activities, and annual enrollment targets

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Section 1321(c) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18041(c) ) is amended by adding at the end the following: In the case of an Exchange established or operated by the Secretary within a State pursuant to this subsection, the Secretary shall carry out outreach and educational activities for purposes of informing individuals about qualified health plans offered through the Exchange, including by informing such individuals of the availability of coverage under such plans and financial assistance for coverage under such plans.

Such outreach and educational activities shall be provided in a manner that is culturally and linguistically appropriate to the needs of the populations being served by the Exchange (including hard-to-reach populations, such as racial and sexual minorities, limited English proficient populations, individuals in rural areas, veterans, and young adults) and shall be provided to populations residing in high health disparity areas (as defined in subparagraph (E)) served by the Exchange, in addition to other populations served by the Exchange.

No funds appropriated under this paragraph shall be used for expenditures for promoting non-ACA compliant health insurance coverage. For purposes of subparagraph (B): The term non-ACA compliant health insurance coverage means— health insurance coverage, or a group health plan, that is not a qualified health plan; and other health care arrangements that are not health plans. Such term includes the following: An association health plan. Short-term limited duration insurance (as defined in section 144.103 of title 45, Code of Federal Regulations (or a successor regulation)).

Out of any funds in the Treasury not otherwise appropriated, there are hereby appropriated for fiscal year 2023 and each subsequent fiscal year, $100,000,000 to carry out this paragraph. Funds appropriated under this subparagraph shall remain available until expended. For purposes of subparagraph (A), the term high health disparity area means a contiguous geographic area that— is located in one census tract or ZIP code; has measurable and documented racial, ethnic, or geographic health disparities; has a low-income population, as demonstrated by— average income below 138 percent of the Federal poverty line; or a rate of participation in the special supplemental nutrition program under section 17 of the Child Nutrition Act of 1966 ( 42 U.S.C. 1786 ) that is higher than the national average rate of participation in such program; has poor health outcomes, as demonstrated by— lower life expectancy than the national average; or a higher percentage of instances of low birth weight than the national average; and is part of a Metropolitan Statistical Area identified by the Office of Management and Budget.

For plan year 2022 and each subsequent plan year, in the case of an Exchange established or operated by the Secretary within a State pursuant to this subsection, the Secretary shall establish annual enrollment targets for such Exchange for such year. . Section 1311 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031 ) is amended by adding at the end the following: The Secretary shall award grants to States that have established an Exchange pursuant to this section, for purposes of assisting such States in conducting open enrollment outreach with respect to qualified health plans.

A State desiring a grant under this subsection shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan demonstrating how the State will use the grant funds to carry out outreach and educational activities consistent with the requirements under section 1321(c)(3). The Secretary shall award grants under this subsection as follows: The Secretary shall award an initial round of grants to each qualifying State in the amount of $1,000,000.

If amounts remain available under this subsection after awards are made under clause (i), the Secretary shall award eligible States that received an award under clause

(i)an amount determined appropriate by the Secretary based on— the State's total population; the percentage of the State's population that is uninsured; the percentage of the State's population that is difficult to insure; and such other factors as the Secretary determines appropriate. With respect to a State receiving a grant under this subsection, the grant funds shall remain available until expended. Subject to clause (iii), as a condition for receiving a grant under this section, a State shall be required to expend non-Federal funds, at minimum, in an amount equal to the lesser of— 25 percent of the amount received under the grant for the purpose described in paragraph (1); or $1,000,000. A State may apply funding allocated to the purpose described in paragraph

(1)prior to receipt of the grant to satisfy the requirement of clause (i). The Secretary may waive the requirement under clause

(i)in response to— a public health emergency or a disaster; or an economic recession or other economic hardship that results in an increase in uninsured individuals. No funds appropriated under this subsection shall be used for expenditures for promoting non-ACA compliant health insurance coverage (as such term is defined in section 1321(c)(3)(C)). Funds received by a State under a grant awarded under this subsection— shall not be taken into consideration by the Secretary when determining whether to award the State a grant under section 2113 of the Social Security Act ( 42 U.S.C. 1397mm ); and may not be used by the State to satisfy the maintenance of effort requirement under subsection

(e)of such section. To carry out this subsection, there are appropriated, out of amounts in the Treasury not otherwise appropriated, $50,000,000 for fiscal year 2023 and each subsequent fiscal year. . Not later than 30 days after the date of the enactment of this Act, the Secretary of Health and Human Services shall release to Congress all aggregated documents relating to studies and data sets that were created on or after January 1, 2014, and related to marketing and outreach with respect to qualified health plans offered through Exchanges under title I of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18001 et seq.).

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Sec. 302

Requiring Marketplace outreach, educational activities, and annual enrollment targets

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