Sec. 5. Comprehensive coverage

1,880 words·~9 min read·/bill/118/hr/4303/ih/section-5

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

The Secretary of Health and Human Services shall issue a rule ensuring that all health programs or plans provide consumer-friendly information about abortion coverage provided by health programs or plans. Each person insured by, enrolled in, or otherwise receiving medical care from health programs or plans described in subsection

(c)shall receive coverage of abortion services. Health programs or plans described in section

(c)shall provide coverage of abortion services. The Secretary of Health and Human Services shall issue a rule ensuring that reimbursement rates for such coverage are similar to like care and sufficient to cover the cost of care. The term health program or plan means a public health insurance program or private health insurance plan that provides, or pays the cost of, medical care (as such term is defined in 42 U.S.C. § 300gg–91). Such terms include but are not limited to the following, and any combination thereof: The Medicaid program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ). The Children’s Health Insurance Program under title XXI of the Social Security Act ( 42 U.S.C. 1397 et seq. ). The Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ). A Medicare supplemental policy as defined in section 1882(g)(1) of the Social Security Act ( 42 U.S.C. 1395ss(g)(1) ). The Indian Health Service program under the Indian Health Care Improvement Act ( 25 U.S.C. 1601 et seq. ). Medical care and health benefits under the TRICARE program ( 10 U.S.C. 1071 et seq. ). Benefits for veterans under chapter 17 of title 38, United States Code, and medical care for survivors and dependents of veterans ( 38 U.S.C. 1781 et seq. ). Benefits under the uniform health benefits program for employees of the Department of Defense assigned to a nonappropriated fund instrumentality of the Department established under section 349 of the National Defense Authorization Act for Fiscal Year 1995 ( Public Law 103–337 ; 10 U.S.C. 1587 note). Medical care for individuals in the care or custody of the Department of Homeland Security pursuant to any of section 235, 236, or 241 of the Immigration and Nationality Act ( 8 U.S.C. 1225 , 1226, 1231). Medical care for individuals in the care or custody of the Department of Health and Human Services, Office of Refugee Resettlement under section 235 of the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 ( 8 U.S.C. 1232 ) or section 462 of the Homeland Security Act of 2002 ( 6 U.S.C. 279 ). Medical assistance to refugees under section 412 of the Immigration and Nationality Act ( 8 U.S.C. 1522 ). Other coverage, such as a State health benefits risk pool, as the Secretary of Health and Human Services, in coordination with the Secretary of the Treasury, recognizes for purposes of section 5000A(f)(1)(E) of the Internal Revenue Code of 1986 ( 26 U.S.C. 5000A(f)(1)(E) ). The Federal Employees Health Benefit Plan under chapter 89 of title 5, United States Code. Medical care for individuals under the care or custody of the Department of Justice pursuant to chapter 301 of title 18 ( 18 U.S.C. 4001 et seq. ). Medical care for Peace Corps volunteers under section 5(e) of the Peace Corps Act ( 22 U.S.C. 2504(e) ). Other government-sponsored programs established after the date of the enactment of this Act. Plans in the Federal marketplace or an individual marketplace within a State. Eligible employer-sponsored plan as defined in 26 U.S.C. 5000A(f)(2) . Grandfathered health plan as defined in 42 U.S.C. 18011(e) . A standard health plan established through a State basic health program as defined in 42 U.S.C. 18051 . Other coverage, such as a State health benefits risk pool, as the Secretary of Health and Human Services, in coordination with the Secretary of the Internal Revenue Services, recognizes for purposes of 26 U.S.C. § 5000A(f)(E). Section 1303 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18023 ) is repealed. Section 1903(v)(4) of the Social Security Act ( 42 U.S.C. 1396b(v)(4) ) is amended— by amending subparagraph

(A)to read as follows: Notwithstanding sections 401(a), 402(b), 403, and 421 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, a State shall provide medical assistance under this title, to individuals who are lawfully residing in the United States (including individuals described in paragraph (1), battered individuals described in section 431(c) of such Act, and individuals with an approved or pending application for deferred action or other federally authorized presence), if they otherwise meet the eligibility requirements for medical assistance under the State plan approved under this title (other than the requirement of the receipt of aid or assistance under title IV, supplemental security income benefits under title XVI, or a State supplementary payment). ; by amending subparagraph

(B)to read as follows: No debt shall accrue under an affidavit of support against any sponsor of an individual provided medical assistance under subparagraph

(A)on the basis of provision of assistance to such individual and the cost of such assistance shall not be considered as an unreimbursed cost. ; and in subparagraph (C)— by striking an election by the State under subparagraph

(A)and inserting the application of subparagraph

(A); by inserting or be lawfully present after lawfully reside ; and by inserting or present after lawfully residing each place it appears. Subparagraph

(N)of section 2107(e)(1) of the Social Security Act ( 42 U.S.C. 1397gg(e)(1) ) is amended to read as follows: Paragraph

(4)of section 1903(v) (relating to lawfully present individuals). . Except as provided in subparagraph (A), the amendments made by this subsection shall take effect on the date of enactment of this Act and shall apply to services furnished on or after the date that is 90 days after such date of enactment. In the case of a State plan for medical assistance under title XIX, or a State child health plan under title XXI, of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by this section, the respective State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature. For purposes of eligibility under any of the provisions described in paragraph (2), all individuals granted federally authorized presence in the United States shall be considered to be lawfully present in the United States. The provisions described in this paragraph are the following: Section 1411 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031 ). Section 1402 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18071 ). Section 36B of the Internal Revenue Code of 1986 ( 26 U.S.C. 36B ). Titles XIX and XXI of the Social Security Act, including under section 1903(v) of such Act ( 42 U.S.C. 1396b(v) ). In the case of an individual described in paragraph

(1)who, before the first day of the first annual open enrollment period under subparagraph

(B)of section 1311(c)(6) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(c)(6) ) beginning after the date of enactment of this Act, is granted federally authorized presence in the United States and who, as a result of such subsection, qualifies for a subsidy under a provision described in subparagraph

(B)or

(C)of paragraph (2), the Secretary of Health and Human Services shall establish a special enrollment period under subparagraph

(C)of such section 1311(c)(6) during which such individual may enroll in qualified health plans through Exchanges under title I of the Patient Protection and Affordable Care Act and qualify for such a subsidy. For such an individual who has been granted federally authorized presence in the United States as of the date of enactment of this Act, such special enrollment period shall begin not later than 90 days after such date of enactment. Nothing in this paragraph shall be construed as affecting the authority of the Secretary to establish additional special enrollment periods under such subparagraph (C). — Section 36B of the Internal Revenue Code of 1986 is amended— in subsection (c)(1)(B)— by amending the heading to read as follows: SPECIAL RULE FOR CERTAIN INDIVIDUALS INELIGIBLE FOR MEDICAID DUE TO STATUS ; and by amending clause

(ii)to read as follows: the taxpayer is a noncitizen who is not eligible for the Medicaid program under title XIX of the Social Security Act by reason of the individual’s immigration status, ; and by striking subsection (e). Section 1402 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18071 ) is amended by striking subsection

(e)and redesignating subsection

(f)as subsection (e). Section 1331(e)(1)(B) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18051(e)(1)(B) ) is amended by striking lawfully present in the United States, . Section 1412 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18082 ) is amended by striking subsection

(d)and redesignating subsection

(e)as subsection (d). Subsection

(d)of section 5000A of the Internal Revenue Code of 1986 is amended by striking paragraph

(3)and by redesignating paragraph

(4)as paragraph (3). Section 1411(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18081(a) ) is amended by striking paragraph

(1)and redesignating paragraphs (2), (3), and

(4)as paragraphs (1), (2), and (3), respectively. Section 1312(f) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18032(f) ) is amended— in the heading, by striking ; ACCESS LIMITED TO CITIZENS AND LAWFUL RESIDENTS ; and by striking paragraph (3). The amendments made by this section shall apply to years, plan years, and taxable years, as applicable, beginning after December 31, 2021. Nothing in this Act, including the amendments made by this Act, shall prevent lawfully present noncitizens who are ineligible for full benefits under the Medicaid program under title XIX of the Social Security Act from securing a credit for which such lawfully present noncitizens would be eligible under section 36B(c)(1)(B) of the Internal Revenue Code of 1986 and under the Medicaid provisions for lawfully present noncitizens, as in effect on the date prior to the date of enactment of this Act. For purposes of paragraph (1), the term full benefits means, with respect to an individual and State, medical assistance for all services covered under the State plan under title XIX of the Social Security Act that is not less in amount, duration, or scope, or is determined by the Secretary of Health and Human Services to be substantially equivalent to the medical assistance available for an individual described in section 1902(a)(10)(A)(i) of the Social Security Act ( 42 U.S.C. 1396a(a)(10)(A)(i) ).

Connectionstraces to 25

Traces to 25 documents

U.S. Code