H.R. 6516: To amend the Patient Protection and Affordable Care Act to identify individuals dually enrolled in Medicaid or CHIP and an Exchange.

This bill seeks to amend the Patient Protection and Affordable Care Act (PPACA) to enhance the identification of individuals who are enrolled in both Medicaid or the Children’s Health Insurance Program (CHIP) and a health insurance plan through an Exchange. Specifically, the bill mandates the following actions:

Identification of Dual Enrollments

The bill requires the Secretary of Health and Human Services to create a program that will:

• Compare the enrollment information from each qualified health plan accessed through an Exchange with the data from the Public Assistance Reporting Information System (PARIS), which may be revised in the future.
• This comparison must occur at least once every three months (quarterly).

Purpose of Identification

The main goal of this dual enrollment identification program is to find individuals who are covered by both:

• A qualified health plan through an Exchange, and
• A State Medicaid plan under Title XIX of the Social Security Act, or a State child health plan under Title XXI of the Social Security Act.

Enforcement Measures

Once individuals are identified as being enrolled in both programs, the Secretary is tasked with taking necessary actions to:

• Notify relevant Exchanges and the Secretary of the Treasury about these dual enrollments.
• Ensure that individuals identified under the new program do not receive premium tax credits or cost-sharing reductions that are typically provided under the Internal Revenue Code.

Impact on Individuals

By enforcing these provisions, the bill aims to streamline health insurance coverage and reduce potential overlapping benefits that may be financially unsupported or duplicative.

Relevant Companies

• None found