1. Short title
This Act may be cited as the “Streamlining Verification for Americans Act”.
Streamlining Verification for Americans Act
A BILL
To reform the verification and reporting processes for the health care premium and cost-sharing subsidies.
2. Findings
Congress finds the following:
Employer reporting requirements under the Patient Protection and Affordable Care Act (Public Law 111–148) should strike the appropriate balance between sufficient reporting to enforce the law and protecting the privacy of individuals.
Protection of the privacy of the primary insured individual and each other individual covered under the policy, which should include minimizing the transmittal of social security numbers, should be a priority when implementing reporting requirements.
3. Improving the accuracy of exchange determinations of eligibility for premium assistance tax credits
In general— If an employer provides prospective reporting for any calendar year under subsection (b), such employer shall be treated as making the return described in section 6056(b) of the Internal Revenue Code of 1986 for such year if such return contains, consistent with the requirements of subsection (c)(2), only information with respect to employees with respect to whom the employer has received a notification under section 1411(e)(4)(B)(iii) of the Patient Protection and Affordable Care Act (42 U.S.C. 18081(e)(4)(B)(iii)). If the preceding sentence applies to any employer for any calendar year, such employer shall be treated as furnishing the statements required under section 6056(c) of such Code, if the employer furnishes such statements to such employees with respect to the information included in the return made under the preceding sentence.
Prospective reporting— Not later than 60 days after the date of the enactment of this Act, the Secretary of the Treasury, in consultation with the Secretary of Health and Human Services, the Secretary of Labor, and the Administrator of the Small Business Administration, shall implement a reporting system under which an employer may elect to provide the following information with respect to a calendar year before the beginning of such year:
The name, date, and employer identification number of the employer.
A certification as to whether the employer offers to its full-time employees the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan (as defined in section 5000A(f)(2) of the Internal Revenue Code of 1986) and whether the employer offers the spouses of such full-time employees the opportunity to enroll in such coverage.
The months during the year for which coverage is generally available to full-time employees.
A certification as to whether the coverage described in paragraph (2) satisfies the requirements to qualify for one of the affordability safe harbors promulgated by the Secretary of the Treasury for purposes of section 4980H of the Internal Revenue Code of 1986.
A certification as to whether an employee’s effective date of coverage is generally affected by a waiting period.
Requirements— The reporting system established under subsection (b) shall provide for—
the processes necessary to ensure that Exchanges can access the information described in subsection (b) to assist in verifying eligibility determinations for advance payment of the premium tax credits under section 36B of the Internal Revenue Code of 1986 and the cost-sharing subsidies under section 1402 of the Patient Protection and Affordable Care Act (42 U.S.C. 18071); and
guidance on how employers who voluntarily report in advance under this section could satisfy the report and statement requirements under subsections (b) and (c) of section 6056 of the Internal Revenue Code of 1986 by reporting only with respect to employees with respect to whom the employer has received a notification under section 1411(e)(4)(B)(iii) of the Patient Protection and Affordable Care Act (42 U.S.C. 18081(e)(4)(B)(iii)).
4. Use of current year information in determining subsidy eligibility of applicants
In general— Section 1412(b)(2) of the Patient Protection and Affordable Care Act (42 U.S.C. 18082(b)(2)) is amended to read as follows:
“(2) Changes in circumstances—The Secretary shall provide procedures for making advance determinations on the basis of information other than that described in paragraph (1)(B) upon the request of the individual. Such procedures shall include allowing an individual to have eligibility determined on the basis of household income for a later period or on the basis of the individual’s estimate of such income for the taxable year.”
Conforming amendment— Section 1411(b)(3)(B) of the Patient Protection and Affordable Care Act (42 U.S.C. 18081(b)(3)(B)) is amended to read as follows:
“(B) Changes in circumstance—In the case of an individual with respect to whom section 1412(b)(2) applies, the information described in such section.”
5. Evaluating the development and utilization of systems for exchanges to notify employers of potential excise tax liability under the employer mandate
Not later than 90 days after the date of the enactment of this Act, the Comptroller General of the United States shall conduct a study evaluating, with respect to the period beginning on October 1, 2013, and ending on the date of the enactment of this Act—
the notification of employers by Exchanges established under title I of the Patient Protection and Affordable Care Act that a full-time employee has been determined eligible for an advanced premium assistance tax credit, as required by subsection (e)(4)(B)(iii) of section 1411 of such Act (42 U.S.C. 18081); and
the extent to which the Secretary of Health and Human Services has established a separate appeals process for employers who have been notified that an employee has been determined eligible for an advanced premium assistance tax credit to challenge that eligibility determination, as required by subsection (f)(2) of such section.
6. Protecting dependent privacy
In general— Paragraph (1) of section 6055(b) of the Internal Revenue Code of 1986 is amended by adding at the end the following flush sentence:
Effective date— The amendment made by this section shall apply to returns the due date for which is after December 31, 2013.
7. Electronic statements
Statements from employers— Subsection (c) of section 6056 of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph:
“(3) Electronic delivery—The statement required to be furnished to any employee under paragraph (1) may be furnished to such employee electronically if such employee has consented to receive such statement electronically. For purposes of the preceding sentence, if an employee has consented, before the date of the enactment of this paragraph, to electronically receive, from the person furnishing such statement, other documents used in filing the employee’s return of tax, such employee shall be treated as having consented to receive such statement electronically unless such employee requests that such consent not apply to such statement.”
Statements from insurance providers— Subsection (c) of section 6055 of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph:
“(3) Electronic delivery—The statement required to be furnished to any individual under paragraph (1) may be furnished to such individual electronically if such individual has consented to receive such statement electronically. For purposes of the preceding sentence, if an individual has consented, before the date of the enactment of this paragraph, to electronically receive, from the person furnishing such statement, other documents containing private health information, such individual shall be treated as having consented to receive such statement electronically unless such individual requests that such consent not apply to such statement.”
Effective date— The amendments made by this section shall apply to statements the due date for which is after December 31, 2013.
8. Delaying provision of ACA premium and cost-sharing subsidies until eligibility verification process for such subsidies is complete
In general— Notwithstanding any other provision of law, no premium tax credit under section 36B of the Internal Revenue Code of 1986 or reduced cost-sharing under section 1402 of the Patient Protection and Affordable Care Act (42 U.S.C. 18071) shall be allowed with respect to any individual for any coverage month which begins after December 31, 2014, and before the date on which the process to verify, in accordance with section 1411 of the Patient Protection and Affordable Care Act (42 U.S.C. 18081), the estimated household income and coverage requirements of such individual for purposes of determining eligibility for, and the accurate amount of, such credit or reduction, respectively, has been completed. For purposes of the previous sentence, the verification process described in such sentence with respect to an individual shall not be treated as complete unless a manual or electronic review has been completed of applicable information required to be submitted by such individual under section 1411(b) of such Act (42 U.S.C. 18081(b)) and any inconsistency of such information with records of the Secretary of the Treasury, the Secretary of Homeland Security, or the Commissioner of Social Security has been resolved.
Treatment of individual mandate— Notwithstanding any other provision of law, no penalty shall be imposed under section 5000A of the Internal Revenue Code of 1986 with respect to an individual for any month—
with respect to which such individual would (but for subsection (a)) be allowed a premium tax credit under section 36B of the Internal Revenue Code of 1986; and
which begins after December 31, 2014, and before the date on which the verification process described in subsection (a) has been completed, in accordance with such subsection, with respect to the eligibility of such individual for such credit.