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42 U.S.C. § 18003 — Immediate information that allows consumers to identify affordable coverage options

Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 18003 — Immediate information that allows consumers to identify affordable coverage options

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Source file: Laws/federal/codes/united-states-code/title-42/section-18003-immediate-information-that-allows-consumers-to-identify-affordable-cover--06188f85e7.md
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Source location: Title 42, Chapter 157, § 18003; chapter-157-quality-affordable-health-care-for-all-americans.md

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**(a) Internet portal to affordable coverage options** (1) **Immediate establishment** — Not later than July 1, 2010, the Secretary, in consultation with the States, shall establish a mechanism, including an Internet website, through which a resident of, or small business in, any State may identify affordable health insurance coverage options in that State. (2) **Connecting to affordable coverage** — An Internet website established under paragraph (1) shall, to the extent practicable, provide ways for residents of, and small businesses in, any State to receive information on at least the following coverage options: (A) Health insurance coverage offered by health insurance issuers, other than coverage that provides reimbursement only for the treatment or mitigation of— (i) a single disease or condition; or (ii) an unreasonably limited set of diseases or conditions (as determined by the Secretary). (B) Medicaid coverage under title XIX of the Social Security Act [[42 U.S.C. 1396](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396&num=0&edition=prelim) et seq.]. (C) Coverage under title XXI of the Social Security Act [[42 U.S.C. 1397aa](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397aa&num=0&edition=prelim) et seq.]. (D) A State health benefits high risk pool, to the extent that such high risk pool is offered in such State; and (E) Coverage under a high risk pool under [section 18001 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18001&num=0&edition=prelim). (F) Coverage within the small group market for small businesses and their employees, including reinsurance for early retirees under [section 18002 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section18002&num=0&edition=prelim), tax credits available under [section 45R of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section45R&num=0&edition=prelim) (as added by section 1421), and other information specifically for small businesses regarding affordable health care options. **(b) Enhancing comparative purchasing options** (1) **In general** — Not later than 60 days after March 23, 2010, the Secretary shall develop a standardized format to be used for the presentation of information relating to the coverage options described in subsection (a)(2). Such format shall, at a minimum, require the inclusion of information on the percentage of total premium revenue expended on nonclinical costs (as reported under [section 300gg–18(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300gg–18/a&num=0&edition=prelim)), eligibility, availability, premium rates, and cost sharing with respect to such coverage options and be consistent with the standards adopted for the uniform explanation of coverage as provided for in [section 300gg–15 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300gg-15&num=0&edition=prelim). (2) **Use of format** — The Secretary shall utilize the format developed under paragraph (1) in compiling information concerning coverage options on the Internet website established under subsection (a). **(c) Authority to contract** The Secretary may carry out this section through contracts entered into with qualified entities.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 18001 — Immediate access to insurance for uninsured individuals with a preexisting condition

**(a) In general** Not later than 90 days after March 23, 2010, the Secretary shall establish a temporary high risk health insurance pool program to provide health insurance coverage for eligible individuals during the period beginning on the date on which such program is established and ending on January 1, 2014. **(b) Administration** (1) **In general** — The Secretary may carry out the program under this section directly or through contracts to eligible entities. (2) **Eligible entities** — To be eligible for a contract under paragraph (1), an entity shall— (A) be a State or nonprofit private entity; (B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require; and (C) agree to utilize contract funding to establish and administer a qualified high risk pool for eligible individuals. (3) **Maintenance of effort** — To be eligible to enter into a contract with the Secretary under this subsection, a State shall agree not to reduce the annual amount the State expended for the operation of one or more State high risk pools during the year preceding the year in which such contract is entered into. **(c) Qualified high risk pool** (1) **In general** — Amounts made available under this section shall be used to establish a qualified high risk pool that meets the requirements of paragraph (2). (2) **Requirements** — A qualified high risk pool meets the requirements of this paragraph if such pool— (A) provides to all eligible individuals health insurance coverage that does not impose any preexisting condition exclusion with respect to such coverage; (B) provides health insurance coverage— (i) in which the issuer’s share of the total allowed costs of benefits provided under such co

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1397aa — Purpose; State child health plans

**(a) Purpose** Except with respect to the rural health transformation program established in [section 1397ee(h) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee/h&num=0&edition=prelim), the purpose of this subchapter is to provide funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effective and efficient manner that is coordinated with other sources of health benefits coverage for children. Such assistance shall be provided primarily for obtaining health benefits coverage through— (1) obtaining coverage that meets the requirements of [section 1397cc of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397cc&num=0&edition=prelim), or (2) providing benefits under the State’s medicaid plan under subchapter XIX, or a combination of both. **(b) State child health plan required** A State is not eligible for payment under subsection (a) or (g) of [section 1397ee of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee&num=0&edition=prelim) unless the State has submitted to the Secretary under [section 1397ff of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ff&num=0&edition=prelim) a plan that— (1) sets forth how the State intends to use the funds provided under this subchapter to provide child health assistance to needy children consistent with the provisions of this subchapter, and (2) has been approved under [section 1397ff of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ff&num=0&edition=prelim). **(c) State entitlement** This subchapter constitutes budget authority i

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1397aa

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Federal law — U.S. Code and appendices · legal_authorities

26 U.S.C. § 45R — Employee health insurance expenses of small employers

**(a) General rule** For purposes of section 38, in the case of an eligible small employer, the small employer health insurance credit determined under this section for any taxable year in the credit period is the amount determined under subsection (b). **(b) Health insurance credit amount** Subject to subsection (c), the amount determined under this subsection with respect to any eligible small employer is equal to 50 percent (35 percent in the case of a tax-exempt eligible small employer) of the lesser of— (1) the aggregate amount of nonelective contributions the employer made on behalf of its employees during the taxable year under the arrangement described in subsection (d)(4) for premiums for qualified health plans offered by the employer to its employees through an Exchange, or (2) the aggregate amount of nonelective contributions which the employer would have made during the taxable year under the arrangement if each employee taken into account under paragraph (1) had enrolled in a qualified health plan which had a premium equal to the average premium (as determined by the Secretary of Health and Human Services) for the small group market in the rating area in which the employee enrolls for coverage. **(c) Phaseout of credit amount based on number of employees and average wages** The amount of the credit determined under subsection (b) without regard to this subsection shall be reduced (but not below zero) by the sum of the following amounts: (1) Such amount multiplied by a fraction the numerator of which is the total number of full-time equivalent employees of the employer in excess of 10 and the denominator of which is 15. (2) Such amount multiplied by a fraction the numerator of which is the average annual wages of the employer in excess of the dollar am

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 18002 — Reinsurance for early retirees

**(a) Administration** (1) **In general** — Not later than 90 days after March 23, 2010, the Secretary shall establish a temporary reinsurance program to provide reimbursement to participating employment-based plans for a portion of the cost of providing health insurance coverage to early retirees (and to the eligible spouses, surviving spouses, and dependents of such retirees) during the period beginning on the date on which such program is established and ending on January 1, 2014. (2) **Reference** — In this section: (A) *Health benefits* — The term “health benefits” means medical, surgical, hospital, prescription drug, and such other benefits as shall be determined by the Secretary, whether self-funded, or delivered through the purchase of insurance or otherwise. (B) *Employment-based plan* — The term “employment-based plan” means a group benefits plan providing health benefits that— (i) is— (I) maintained by one or more current or former employers (including without limitation any State or local government or political subdivision thereof or any agency or instrumentality of any of the foregoing), employee organization, a voluntary employees’ beneficiary association, or a committee or board of individuals appointed to administer such plan; or (II) a multiemployer plan (as defined in [section 1002(37) of title 29](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1002/37&num=0&edition=prelim)); and (ii) provides health benefits to early retirees. (C) *Early retirees* — The term “early retirees” means individuals who are age 55 and older but are not eligible for coverage under title XVIII of the Social Security Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 18002

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1396 — Medicaid and CHIP Payment and Access Commission

**(a) Establishment** There is hereby established the Medicaid and CHIP Payment and Access Commission (in this section referred to as “MACPAC”). **(b) Duties** (1) **Review of access policies for all States and annual reports** — MACPAC shall— (A) review policies of the Medicaid program established under this subchapter (in this section referred to as “Medicaid”) and the State Children’s Health Insurance Program established under subchapter XXI (in this section referred to as “CHIP”) affecting access to covered items and services, including topics described in paragraph (2); (B) make recommendations to Congress, the Secretary, and States concerning such access policies; (C) by not later than March 15 of each year (beginning with 2010), submit a report to Congress containing the results of such reviews and MACPAC’s recommendations concerning such policies; and (D) by not later than June 15 of each year (beginning with 2010), submit a report to Congress containing an examination of issues affecting Medicaid and CHIP, including the implications of changes in health care delivery in the United States and in the market for health care services on such programs. (2) **Specific topics to be reviewed** — Specifically, MACPAC shall review and assess the following: (A) *Medicaid and CHIP payment policies* — Payment policies under Medicaid and CHIP, including— (i) the factors affecting expenditures for the efficient provision of items and services in different sectors, including the process for updating payments to medical, dental, and health professionals, hospitals, residential and long-term care providers, providers of home and community based services, Federally-qualified health centers and rural health clinics, managed care entities, and providers of ot

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1305 — Short title of chapter

This chapter may be cited as the “Social Security Act”.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1396 — Medicaid and CHIP Payment and Access

Page 4009 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1396 of the enactment of this Act [Oct. 6, 2014], the Sec- retary shall develop and report to Congress on a stra- tegic plan for collecting or otherwise accessing data on race and ethnicity for purposes of specifying quality measures and resource use and other measures under subsections (c) and (d) of section 1899B of the Social Se- curity Act, as added by subsection (a), and, as the Sec- retary determines appropriate, other similar provisions of, including payment adjustments under, title XVIII of such Act (42 U.S.C. 1395 et seq.).’’ SUBCHAPTER XIX—GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS § 1396. Medicaid and CHIP Payment and Access Commission (a) Establishment There is hereby established the Medicaid and CHIP Payment and Access Commission (in this section referred to as ‘‘MACPAC’’). (b) Duties (1) Review of access policies for all States and annual reports MACPAC shall— (A) review policies of the Medicaid pro- gram established under this subchapter (in this section referred to as ‘‘Medicaid’’) and the State Children’s Health Insurance Pro- gram established under subchapter XXI (in this section referred to as ‘‘CHIP’’) affecting access to covered items and services, includ- ing topics described in paragraph (2); (B) make recommendations to Congress, the Secretary, and States concerning such access policies; (C) by not later than March 15 of each year (beginning with 2010), submit a report to Congress containing the results of such re- views and MACPAC’s recommendations con- cerning such policies; and (D) by not later than June 15 of each year (beginning with 2010), submit a report to Congress containing an examination of issues affecting Medicaid and CHIP, includ- ing the impli

Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1396

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1397aa — Purpose; State child health plans

Page 4452 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1397n–13 (5) Social impact partnership model The term ‘‘social impact partnership model’’ means a method of financing social services in which— (A) Federal funds are awarded to a State or local government only if a State or local government achieves certain outcomes agreed on by the State or local government and the Secretary; and (B) the State or local government coordi- nates with service providers, investors (if ap- plicable to the project), and (if necessary) an intermediary to identify— (i) an intervention expected to produce the outcome; (ii) a service provider to deliver the intervention to the target population; and (iii) investors to fund the delivery of the intervention. (6) State The term ‘‘State’’ means each State of the United States, the District of Columbia, each commonwealth, territory or possession of the United States, and each federally recognized Indian tribe. (Aug. 14, 1935, ch. 531, title XX, § 2063, as added Pub. L. 115–123, div. E, title VIII, § 50802(2), Feb. 9, 2018, 132 Stat. 282.) § 1397n–13. Funding Out of any money in the Treasury of the United States not otherwise appropriated, there is hereby appropriated $100,000,000 for fiscal year 2018 to carry out this division. (Aug. 14, 1935, ch. 531, title XX, § 2064, as added Pub. L. 115–123, div. E, title VIII, § 50802(2), Feb. 9, 2018, 132 Stat. 282.) SUBCHAPTER XXI—STATE CHILDREN’S HEALTH INSURANCE PROGRAM § 1397aa. Purpose; State child health plans (a) Purpose The purpose of this subchapter is to provide funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effec- tive and efficient manner that is coordinated with other so

Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1397aa

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 18003 — Immediate information that allows con-

Page 9091 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 18003 gram under this section. Such funds shall be available without fiscal year limitation. (f) Limitation The Secretary has the authority to stop tak- ing applications for participation in the pro- gram based on the availability of funding under subsection (e). (Pub. L. 111–148, title I, § 1102, title X, § 10102(a), Mar. 23, 2010, 124 Stat. 143, 892.) Editorial Notes REFERENCES IN TEXT The Social Security Act, referred to in subsec. (a)(2)(C), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XVIII of the Act is classified generally to subchapter XVIII (§ 1395 et seq.) of chapter 7 of this title. For com- plete classification of this Act to the Code, see section 1305 of this title and Tables. AMENDMENTS 2010—Subsec. (a)(2)(B). Pub. L. 111–148, § 10102(a)(1), substituted ‘‘group benefits plan providing health bene- fits’’ for ‘‘group health benefits plan’’ in introductory provisions. Subsec. (a)(2)(B)(i)(I). Pub. L. 111–148, § 10102(a)(2), in- serted ‘‘or any agency or instrumentality of any of the foregoing’’ after ‘‘political subdivision thereof’’. § 18003. Immediate information that allows con- sumers to identify affordable coverage op- tions (a) Internet portal to affordable coverage options (1) Immediate establishment Not later than July 1, 2010, the Secretary, in consultation with the States, shall establish a mechanism, including an Internet website, through which a resident of, or small business in, any State may identify affordable health insurance coverage options in that State. (2) Connecting to affordable coverage An Internet website established under para- graph (1) shall, to the extent practicable, pro- vide ways for residents of, and small busi- nesses in, any State to recei

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