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

#6516 | HR Congress #119

Policy Area: Health
Subjects:

Last Action: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. (12/9/2025)

Bill Text Source: Congress.gov

Summary and Impacts
Original Text

Bill Summary

This legislation proposes an amendment to the Patient Protection and Affordable Care Act (PPACA) aimed at improving the identification of individuals who are dually enrolled in Medicaid or the Children's Health Insurance Program (CHIP) and a health plan offered through an Exchange.

The key provisions include:

1. **Establishment of a Program**: The Secretary of Health and Human Services is required to create a program that will regularly (at least quarterly) compare enrollment information from qualified health plans in the Exchanges with data from state Medicaid and CHIP programs. This comparison will utilize the Public Assistance Reporting Information System (PARIS) or a similar system.

2. **Identification of Dual Enrollments**: The goal of the program is to identify individuals who are receiving benefits from both a qualified health plan and a Medicaid or CHIP plan, thereby ensuring that those individuals are not improperly receiving premium tax credits or cost-sharing reductions intended for those who are not enrolled in other forms of assistance.

3. **Enforcement Measures**: The Secretary will be responsible for taking appropriate actions to notify Exchanges and the Treasury Department about individuals identified under this program, ensuring compliance and preventing overlapping benefits.

Overall, this amendment seeks to enhance the integrity of the health care assistance programs by preventing individuals from receiving financial support for health coverage when they are already covered through Medicaid or CHIP.

Possible Impacts

The legislation described in the bill has implications for individuals who are dually enrolled in Medicaid or the Children's Health Insurance Program (CHIP) and a health plan through an Exchange. Here are three examples of how this could affect people:

1. **Reduction of Financial Aid for Dually Enrolled Individuals**:
The identification of individuals who are dually enrolled means that those found to be receiving both Medicaid/CHIP benefits and premium tax credits or cost-sharing reductions through an Exchange may lose their financial assistance. This could lead to increased out-of-pocket costs for medical services for those individuals, as they may no longer qualify for subsidies that help reduce the cost of their health insurance.

2. **Increased Administrative Oversight**:
The requirement for the Secretary to establish a program for identifying dually enrolled individuals could lead to improved data sharing and oversight. While this may streamline processes and reduce instances of overlapping coverage, it could also create additional administrative burdens for individuals who may need to provide documentation or clarification regarding their eligibility, which can cause confusion and stress.

3. **Impact on Access to Healthcare**:
For individuals who rely on both Medicaid/CHIP and Exchange plans for comprehensive coverage, the potential loss of premium tax credits or cost-sharing reductions could result in reduced access to necessary healthcare services. Individuals may find it financially challenging to maintain their current level of care, leading to potential delays in treatment or avoidance of necessary medical services due to cost concerns. This could adversely affect their overall health and well-being.

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6516 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 6516

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


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            December 9, 2025

 Mr. Burchett introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


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

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. IDENTIFICATION OF DUAL MEDICAID OR CHIP AND EXCHANGE 
              ENROLLMENTS.

    Section 1311(c) of the Patient Protection and Affordable Care Act 
(42 U.S.C. 18031(c)) is amended by adding at the end the following new 
paragraph:
            ``(8) Identification of dual medicaid and exchange 
        enrollments.--
                    ``(A) In general.--The Secretary shall, not later 
                than 60 days after the date of the enactment of this 
                paragraph, establish a program under which, on a 
                recurring basis, but not less frequently than 
                quarterly, the information of each individual enrolled 
                in a qualified health plan through an Exchange is 
                compared through the Public Assistance Reporting 
                Information System (PARIS) facilitated by the Secretary 
                (or any successor system) with the information of each 
                individual enrolled in a State plan (or waiver of such 
                plan) under title XIX of the Social Security Act, or a 
                State child health plan under title XXI of such Act (or 
                a waiver of such plan), for purposes of identifying 
                individuals enrolled in both such a qualified health 
                plan and such a State plan (or waiver) or State child 
                health plan (or waiver).
                    ``(B) Enforcement.--The Secretary shall take such 
                actions as the Secretary determines appropriate (such 
                as the notification of applicable Exchanges and the 
                Secretary of the Treasury) to ensure that no individual 
                identified under the program established under 
                subparagraph (A) is receiving premium tax credits under 
                section 36B of the Internal Revenue Code of 1986 or 
                cost sharing reductions under section 1402.''.
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