To amend the Patient Protection and Affordable Care Act to prevent duplicate enrollments in Exchanges.
Summary
What This Bill Does
This ACA program-integrity bill adds a duplicate-enrollment check to section 1411 of the Affordable Care Act. Within 60 days after enactment, the Secretary must establish a process, as part of the existing Exchange eligibility program, to identify whether the Social Security number supplied for an individual seeking individual-market qualified health plan coverage through an Exchange matches the Social Security number of any enrollee in any Exchange for the same effective coverage period. When identical Social Security numbers are identified, the Secretary must take the actions necessary to ensure that duplicative advance payments of premium tax credits under section 1412 are not made for that individual. The bill targets duplicate subsidy payments, not the basic eligibility of a person to hold health coverage.
Who Benefits and How
Federal taxpayers benefit because duplicate advance premium tax credit payments are supposed to be blocked. CMS Exchange administrators benefit from a statutory mandate to match Social Security numbers across Exchange enrollments and act on matches. Qualified health plan issuers benefit if subsidy payments tied to duplicate enrollments are cleaned up before reconciliation problems grow. Legitimate Exchange enrollees benefit if fraud controls protect program integrity without cancelling proper coverage.
Who Bears the Burden and How
HHS and CMS technology staff must build the duplicate-enrollment process within 60 days, compare Social Security numbers across Exchanges for overlapping coverage periods, and take action to stop duplicate advance premium tax credit payments. Exchange administrators and qualified health plan issuers may need to adjust enrollment workflows, notices, and payment reconciliation. Enrollees with duplicate records may face review or correction steps before subsidies continue.
Key Provisions
- Requires a duplicate Social Security number matching process within 60 days after enactment.
- Applies the process to qualified health plan enrollments through any Exchange for the same effective coverage period.
- Requires HHS to take necessary actions to prevent duplicative advance premium tax credit payments.
- Targets duplicate subsidy payments while leaving ordinary Exchange eligibility rules in place.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Requires HHS to create within 60 days an Exchange process that detects duplicate Social Security numbers across qualified health plan enrollments for the same coverage period and prevents duplicative advance premium tax credit payments.
Key Policy Areas
Healthcare, Tax, Program Integrity
Primary Purpose
Requires HHS to create within 60 days an Exchange process that detects duplicate Social Security numbers across qualified health plan enrollments for the same coverage period and prevents duplicative advance premium tax credit payments.
Policy Domains
Substantive provisions
Identified Gains
- Federal taxpayers
- CMS Exchange administrators
- Qualified health plan issuers
- Legitimate Exchange enrollees
Identified Costs
- HHS technology staff
- CMS Exchange administrators
- Exchange administrators
- Qualified health plan issuers
- Enrollees with duplicate records
Sponsors
Legislative Progress
In CommitteeMr. Burchett introduced the following bill; which was referred to …
Referred to the Committee on Energy and Commerce, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
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