Promoting consumer outreach and education

(a) In general Section 1311(i) of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(i)) is amended— (1) in paragraph (2), by adding at the end the following new subparagraph: (C) Selection of recipients In the case of an Exchange established and operated by the Secretary within a State pursuant to section 1321(c), in awarding grants under paragraph (1), the Exchange shall— (i) select entities to receive such grants based on an entity’s demonstrated capacity to carry out each of the duties specified in paragraph (3); (ii) not take into account whether or not the entity has demonstrated how the entity will provide information to individuals relating to group health plans offered by a group or association of employers or short-term limited duration insurance (as defined by the Secretary for purposes of section 2791(b)(5) of the Public Health Service Act); and (iii) ensure that, each year, the Exchange awards such a grant to— (I) at least one entity described in this paragraph that is a community and consumer-focused nonprofit group; and (II) at least one entity described in subparagraph (B), which may include another community and consumer-focused nonprofit group in addition to any such group awarded a grant pursuant to subclause (I). In awarding such grants, an Exchange may consider an entity’s record with respect to waste, fraud, and abuse for purposes of maintaining the integrity of such Exchange.; (2) in paragraph (3)— (A) by amending subparagraph (C) to read as follows: (C) facilitate enrollment, including with respect to individuals with limited English proficiency and individuals with chronic illnesses, in qualified health plans, State Medicaid plans under title XIX of the Social Security Act, and State child health plans under title XXI of such Act;; (B) in subparagraph (D), by striking and at the end; (C) in subparagraph (E), by striking the period at the end and inserting; and; (D) by inserting after subparagraph (E) the following new subparagraph: (F) provide referrals to community-based organizations that address social needs related to health outcomes.; and (E) by adding at the end the following flush text: The duties specified in the preceding sentence may be carried out by such a navigator at any time during a year.; (3) in paragraph (4)(A)— (A) in the matter preceding clause (i), by striking not; (B) in clause (i)— (i) by inserting not before be; and (ii) by striking; or and inserting a semicolon; (C) in clause (ii)— (i) by inserting not before receive; and (ii) by striking the period and inserting a semicolon; and (D) by adding at the end the following new clauses: (iii) maintain physical presence in the State of the Exchange so as to allow in-person assistance to consumers; and (iv) receive opioid specific education and training that ensures the navigator can best educate individuals on qualified health plans offered through an Exchange, specifically coverage under such plans for opioid health care treatment.; and (4) in paragraph (6)— (A) by striking Grants under and inserting the following: (A) State exchanges Grants under; and (B) by adding at the end the following new subparagraph: (B) Federal exchanges For purposes of carrying out this subsection, with respect to an Exchange established and operated by the Secretary within a State pursuant to section 1321(c), the Secretary shall obligate $100,000,000 out of amounts collected through the user fees on participating health insurance issuers pursuant to section 156.50 of title 45, Code of Federal Regulations (or any successor regulations), for fiscal year 2027 and each subsequent fiscal year. Such amount for a fiscal year shall remain available until expended.. (b) Effective date The amendments made by this section shall apply with respect to plan years beginning on or after January 1, 2027.