1. Short title This Act may be cited as the State Health Care Premium Reduction Act . 2. Improve Health Insurance Affordability Fund Subtitle D of title I of the Patient Protection and Affordable Care Act is amended by inserting after part 5 ( 42 U.S.C. 18061 et seq.) the following new part: 6 Improve Health Insurance Affordability Fund 1351. Establishment of program There is hereby established the Improve Health Insurance Affordability Fund to be administered by the Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services (in this section referred to as the Administrator ), to provide funding, in accordance with this title, to the 50 States and the District of Columbia (each referred to in this section as a State ) beginning on January 1, 2020, for the purposes described in section 1352. 1352. Use of funds (a) In general A State shall use the funds allocated to the State under this part for one of the following purposes: (1) To provide reinsurance payments to health insurance issuers with respect to individuals enrolled under individual health insurance coverage (other than through a plan described in subsection (b)) offered by such issuers. (2) To provide assistance (other than through payments described in paragraph (1)) to reduce out-of-pocket costs, such as copayments, coinsurance, premiums, and deductibles, of individuals enrolled under qualified health plans offered on the individual market through an Exchange. (b) Exclusion of certain grandfathered and transitional plans For purposes of subsection (a), a plan described in this subsection is the following: (1) A grandfathered health plan (as defined in section 1251). (2) A plan (commonly referred to as a transitional plan ) continued under the letter issued by the Centers for Medicare & Medicaid Services on November 14, 2013, to the State Insurance Commissioners outlining a transitional policy for coverage in the individual and small group markets to which section 1251 does not apply, and