,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #cfjg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #ba1         
#bjac,mr4 ,mulvaney 7= himself & ,mr4   
,g[dy7 introduc$ ! foll[+ bill2 :i* 0   
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to enable ,/ates to
 opt out ( c]ta9 provisions ( ! ,pati5t 
,protection & ,af=dable ,c>e ,act4  #a4 
,%ort title ,?is ,act may be cit$ z !   
,/ate ,heal? ,c>e ,*oice ,act4  #b4     
,purpose ,x is ! purpose ( ?is ,act to  
protect ,/ates' rights & to ensure t    
,/ates h ! option to cont9ue to implem5t
 ,/ate laws relat+ to heal? c>e deliv]y 
& heal? insurance t 7 9 effect prior to 
! date ( enactm5t ( ! ,pati5t           
,protection & ,af=dable ,c>e ,act       
7,public ,law #aaa-adh74  #c4           
,protection ( ,/ate flexibility to      

provide heal? cov]age  7a7 ,/ate opt out
 ( c]ta9 provisions ( ,,ppaca  7#a7 ,9  
g5]al ,a ,/ate describ$ 9 subsection 7b7
 may elect to limit ! application ( any 
or all ( ! provisions ( ! ,pati5t       
,protection & ,af=dable ,c>e ,act       
7,public ,law #aaa-adh7 describ$ 9      
p>agraph 7#b7 ) respect to heal?        
insurance cov]age )9 t ,/ate4  7#b7     
,provisions describ$ ,! provisions ( !  
,pati5t ,protection & ,af=dable ,c>e    
,act describ$ 9 ?is p>agraph are z      
foll[s3 7,a7 ,subtitles ,a ?r\gh ,c (   
title ,i 7& ! am5dm5ts made by su*      
subtitles71 except = sections #abec &   
#abed4  7,b7 ,p>ts ,i1 ,,ii1 ,,iii1 & ,v
 ( subtitle ,d ( title ,i 7& ! am5dm5ts 
made by su* p>ts74  7,c7 ,"p ,i (       
subtitle ,e ( title ,i 7& ! am5dm5ts    
made by su* "p74  7,d7 ,subtitle ,f (   
title ,i 7& ! am5dm5ts made by su* "p74 
7,e7 ,section #aefa 7& ! am5dm5t made by
 su* section74  7,f7 ,sections #ajaja   
?r\gh #ajajg 7& ! am5dm5ts made by su*  
sections74  7b7 ,/ate describ$  7#a7    

,enactm5t ( ,/ate law ,a ,/ate describ$ 
9 ?is subsection is a ,/ate t enacts a  
law aft] ! date ( enactm5t ( ?is ,act   
t-- 7,a7 expresses ! int5t ( ! ,/ate to 
opt out ( "o or m ( ! provisions ( !    
,pati5t ,protection & ,af=dable ,c>e    
,act 7,public ,law #aaa-adh7 describ$ 9 
subsection 7a72  7,b7 conta9s a li/ ( ! 
provisions ( su* ,act :i* w n apply to !
 ,/ate "u ! ,/ate law2 &  7,c7 expresses
 ! int5t ( ! ,/ate to cont9ue to adm9i/]
 heal? cov]age-relat$ laws z 9 effect 9 
! ,/ate on ,m>* #bc1 #bjaj1 or t        
provides = ! implem5tation ( relat$     
,/ate laws enact$ aft] su* date4  7#b7  
,repeal ,if a ,/ate repeals a law       
describ$ 9 p>agraph 7#a71 ! provisions (
 ! ,pati5t ,protection & ,af=dable ,c>e 
,act li/$ 9 su* law %all apply ) respect
 to su* ,/ate beg9n+ on ! date ( su*    
repeal4  7c7 ,regulations ,! ,secret>y (
 ,heal? & ,human ,s]vices1 9            
consultation ) ! ,secret>y ( !          
,treasury1 %all promulgate regulations  
to provide = ! implem5tation ( ?is ,act4