,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #cgcg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #ab1         
#bjac,mr4 ,grayson introduc$ ! foll[+   
bill2 :i* 0 ref]r$ to ! ,committee on   
,ways & ,means  ,a ,,bill  ,to am5d     
title ,,xviii ( ! ,social ,security ,act
 to provide = an option = any citiz5 or 
p]man5t resid5t ( ! ,unit$ ,/ates to buy
 into ,m$ic>e4  #a4 ,%ort title ,?is    
,act may be cit$ z ! ,public ,option    
,act or ! ,m$ic>e ,y ,c ,buy ,into ,act4
  #b4 ,univ]sal ,m$ic>e buy-9 option    
7a7 ,9 g5]al ,"p ,a ( title ,,xviii ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acie;c et seq47 is am5d$-- 7#a7 9      
section #ahah7;a7 7#db ,u4,s4,c4        
#acie;i-#b7;a771 by /rik+ or #ahah;,a & 
ins]t+ 1 #ahah;,a1 or #ahah;,b2 &  7#b7 
by ins]t+ aft] section #ahah;,a ! foll[+
 new section3  #ahah;,b4 ,univ]sal buy-9
  7a7 ,9 g5]al ,e individual :o-- 7#a7  
is a resid5t ( ! ,unit$ ,/ates2  7#b7 is
 ei!r 7,a7 a citiz5 or national ( !     
,unit$ ,/ates1 or 7,b7 an ali5 lawfully 

admitt$ = p]man5t resid5ce2 &  7#c7 is n
 o!rwise entitl$ to b5efits "u ?is "p or
 eligible to enroll "u ?is "p2  %all be 
eligible to enroll 9 ! insurance program
 e/abli%$ by ?is "p4 ,an individual may 
enroll "u ?is section only 9 su* mann] &
 =m z may be prescrib$ 9 regulations1 & 
only dur+ an enrollm5t p]iod prescrib$ 9
 or "u ?is section4  7b7 ,enrollm5t2    
cov]age ,! ,secret>y %all e/abli%       
enrollm5t p]iods & cov]age "u ?is       
section consi/5t ) ! pr9ciples =        
e/abli%m5t ( enrollm5t p]iods & cov]age 
= individuals "u section #ahah1 except t
 no entitlem5t to b5efits "u ?is "p %all
 be effective be=e ! fir/ day ( ! fir/  
cal5d> ye> beg9n+ aft] ! date ( !       
enactm5t ( ?is ,act4  7c7 ,premiums     
7#a7 ,9 g5]al ,! provisions (           
subsections 7d77#a71 7d77#b71 & 7d77#c7 
( section #ahah ins(> z !y apply to     
premiums 7includ+ collection ( premiums7
 %all apply to premiums & collection (  
premiums "u ?is section1 except t-- 7,a7
 p>agraphs 7#d7 & 7#e7 ( section #ahah  

%all n be applicable2 &  7,b7 ! e/imate 
( ! mon?ly actu>ial rate "u section     
#ahah7;d7 %all be comput$ & appli$ "u   
?is p>agraph bas$ ^u co/s incurr$ =     
individuals )9 ea* age cohort specifi$ 9
 p>agraph 7#b7 r ?an = all individuals  
age #fe & old]4  7#b7 ,age cohorts ,!   
age cohorts specifi$ 9 ?is p>agraph are 
z foll[s3 7,a7 ,individuals "u #ai ye>s 
( age4  7,b7 ,individuals at lea/ #ai   
ye>s ( age b n m ?an #be ye>s ( age4    
7,c7 ,individuals at lea/ #bf ye>s ( age
 & n m ?an #ce ye>s ( age4  7,d7        
,individuals at lea/ #cf ye>s ( age & n 
m ?an #de ye>s ( age4  7,e7 ,individuals
 at lea/ #df ye>s ( age & n m ?an #ee   
ye>s ( age4  7,f7 ,individuals at lea/  
#ef ye>s ( age & n m ?an #fd ye>s ( age4
  7d7 ,treatm5t ,an individual enroll$  
"u ?is "p pursuant to ?is section %all n
 be treat$ z enroll$ "u ?is "p 7or any  
o!r "p ( ?is title7 = purposes ( obta9+ 
m$ical assi/ance = m$ic>e co/-%>+ or    
o!rwise "u title ,,xix4  7e7 ,treatm5t 9
 relation to ! af=dable c>e act  7#a7   

,satisfaction ( individual m&ate ,=     
purposes ( apply+ section #ejjj;,a ( !  
,int]nal ,rev5ue ,code ( #aihf 7relat+  
to requirem5t to ma9ta9 m9imum ess5tial 
cov]age71 ! cov]age provid$ "u ?is      
section con/itutes m9imum ess5tial      
cov]age "u subsection 7f77#a77;,a77i7 ( 
su* section4  7#b7 ,eligibility =       
premium assi/ance ,= purposes ( apply+  
section #cf;,b ( ! ,int]nal ,rev5ue     
,code ( #aihf1 cov]age provid$ "u ?is   
section %all be treat$ z provision ( a  
qualifi$ heal? plan (f]$ 9 ! individual 
m>ket 9 ! ,ex*ange :]e ! individual     
resides4  4