,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #dgif  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #b1 #bjad ,ms4  
,jackson ,lee 7= h]self1 ,ms4 ,cl>ke (  
,new ,york1 ,ms4 ,br[n ( ,florida1 ,mr4 
,clay1 ,mr4 ,rangel1 & ,ms4 ,norton7    
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce  ,a  
,,bill  ,to direct ! ,secret>y ( ,heal? 
& ,human ,s]vices to conduct outrea*    
ef=ts to provide c]ta9 heal? insurance  
in=mation to individuals enroll$ 9      
qualifi$ heal? plans (f]$ ?r\gh an      
,ex*ange e/abli%$ "u title ,i ( !       
,pati5t ,protection & ,af=dable ,c>e    
,act or ,/ate plans "u ! ,m$icaid       
program "u title ,,xix ( ! ,social      
,security ,act1 & = o!r purposes4  #a4  
,%ort title ,?is ,act may be cit$ z !   
,keep+ ,well by ,us+ ,y\r ,pati5t       
,protection & ,af=dable ,c>e ,act ,plan4
  #b4 ,outrea* to c]ta9 individuals on  
c]ta9 heal? insurance in=mation  7a7 ,9 
g5]al ,beg9n+ n lat] ?an #ij days aft] !
 date ( ! enactm5t ( ?is ,act1 !        

,secret>y ( ,heal? & ,human ,s]vices    
%all conduct outrea* ef=ts to provide1  
us+ ! mo/ effective means 7z det]m9$ by 
! ,secret>y71 ! heal? insurance         
in=mation describ$ 9 subsection 7b7 to--
  7#a7 individuals enroll$ 9 qualifi$   
heal? plans (f]$ ?r\gh an ,ex*ange      
e/abli%$ "u title ,i ( ! ,pati5t        
,protection & ,af=dable ,c>e ,act       
7,public ,law #aaa-adh72 &  7#b7        
individuals enroll$ 9 ,/ate plans 7or "u
 a waiv] ( su* a plan7 "u ! ,m$icaid    
program "u title ,,xix ( ! ,social      
,security ,act4  7b7 ,in=mation describ$
 ,= purposes ( subsection 7a71 !        
in=mation describ$ 9 ?is subsection is  
any in=mation1 ! availability ( :i* !   
,secret>y ( ,heal? & ,human ,s]vices    
det]m9es w enc\rage ! utilization (     
prim>y c>e or prev5tive s]vices by !    
individuals describ$ 9 su* subsection1  
includ+ ! foll[+3  7#a7 ,in=mation on ! 
ext5t to :i* ! ess5tial heal? b5efits   
specifi$ 9 section #acjb7;b77#a7 ( !    
,pati5t ,protection & ,af=dable ,c>e    

,act 7#db ,u4,s4,c4 #ahjbb7;b77#a77 are 
provid$ by a plan describ$ 9 subsection 
7a74  7#b7 ,in=mation on :i* prev5tive  
heal? s]vices are cov]$ "u su* a plan   
)\t ! application ( any co/-%>+ 7su* z a
 copaym5t or co9surance71 includ+       
scre5+s = c]ta9 conditions su* z        
diabetes & high blood pressure1         
vacc9ations = adults aga9/ influ5za1    
measles1 mumps1 rubella1 & o!r infecti\s
 diseases1 & well-woman visits4  7#c7 ,)
 respect to qualifi$ heal? plans        
describ$ 9 subsection 7a77#a71 ! foll[+ 
in=mation pres5t$ 9 a mann] t all[s =   
comp>ison ( plans )9 ea* ,/ate3  7,a7   
,in=mation on ! rates ( reimbursem5t    
recogniz$ "u ea* su* qualifi$ heal? plan
 ) respect to items & s]vices 7z        
specifi$ by ! ,secret>y7 t are furni%$  
to individuals enroll$ 9 su* plan by    
heal? c>e provid]s p>ticipat+ 9 !       
network ( ! plan1 su* z rates (         
reimbursem5t applicable to em]g5cy c>e  
s]vices1 laboratory te/s1 diagno/ic     
te/s1 & physician s]vices4  7,b7        

,in=mation on any co/-%>+ requir$ "u ea*
 su* plan ) respect to su* items &      
s]vices furni%$ to su* individuals by   
su* provid]s & an explanation on ! ext5t
 to :i* su* co/-%>+ is bas$ on su*      
recogniz$ rates ( reimbursem5t4  7,c7 ,a
 /atem5t t--  7i7 ! rates ( reimbursem5t
 t are collectable by heal? c>e provid]s
 n p>ticipat+ 9 ! network ( su* a plan =
 furni%+ su* items & s]vices to su*     
individuals may be m ?an ! rates (      
reimbursem5t recogniz$ "u su* plan = su*
 items & s]vices furni%$ to su*         
individuals by heal? c>e provid]s       
p>ticipat+ 9 ! network ( su* plan2 &    
7ii7 any co/-%>+ requir$ "u su* a plan )
 respect to su* items & s]vices furni%$ 
to su* individuals by heal? c>e provid]s
 n p>ticipat+ 9 ! network ( su* plan may
 be m ?an su* co/-%>+ ) respect to su*  
items & s]vices furni%$ to su*          
individuals by heal? c>e provid]s       
p>ticipat+ 9 ! network ( su* plan4  7#d7
 ,an explanation ( basic heal? insurance
 t]ms 7z det]m9$ by ! ,secret>y71       

includ+ d$uctibles1 co/-%>+1 copaym5t1 &
 co9surance1 & ! application ( su* t]ms 
to an individual enroll$ 9 a plan       
describ$ 9 subsection 7a71 illu/rat$ )  
examples ( ! application ( su* t]ms )   
respect to su* individuals "u diff]5t   
circum/ances & 9 diff]5t heal? c>e      
sett+s4  7c7 ,report on out-(-,pocket   
co/s ,n lat] ?an #ahj days aft] ! date (
 ! enactm5t ( ?is ,act1 ) respect to !  
mo/ rec5t plan ye> = :i* in=mation is   
available1 ! ,secret>y ( ,heal? & ,human
 ,s]vices %all submit to ! ,committee on
 ,en]gy & ,comm]ce ( ! ,h\se (          
,repres5tatives & ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions (
 ! ,s5ate a report t--  7#a7 conta9s    
in=mation1 = ea* ,/ate 7includ+ !       
,di/rict ( ,columbia71 on ! m$ian       
co/-%>+ responsibility1 ) respect to    
qualifi$ heal? plans (f]$ ?r\gh an      
,ex*ange 9 su* ,/ate1 ( heal? c>e       
s]vices--  7,a7 ! numb] ( :i* & types ( 
:i* are det]m9$ appropriate by !        
,secret>y to be includ$ 9 ! report2 &   

7,b7 t h be5 id5tifi$ by ! ,secret>y z  
s]vices--  7i7 = :i*1 ) respect to su*  
plan ye>1 paym5t may only be made "u su*
 a plan aft] satisfaction ( ! d$uctible 
applicable "u su* plan2 &  7ii7 = :i*   
reimbursem5t "u su* plan is made mo/    
frequ5tly dur+ su* plan ye>2 &  7#b7    
describes ! be/ me?od = mak+ ! in=mation
 ref]r$ to 9 p>agraph 7#a7 available to 
! public4