,,ii  #aac? ,,congress  #b;d ,session   
,s4 #bagd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #bg1 #bjad ,mr4   
,w>n] 7= himself1 ,mr4 ,man*91 ,ms4     
,l&rieu1 ,ms4 ,heitkamp1 ,mr4 ,begi*1   
,mr4 ,frank51 & ,ms4 ,klobu*>7 introduc$
 ! foll[+ bill2 :i* 0 read twice &      
ref]r$ to ! ,committee on ,heal?1       
,education1 ,labor1 & ,p5sions  ,a      
,,bill  ,to am5d ! ,pati5t ,protection &
 ,af=dable ,c>e ,act to provide great]  
flexibility 9 (f]+ heal? insurance      
cov]age across ,/ate l9es4  #a4 ,%ort   
title  ,?is ,act may be cit$ z !        
,commons5se ,competition & ,access to   
,heal? ,insurance ,act4  #b4 ,provid+   
small bus9ess heal? insurance across    
,/ate l9es ,section #accc7;a77#a77;,a7 (
 ! ,pati5t ,protection & ,af=dable ,c>e 
,act 7#db ,u4,s4,c4 #ahjec7;a77#a77;,a77
 is am5d$ by ins]t+ & small gr\p m>kets 
aft] individual m>kets4  #c4 ,report &  
models ,section #accc ( ! ,pati5t       
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjec7 is am5d$ by add+ at ! 

end ! foll[+3  7b7 ,,naic report &      
models  7#a7 ,9 g5]al ,n lat] ?an       
,decemb] #ca1 #bjad1 ! ,secret>y %all   
reque/ t ! ,national ,association (     
,insurance ,commission]s submit to !    
,secret>y a report conc]n+ heal? plans  
provid$ = "u ?is section4 ,su* report   
%all include-- 7,a7 a description ( !   
*all5ges t ,/ates w\ld face by p]mitt+  
issu]s ( qualifi$ heal? plans to (f] su*
 plans 9 ,/ates o!r ?an ^? ,/ates :]e   
su* plan 0 orig9ally writt5 or issu$2   
7,b7 an assessm5t ( h[ an out-(-,/ate   
insur] w\ld g ab\t build+ an adequate   
provid] network2  7,c7 a description (  
h[ su* *all5ges c\ld be less5$ )\t      
weak5+ ! en=cem5t ( laws & regulations  
describ$ 9 subsection 7a77#a77;,b77i7 9 
any ,/ate t is includ$ 9 a compact "u   
?is section2  7,d7 a description ( !    
commonalities t exi/ 9 ,/ate laws &     
opportunities to all[ issu]s ( qualifi$ 
heal? plans to (f] su* plans 9 ,/ates   
o!r ?an ^? ,/ates :]e su* plan 0        
orig9ally writt5 or issu$2 &  7,e7      

models to be us$ by ,/ates to e/abli% & 
ent] into int]/ate heal? c>e *oice      
compacts "u ?is section1 :i*-- 7i7 may  
include model legislation = use by      
,/ates to enact laws to ent] into su*   
compacts2  7ii7 %all id5tify h[ ,/ates  
w\ld cont9ue to en=ce1 & n weak51 ! laws
 & regulations describ$ 9 subsection    
7a77#a77;,b77i7 9 any ,/ate t is includ$
 9 su* compact2 &  7iii7 %all id5tify h[
 su* models w\ld ensure t !re is no     
violation ( ! conditions = ,secret>ial  
approval "u subsection 7a77#c74  7#b7   
,o!r organizations & entities ,9 mak+ ! 
reque/ "u p>agraph 7#a71 ! ,secret>y may
 also reque/ t ! ,national ,association 
( ,insurance ,commission]s ga!r concepts
 = inclusion 9 ! report "u su* p>agraph 
f organizations & entities t h exp]i5ce 
9 (f]+ qualifi$ heal? plans 9 ,/ates 9  
:i* su* plans 7 n orig9ally issu$4  7c7 
,report by ,secret>y ,n lat] ?an        
,decemb] #ca1 #bjad1 ! ,secret>y1 9     
consultation ) ! ,national ,association 
( ,insurance ,commission]s1 %all submit 

to ,congress a report t describes h[ !  
,secret>y may utilize ! flexibility     
provid$ by section #acaa7;f77#a7 7relat+
 to all[+ a regional or int]/ate        
ex*ange7 to all[ heal? insurance issu]s 
(f]+ qualifi$ heal? plans 9 an ,ex*ange 
op]at$ by ! ,f$]al ,gov]nm5t to (f]     
plans 9 a ,/ate o!r ?an ! ,/ate 9 :i*   
su* plan 0 orig9ally writt5 or issu$4   
,su* report %all describe h[ an ,ex*ange
 op]at$ by ! ,f$]al ,gov]nm5t c be a    
conduit to =m+ int]/ate insurance ,/ate 
compacts4  4