,,ii  #aac? ,,congress  #b;d ,session   
,s4 #bbec  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,april #aj1 #bjad,mr4  
,frank5 7= himself1 ,mr4 ,kirk1 & ,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 = a tempor>y %ift 9 ! s*$ul$    
collection ( ! transitional re9surance  
program paym5ts4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,heal? ,c>e        
,fairness & ,/ability ,act4  #b4 ,%ift 9
 ! collection ( ! paym5t = !            
transitional re9surance program  7a7 ,9 
g5]al ,section #acda7;b7 ( ! ,pati5t    
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjfa7;b77 is am5d$-- 7#a7 9 
p>agraph 7#a7-- 7,a7 9 subp>agraph      
7,a7-- 7i7 by ins]t+ beg9n+ on ,janu>y  
#a1 #bjah1 aft] requir$ to make paym5ts2
 &  7ii7 by /rik+ any plan ye> beg9n+ 9 
! #c-ye> p]iod & all t foll[s ?r\gh !   
end & ins]t+ paym5ts made "u subp>agraph

 7,c7 7z specifi$ 9 p>agraph 7#c7722    
7,b7 9 subp>agraph 7,b71 by /rik+ & uses
 & all t foll[s ?r\gh ! p]iod & ins]t+ 2
 &2 &  7,c7 by add+ at ! end ! foll[+3  
7,c7 ! applicable re9surance entity     
makes re9surance paym5ts to heal?       
insurance issu]s describ$ 9 subp>agraph 
7,a7 t cov] high risk individuals 9 !   
individual m>ket 7exclud+ gr&fa!r$ heal?
 plans7 = any plan ye> beg9n+ 9 ! #c-ye>
 p]iod beg9n+ ,janu>y #a1 #bjad1 9 an   
aggregate am\nt ( up to ! total ( !     
aggregate contribution am\nts describ$ 9
 p>agraph 7#c77;,b77iv71 subject to     
p>agraph 7#d74  2  7#b7 9 p>agraph 7#b71
 by /rik+ p>agraph 7#a77;,b7 & ins]t+   
p>agraph 7#a77;,c72  7#c7 9 p>agraph    
7#c7-- 7,a7 9 subp>agraph 7,a71 by /rik+
 #bjad & ins]t+ #bjah2 &  7,b7 9        
subp>agraph 7,b7-- 7i7 9 clause 7ii71 by
 /rik+ adm9i/rative & ins]t+ op]ational2
  7ii7 by r$esignat+ clauses 7iii7 &    
7iv7 z clauses 7iv7 & 7v71 respectively2
  7iii7 by ins]t+ aft] clause 7ii71 !   
foll[+3  7iii7 ! aggregate contribution 

am\nt = all ,/ates %all be bas$ on !    
total am\nt ( re9surance paym5ts made "u
 p>agraph 7#a77;,c72  2  7iv7 by /rik+  
clause 7iv71 z s r$esignat$1 & ins]t+ ! 
foll[+3  7iv7 ! aggregate contribution  
am\nt collect$ "u clause 7iii7 %all1 )\t
 reg>d to am\nts describ$ 9 clause 7ii71
 be limit$ to #aj1jjj1jjj1jjj bas$ on ! 
plan ye>s beg9n+ 9 #bjad1 #f1jjj1jjj1jjj
 bas$ on ! plan ye>s beg9n+ 9 #bjae1 &  
#d1jjj1jjj1jjj bas$ on ! plan ye>s      
beg9n+ 9 #bjaf2  2  7v7 9 clause 7v71 z 
s r$esignat$1 by /rik+ clause 7iii7 ea* 
place t su* t]m appe>s & ins]t+ clause  
7iv72 &  7vi7 by ins]t+ aft] clause 7v71
 ! foll[+3  7vi7 9 addition to !        
contribution am\nts "u clauses 7iii71   
7iv71 & 7v71 ea* issu]'s contribution   
am\nt-- 7,i7 %all reflect its           
proportionate %>e ( an additional       
#bj1cjj1jjj = op]ational exp5ses =      
re9surance paym5ts = cal5d> ye> #bjad & 
= re9surance collections = cal5d> ye>   
#bjah2  7,,ii7 %all reflect its         
proportionate %>e ( op]ational exp5ses =

 re9surance paym5ts = cal5d> ye> #bjae &
 = re9surance collections = cal5d> ye>  
#bjai2 &  7,,iii7 %all reflect its      
proportionate %>e ( op]ational exp5ses =
 re9surance paym5ts = cal5d> ye> #bjaf &
 = re9surance collections = cal5d> ye>  
#bjbj2 &  7vii7 collection ( !          
contribution am\nts provid$ = 9 clauses 
7ii7 ?r\gh 7vi7 %all be initiat$-- 7,i7 
= cal5d> ye> #bjad1 n e>li] ?an ,janu>y 
#a1 #bjah2  7,,ii7 = cal5d> ye> #bjae1 n
 e>li] ?an ,janu>y #a1 #bjai2 &  7,,iii7
 = cal5d> ye> #bjaf1 n e>li] ?an ,janu>y
 #a1 #bjbj4  2  7#d7 9 p>agraph 7#d7--  
7,a7 9 subp>agraph 7,a7-- 7i7 by /rik+  
contribution am\nts collect$ = any      
cal5d> ye> & ins]t+ am\nt provid$ "u    
p>agraph 7#e7 = re9surance paym5ts      
describ$ 9 p>agraph 7#a77;,c72 &  7ii7  
by /rik+ 2 & & ins]t+ a p]iod2  7,b7 by 
/rik+ subp>agraph 7,b72  7,c7 by /rik+  
t-- & all t foll[s ?r\gh ! contribution 
9 subp>agraph 7,a7 & ins]t+ t !         
contribution2 &  7,d7 9 ! flu% matt] at 
! end1 by /rik+ p>agraph 7#c77;,b77iv7 &

 ins]t+ ! foll[+3 p>agraph 7#c77;,b77v7 
& any am\nts collect$ "u clause 7ii7 (  
p>agraph 7#c77;,b7 t1 :5 comb9$ ) !     
fund+ provid$ = "u p>agraph 7#e71 exce$ 
! aggregate am\nt p]mitt$ = mak+ !      
re9surance paym5ts describ$ 9 p>agraph  
7#a77;,c7 & to fund ! op]ational exp5ses
 ( applicable re9surance entities12 &   
7#e7 by add+ at ! end ! foll[+3  7#e7   
,fund+ ,to c>ry out ?is section1 !re is 
appropriat$1 out ( any money 9 !        
,treasury n o!rwise appropriat$1 an     
am\nt equal to ! aggregate am\nt to be  
collect$ = plan ye>s beg9n+ 9 #bjad set 
=? 9 p>agraph 7#c77;,b77iv7 = re9surance
 paym5ts describ$ 9 p>agraph 7#a77;,c71 
& an am\nt equal to ! contribution      
am\nts set =? 9 p>agraph 7#c77;,b77vi7  
to fund op]ational exp5ses ( applicable 
re9surance entities4  4  7b7 ,rule (    
con/ruction ,no?+ 9 ! am5dm5ts made by  
?is section %all be con/ru$ to increase 
! am\nt ( paym5ts to be collect$ "u     
subsection 7b77#a77;,a7 or to decrease !
 am\nt ( ! re9surance paym5ts to be made

 "u subsection 7b77#a77;,c7 ( section   
#acda ( ! ,pati5t ,protection &         
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjfa74  7c7 ,m$ical loss ratio ,!     
,secret>y ( ,heal? & ,human ,s]vices    
%all promulgate regulations or guidance 
to ensure t heal? insurance issu]s      
reflect *anges made 9 section #acda ( ! 
,pati5t ,protection & ,af=dable ,c>e    
,act ) section #bgah ( ! ,public ,heal? 
,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ah7
 & sections #acdb & #acab7;c7 ( !       
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjfc &            
#ahjcb7;c774