,,ii  #aad? ,,congress  #b;d ,session   
,s4 #bejj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,febru>y #d1 #bjaf,mr4 
,b5net introduc$ ! foll[+ bill2 :i* 0   
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to provide = ! e/abli%m5t ( 
a heal? insurance premium r$uction      
program to ensure t heal? insurance     
premiums rema9 l[ = ,am]ican families4  
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,heal? ,c>e ,premium ,r$uction ,act4  
#b4 ,/ate heal? insurance premium       
r$uction program ,"p #e ( subtitle ,d ( 
title ,i ( ! ,pati5t ,protection &      
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjfa et seq47 is am5d$ by add+ at !   
end ! foll[+3  #acdd4 ,/ate heal?       
insurance premium r$uction program  7a7 
,grants ,! ,secret>y %all e/abli% a     
program = aw>d+ a grant to a ,/ate to   
enable su* ,/ate to support1 9          
connection ) r$uc+ heal? insurance      
premiums & provid+ af=dable heal?       
b5efits cov]age t includes a            

risk-adju/m5t me*anism = ! purpose (    
support+ ! pur*ase ( private heal?      
insurance by consum]s 9 ! ,/ate1 & =    
ensur+ /able heal? insurance premiums   
?r\gh ! activities c>ri$ out "u         
subsection 7e74  7b7 ,requirem5t ,to be 
eligible to receive a grant "u ?is      
section a ,/ate %all--  7#a7 submit to !
 ,secret>y an application at su* "t1 9  
su* mann]1 & conta9+ su* in=mation z !  
,secret>y %all require2  7#b7 include 9 
su* application a description ( ! ,/ate 
private heal? insurance m>ket1 includ+ a
 li/ ( c\nty-specific premium increase  
p]c5tages t are #aj p]c5t or great]1 &  
an assurance t su* ,/ate w comply ) !   
requirem5ts ( section #aaja7;c77#b72 &  
7#c7 include 9 su* application an       
assurance t ! ,/ate w exp5d all or a    
portion ( ! funds receiv$ "u ! grant on 
! risk-adju/m5t me*anism = ! ,/ate4  7c7
 ,priority review  7#a7 ,evaluation ,!  
,secret>y1 9 consultation ) ! ,assi/ant 
,secret>y = ,plann+ & ,evaluation1 %all 
conduct an evaluation ( all regions 9 ! 

,unit$ ,/ates to assess :i* regions 7t  
may be compris$ ( collections (         
geographic subdivisions su* z           
,core-,bas$ ,/ati/ical ,areas1 c5sus    
tracts1 or ,,zip ,codes7 h ! highe/     
premiums = heal? insurance cov]age4     
7#b7 ,priority ,/ates id5tifi$ "u !     
evaluation "u p>agraph 7#a7 %all receive
 priority 9 obta9+ grants "u ?is section
 9 ord] to /abilize premium tr5ds4  7d7 
,use ( funds  7#a7 ,set-aside ,a ,/ate t
 receives a grant "u ?is section %all   
use grant funds to c>ry out ! foll[+3   
7,a7 ,activities to provide = a r$uction
 9 heal? insurance premium tr5ds &      
actual premiums ?r\gh programs su* z    
,/ate-specific co/-%>+ programs to r$uce
 deductibles & out-(-pocket exp5ses4    
7,b7 ,activities to increase ! numb] (  
individuals 9 ! ,/ate t receive heal?   
insurance cov]age4  7,c7 ,a ,/ate-run   
premium rate review program to det]m9e  
unreasonable heal? insurance premium    
increases & assi/ ! ,/ate 9 facilitat+  
an effective program to r$uce su* rates 

9 accordance ) section #bgid ( ! ,public
 ,heal? ,s]vice ,act4  7,d7 ,activities 
"u section #accb to all[ = great] ,/ate 
flexibility 9 address+ af=dability1     
quality1 & accessibility ( heal?        
insurance 9 ! ,/ates4  7#b7 ,bonus      
paym5ts  7,a7 ,9 g5]al ,! ,secret>y1 9  
consultation ) ! ,assi/ant ,secret>y =  
,plann+ & ,evaluation1 %all conduct an  
evaluation ( all regions 9 ! ,unit$     
,/ates to assess :i* regions 7t may be  
compris$ ( collections ( geographic     
subdivisions su* z ,core-,bas$          
,/ati/ical ,areas1 c5sus tracts1 or     
,,zip ,codes7 h ! highe/ premiums =     
heal? insurance cov]age4 ,su* evaluation
 %all det]m9e ! foll[+3  7i7 ,! numb] ( 
individuals ) access to heal? insurance 
cov]age 9 ea* region4  7ii7 ,! av]age   
premiums & out-(-pocket exp5ses p] p]son
 9 ea* su* region4  7iii7 ,! am\nt (    
uncomp5sat$ heal? c>e provid$ by        
hospitals1 cl9ics1 & safety-net provid]s
 9 ea* su* region4  7iv7 ,! ext5t to :i*
 a ,/ate has us$ tools to control &     

analyze heal? c>e co/s ?r\gh heal? c>e  
data collection4  7,b7 ,use ,am\nts     
provid$ z a bonus paym5t "u ?is p>agraph
 may be us$ by ! ,/ate = activities     
design$ to r$uce heal? insurance        
premiums1 or to keep su* premiums f     
ris+1 = consum]s 9 ! ,/ate1 9           
coord9ation ) ! ,dep>tm5t ( ,heal? &    
,human ,s]vices4 ,su* activities may    
include ! provision ( direct assi/ance  
to consum]s 9 ! =m ( tax cr$its to r$uce
 premiums4  7e7 ,risk mitigation & risk 
corridors  7#a7 ,9 g5]al ,! ,secret>y   
%all di/ribute am\nts available = ! risk
 mitigation & risk corridor program "u  
subsection 7d7 = cal5d> ye>s #bjaf1     
#bjag1 & #bjah4  7#b7 ,paym5ts ,paym5ts 
%all be made "u ?is subsection 9        
accordance ) su* section #acdb4  7#c7   
,use ( funds ,a ,/ate %all use am\nts   
receiv$ "u ?is subsection = activities  
describ$ 9 subsection 7d77#a74  7f7     
,fund+  7#a7 ,9 g5]al ,! ,secret>y %all 
c>ry out ?is section us+ am\nts made    
available = ! ,dep>tm5t ( ,heal? &      

,human ,s]vices & rema9+ unobligat$4    
7#b7 ,no limitation on o!r assi/ance    
,no?+ 9 ?is section %all be con/ru$ z   
prohibit+ ! ,secret>y & ! ,secret>y ( ! 
,treasury f utiliz+ additional funds to 
c>ry out ?is section or o!r programs to 
support ! subsidiz$1 af=dable pur*ase ( 
private heal? insurance cov]age1 not)/&+
 ! ,consolidat$ & ,fur!r ,cont9u+       
,appropriations ,act1 #bjae 7,public    
,law #aac-bce74  4