,,ii  #aad? ,,congress  #a/ ,session    
,s4 #bed  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,janu>y #bf1 #bjae,mr4 
,portman 7= himself1 ,ms4 ,ayotte1 ,mr4 
,mc,cain1 & ,mr4 ,scott7 introduc$ !    
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,f9ance  ,a ,,bill   
,to l[] heal? premiums & increase *oice 
= small bus9esses4  #a4 ,%ort title2    
table ( cont5ts  7a7 ,%ort title ,?is   
,act may be cit$ z ! ,small ,bus9ess    
,heal? ,relief ,act ( #bjae4  7b7 ,table
 ( cont5ts ,! table ( cont5ts = ?is ,act
 is z foll[s3 ,sec4 #a4 ,%ort title2    
table ( cont5ts4 ,,title ,i--,mak+      
cov]age af=dable = small bus9esses ,sec4
 #aja4 ,protect+ ,am]ican jobs & wages4 
,sec4 #ajb4 ,increas+ flexibility =     
small bus9esses4 ,sec4 #ajc4 ,increas+  
*oices = ,am]icans4 ,sec4 #ajd4         
,protect+ pati5ts f high] premiums4     
,sec4 #aje4 ,ensur+ af=dable cov]age4   
,,title ,,ii--,increas+ consum] control 
,sec4 #bja4 ,repeal ( re/riction on     
ov]-!-c\nt] m$ic9es4 ,sec4 #bjb4 ,repeal

 ( ! annual cap4 ,,title ,,iii--,all[+  
individuals to keep cov]age !y l ,sec4  
#cja4 ,all[+ individuals to keep !      
cov]age !y h if !y l x4  ,i ,mak+       
cov]age af=dable = small bus9esses      
#aja4 ,protect+ ,am]ican jobs & wages   
7a7 ,repeal ( %>$ responsibility paym5t 
= employ]s reg>d+ heal? cov]age  7#a7 ,9
 g5]al ,*apt] #dc ( ! ,int]nal ,rev5ue  
,code ( #aihf is am5d$ by /rik+ section 
#dihj;,h4  7#b7 ,con=m+ am5dm5ts  7,a7  
,! table ( sections = *apt] #dc ( !     
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by /rik+ ! item relat+ to section       
#dihj;,h4  7,b7 ,section                
#acaa7;d77#d77;,i7 ( ! ,pati5t          
,protection & ,af=dable ,c>e ,act is    
am5d$ by ins]t+ & at ! end ( clause 7i7 
& by /rik+ clause 7ii74  7,c7 ,section  
#accb7;a77#b77;,d7 ( su* ,act is am5d$  
by /rik+ #cf;,b1 #dihj;,h1 & #ejjj;,a & 
ins]t+ #cf;,b & #ejjj;,a4  7,d7 ,section
 #adaa7;e77#d77;,b7 ( su* ,act is am5d$ 
by /rik+ clause 7iii74  7,e7 ,section   
#adaa7;f7 ( su* ,act is am5d$ to read z 

foll[s3  7f7 ,appeals & r$et]m9ations ,!
 ,secret>y1 9 consultation ) ! ,secret>y
 ( ! ,treasury1 ! ,secret>y ( ,homel&   
,security1 & ! ,commission] ( ,social   
,security1 %all e/abli% proc$ures by :i*
 ! ,secret>y or "o ( su* o!r ,f$]al     
(fic]s-- 7#a7 he>s & makes decisions )  
respect to appeals ( any det]m9ation "u 
subsection 7e72 &  7#b7 r$et]m9es       
eligibility on a p]iodic basis 9        
appropriate circum/ances4  4  7,f7      
,section #adaa ( su* ,act is am5d$ by   
/rik+ subsection 7i74  7,g7 ,section    
#adab7;a77#b7 ( su* ,act is am5d$ to    
read z foll[s3  7#b7 ! ,secret>y        
notifies ! ,ex*ange & ! ,secret>y ( !   
,treasury ( ! advance det]m9ations2 &  4
  7,h7 ,section #aeac ( su* ,act is     
am5d$ by /rik+ subsection 7c74  7#c7    
,effective date ,! am5dm5ts made by ?is 
subsection %all apply to mon?s aft]     
,decemb] #ca1 #bjac4  7b7 ,repeal (     
report+ ( employ] heal? insurance       
cov]age  7#a7 ,9 g5]al ,subp>t ,d ( "p  
,,iii ( sub*apt] ,a ( *apt] #fa ( !     

,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by /rik+ section #fjef4  7#b7 ,con=m+   
am5dm5ts  7,a7 ,section                 
#fgbd7;d77#a77;,b7 ( ! ,int]nal ,rev5ue 
,code ( #aihf is am5d$ by ins]t+ or at !
 end ( clause 7xxiii71 by /rik+ 1 or at 
! end ( clause 7xxiv7 & ins]t+ a p]iod1 
& by /rik+ clause 7xxv74  7,b7 ,section 
#fgbd7;d77#b7 ( su* ,code is am5d$ by   
ins]t+ or at ! end ( subp>agraph 7,,ff71
 by /rik+ 1 or at ! end ( subp>agraph   
7,,gg7 & ins]t+ a p]iod1 & by /rik+     
subp>agraph 7,,hh74  7#c7 ,effective    
date ,! am5dm5ts made by ?is subsection 
%all apply to p]iods beg9n+ aft]        
,decemb] #ca1 #bjac4  #ajb4 ,increas+   
flexibility = small bus9esses ,section  
#acjb7;c77#b7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act 7,public ,law       
#aaa-adh7 is repeal$4  #ajc4 ,increas+  
*oices = ,am]icans  7a7 ,qualifi$ heal? 
plan cov]age satisfi$ by high d$uctible 
heal? plan ) heal? sav+s acc\nt ,section
 #acjb7;e7 ( ! ,pati5t ,protection &    
,af=dable ,c>e ,act 7#db ,u4,s4,c4      

#ahjbb7;e77 is am5d$ to read z foll[s3  
7e7 ,high d$uctible heal? plan ) heal?  
sav+s acc\nt ,a heal? plan n provid+ a  
bronze1 silv]1 gold1 or plat9um level ( 
cov]age %all be treat$ z meet+ !        
requirem5ts ( subsection 7d7 ) respect  
to any plan ye> = any enrollee if ! plan
 meets ! requirem5ts = a high d$uctible 
heal? plan "u section #bbc7;c77#b7 ( !  
,int]nal ,rev5ue ,code ( #aihf & su*    
enrollee has e/abli%$ a heal? sav+s     
acc\nt 7z def9$ 9 section #bbc7;d77#a7 (
 su* ,code7 9 relation to su* plan4  4  
7b7 ,con=m+ am5dm5ts  7#a7 ,subp>agraph 
7,c7 ( section #acab7;d77#c7 ( ! ,pati5t
 ,protection & ,af=dable ,c>e ,act 7#db 
,u4,s4,c4 #ahjcb7;d77#c77 is am5d$ by   
/rik+ 1 except & all t foll[s ?r\gh     
#acjb7;e77#b74  7#b7 ,subp>agraph 7,a7 (
 section #cf;,b7c77#c7 ( ! ,int]nal     
,rev5ue ,code ( #aihf1 z add$ by section
 #adja7;a7 ( ! ,pati5t ,protection &    
,af=dable ,c>e ,act 7,public ,law       
#aaa-adh7 is am5d$ by /rik+ 1 except &  
all t foll[s ?r\gh su* ,act4  7#c7      

,subp>agraph 7,b7 ( section             
#accd7;c77#a7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjed7;c77#a77 is am5d$ by /rik+ &     
cata/rophic cov]age4  #ajd4 ,protect+   
pati5ts f high] premiums ,section #ijaj 
( ! ,pati5t ,protection & ,af=dable ,c>e
 ,act 7,public ,law #aaa-adh71 z am5d$  
by section #ajije ( su* ,act1 is        
repeal$4  #aje4 ,ensur+ af=dable cov]age
 ,section #bgja7;a77#a77;,a77iii7 ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj7;a77#a77;,a77iii771 z    
add$ by section #abja ( ! ,pati5t       
,protection & ,af=dable ,c>e ,act       
7,public ,law #aaa-adh71 is am5d$ by    
/rik+ 1 except & all t foll[s ?r\gh     
#bgjg7;c774  ,,ii ,increas+ consum]     
control  #bja4 ,repeal ( re/riction on  
ov]-!-c\nt] m$ic9es  7a7 ,h,s,as        
,section #bbc7;d77#b77;,a7 ( ! ,int]nal 
,rev5ue ,code ( #aihf is am5d$ by /rik+ 
! la/ s5t5ce !re(4  7b7 ,ar*] ,m,s,as   
,section #bbj7;d77#b77;,a7 ( ! ,int]nal 
,rev5ue ,code ( #aihf is am5d$ by /rik+ 

! la/ s5t5ce !re(4  7c7 ,heal? flexible 
sp5d+ arrangem5ts & heal? reimbursem5t  
arrangem5ts ,section #ajf ( ! ,int]nal  
,rev5ue ,code ( #aihf is am5d$ by /rik+ 
subsection 7f74  7d7 ,effective date    
7#a7 ,di/ributions f sav+s acc\nts ,!   
am5dm5ts made by subsections 7a7 & 7b7  
%all apply to am\nts paid ) respect to  
taxable ye>s beg9n+ aft] ,decemb] #ca1  
#bjad4  7#b7 ,reimbursem5ts ,! am5dm5t  
made by subsection 7c7 %all apply to    
exp5ses incurr$ ) respect to taxable    
ye>s beg9n+ aft] ,decemb] #ca1 #bjad4   
#bjb4 ,repeal ( ! annual cap  7a7 ,9    
g5]al ,section #abe ( ! ,int]nal ,rev5ue
 ,code ( #aihf is am5d$ by /rik+        
subsection 7i7 & by r$esignat+          
subsections 7j7 & 7k7 z subsections 7i7 
& 7j71 respectively4  7b7 ,effective    
date ,! am5dm5ts made by ?is section    
%all apply to taxable ye>s beg9n+ aft]  
,decemb] #ca1 #bjad4  ,,iii ,all[+      
individuals to keep cov]age !y l  #cja4 
,all[+ individuals to keep ! cov]age !y 
h if !y l x  7a7 ,9 g5]al ,section      

#abea7;a77#b7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjaa7 is am5d$-- 7#a7 by /rik+ ,except
 z provid$ 9 p>agraph 7#c71 & ins]t+ !  
foll[+3  7,a7 ,9 g5]al ,except z provid$
 9 p>agraphs 7#c7 & 7#d71  2 &  7#b7 by 
add+ at ! end ! foll[+3  7,b7 ,protect+ 
employ]s & consum]s ) gr&fa!r$ cov]age  
7i7 ,9 g5]al ,a gr\p heal? plan or heal?
 insurance cov]age 9 :i* an individual  
is enroll$ on or aft] ,m>* #bc1 #bjaj1 b
 be=e any plan ye> beg9n+ n lat] ?an #a 
ye> aft] ! date ( ! enactm5t ( ?is      
subp>agraph1 & :i* is deem$ to be a     
gr&fa!r$ heal? plan "u ?is section1 %all
 cont9ue to be consid]$ a gr&fa!r$ heal?
 plan ) respect to su* individual       
reg>dless ( any modification to !       
co/-%>+ levels1 employ] contribution    
rates1 or cov]$ b5efits "u su* plan or  
cov]age z o!rwise p]mitt$ "u ?is ,act 7&
 ! am5dm5ts made by ?is ,act74  7ii7    
,regulations ,! ,secret>y %all          
promulgate regulations to cl>ify !      
application ( clause 7i7 to a plan or   

cov]age t cont9ues to be a gr&fa!r$     
heal? plan pursuant to su* clause4  4   
7b7 ,effective date2 previ\sly          
promulgat$ regulations void$  7#a7      
,effective date ,! am5dm5ts made by ?is 
section %all take effect z if includ$ 9 
! enactm5t ( ! ,pati5t ,protection &    
,af=dable ,c>e ,act4  7#b7 ,previ\sly   
promulgat$ regulations void$ ,any       
regulations relat+ to section           
#abea7;a77#b7 ( su* ,act promulgat$ be=e
 ! date ( ! enactm5t ( ?is ,act %all h  
no =ce or effect4