,,ii  #aadth ,,congress  #b;d ,session  
,s4 #ccbj  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,september #ac1
 #bjaf ,mr4 ,sullivan 7for himself and  
,ms4 ,murkowski7 introduced the         
following bill2 which was read twice and
 referred to the ,committee on ,health1 
,education1 ,labor1 and ,pensions  ,a   
,,bill  ,to waive the essential health  
benefits requirements for certain       
,states4  #a4 ,short title  ,this ,act  
may be cited as the ,ensuring ,health   
,care ,opportunities ,act4  #b4 ,waiver 
of essential health benefits            
requirements  7a7 ,in general ,in the   
case of a ,state in which the applicable
 ,state authority 7as defined in section
 #bgia7;d77#a7 of the ,public ,health   
,service ,act 7#db ,u4,s4,c4            
#cjj;gg-#ia7;d77#a777 certifies to the  
,secretary of ,health and ,human        
,services that1 with respect to at least
 one county 7or1 in the case of a ,state
 that does not have counties1 equivalent
 municipality71 only one health         

insurance issuer offers coverage in the 
individual market for a plan year1 the  
following shall not apply to health     
plans in such ,state for such plan year3
  7#a7 ,the requirement under section   
#acja7;a77#a7 of the ,patient           
,protection and ,affordable ,care ,act  
7#db ,u4,s4,c4 #ahjba7;a77#a77 that1 to 
be a qualified health plan eligible to  
be offered through an ,exchange in the  
,state1 such plan provide the essential 
health benefits package described in    
section #acjb7;a7 of such ,act 7#db     
,u4,s4,c4 #ahjbb7;a774  7#b7 ,the       
requirement under section #bgjg7;a7 of  
the ,public ,health ,service ,act 7#db  
,u4,s4,c4 #cjj;gg-#f7;a77 that health   
insurance coverage offered in the       
individual or small group market in the 
,state includes the essential health    
benefits package required under section 
#acjb7;a7 of the ,patient ,protection   
and ,affordable ,care ,act 7#db         
,u4,s4,c4 #ahjbb7;a774  7b7  ,state     
certification ,to be eligible for a     

waiver under subsection 7a71 a ,state   
shall make the certification described  
in subsection 7a7 not later than--  7#a7
 #ij days after the date of enactment of
 this ,act1 in the case of a ,state in  
which1 on the date of enactment of this 
,act1 at least one county in the ,state 
7or1 in the case of a ,state that does  
not have counties1 equivalent           
municipality71 only one health insurance
 issuer offers coverage in the          
individual market for the plan year in  
effect on such date of enactment2 and   
7#b7 #ij days after the applicable      
,state authority 7as defined in section 
#bgia7;d77#a7 of the ,public ,health    
,service ,act 7#db ,u4,s4,c4            
#cjj;gg-#ia7;d77#a777 first discovers1  
or reasonably should discover1 that1 in 
at least one county in the ,state 7or1  
in the case of a ,state that does not   
have counties1 equivalent municipality71
 only one health insurance issuer offers
 in the current plan year1 or will offer
 in a future plan year1 coverage in the 

individual market for the current plan  
year or a future plan year1 as          
applicable1 in the case of a ,state not 
described in paragraph 7#a74  7c7 ,term 
of waiver ,a waiver under this section  
may extend over a period of not more    
than #e years1 provided that the ,state 
continues to meet the criteria for      
eligibility for the waiver under        
subsection 7a74 ,a ,state that continues
 to meet such criteria for more than #e 
years may re-certify under subsection   
7a7 every #e years4  7d7 ,plans offering
 essential health benefits ,nothing in  
this ,act prevents a health insurance   
issuer from offering in a ,state to     
which a waiver under subsection 7a7     
applies health insurance coverage that  
includes the essential health benefits  
package described in section #acjb7;a7  
of the ,patient ,protection and         
,affordable ,care ,act 7#db ,u4,s4,c4   
#ahjbb7;a774