,,ii  ,calendar ,no4 #fbh #aadth        
,,congress  #b;d ,session  ,s4 #ccbf    
,,in ,,the ,,senate ,,of ,,the ,,united 
,,states  ,september #ad1 #bjaf ,mr4    
,alexander 7for himself1 ,ms4 ,ayotte1  
,mr4 ,barrasso1 ,mr4 ,cochran1 ,mr4     
,johnson1 ,mr4 ,kirk1 ,mr4 ,perdue1 and 
,mr4 ,portman7 introduced the following 
bill2 which was read the first time     
,september #ae1 #bjaf,read the second   
time and placed on the calendar  ,a     
,,bill  ,to give ,states the authority  
to provide temporary access to          
affordable private health insurance     
options outside of ,obamacare exchanges4
  #a4 ,short title  ,this ,act may be   
cited as the ,state ,flexibility to     
,provide ,affordable ,health ,options   
,act4  #b4 ,temporary access to         
affordable private health insurance     
options outside of ,obamacare ,exchanges
  7a7 ,in general ,for purposes of      
applying the provisions of title ,i of  
the ,patient ,protection and ,affordable
 ,care ,act 7including the amendments   

made by that title7 to a ,state that has
 made a determination under subsection  
7b71 the term qualified health plan     
shall be deemed to include any health   
insurance plan that is authorized by the
 ,state to be offered in the individual 
or small group market in the ,state     
other than through the ,state ,exchange 
established under title ,i of the       
,patient ,protection and ,affordable    
,care ,act 7or ,federal ,exchange in the
 case of a ,state that is not operating 
such an ,exchange74  7b7 ,state         
determination and notification  7#a7 ,in
 general ,the ,governor of a ,state1 in 
consultation with 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 of a ,state may   
make a determination that temporary     
access to affordable private health     
insurance options outside of an         
,exchange established under title ,i of 
the ,patient ,protection and ,affordable

 ,care ,act is necessary to ensure that 
residents of the ,state have access to  
an adequate number of affordable private
 health insurance options in the        
individual or small group markets in    
such ,state4  7#b7 ,certification ,in   
making a determination under paragraph  
7#a71 the ,governor shall certify to the
 ,secretary of ,health and ,human       
,services--  7,a7 that there is at least
 one county 7or1 in the case of a ,state
 that does not have counties1 an        
equivalent municipality7 in the ,state  
in which none or only one health        
insurance issuer offers1 or is expected 
to offer1 coverage through the ,state   
,exchange 7or ,federal ,exchange in the 
case of a ,state that is not operating  
such an ,exchange7 for the #bjag plan   
year2 or  7,b7 the existence of other   
factors in the ,state1 such as increased
 rates or premiums for private health   
insurance coverage offered1 or expected 
to be offered1 through the ,state       
,exchange 7or ,federal ,exchange in the 

case of a ,state that is not operating  
such an ,exchange7 for the #bjag plan   
year4  7#c7 ,notification ,a ,state     
shall notify the ,secretary of ,health  
and ,human ,services of a determination 
under this subsection not later than    
,november #a1 #bjaf4  7c7               
,nonapplication of individual mandate   
,section #ejjj;,a of the ,internal      
,revenue ,code of #aihf shall not apply 
with respect to residents of a ,state   
that has made a determination under     
subsection 7b7 for the #bjag plan year4 
7d7 ,application of provision ,the      
provisions of this section shall only   
apply during the #bjag plan year4       
,september #ae1 #bjaf,read the second   
time and placed on the calendar