,,ii  ,cal5d> ,no4 #fbh #aad? ,,congress
  #b;d ,session  ,s4 #ccbf  ,,9 ,,!     
,,s5ate ,,( ,,! ,,unit$ ,,/ates         
,septemb] #ad1 #bjaf ,mr4 ,alex&] 7=    
himself1 ,ms4 ,ayotte1 ,mr4 ,b>rasso1   
,mr4 ,co*ran1 ,mr4 ,johnson1 ,mr4 ,kirk1
 ,mr4 ,p]due1 & ,mr4 ,portman7 introduc$
 ! foll[+ bill2 :i* 0 read ! fir/ "t    
,septemb] #ae1 #bjaf,read ! second "t & 
plac$ on ! cal5d>  ,a ,,bill  ,to give  
,/ates ! au?ority to provide tempor>y   
access to af=dable private heal?        
insurance options outside ( ,obamac>e   
ex*anges4  #a4 ,%ort title  ,?is ,act   
may be cit$ z ! ,/ate ,flexibility to   
,provide ,af=dable ,heal? ,options ,act4
  #b4 ,tempor>y access to af=dable      
private heal? insurance options outside 
( ,obamac>e ,ex*anges  7a7 ,9 g5]al ,=  
purposes ( apply+ ! provisions ( title  
,i ( ! ,pati5t ,protection & ,af=dable  
,c>e ,act 7includ+ ! am5dm5ts made by t 
title7 to a ,/ate t has made a          
det]m9ation "u subsection 7b71 ! t]m    
qualifi$ heal? plan %all be deem$ to    

include any heal? insurance plan t is   
au?oriz$ by ! ,/ate to be (f]$ 9 !      
individual or small gr\p m>ket 9 ! ,/ate
 o!r ?an ?r\gh ! ,/ate ,ex*ange e/abli%$
 "u title ,i ( ! ,pati5t ,protection &  
,af=dable ,c>e ,act 7or ,f$]al ,ex*ange 
9 ! case ( a ,/ate t is n op]at+ su* an 
,ex*ange74  7b7 ,/ate det]m9ation &     
notification  7#a7 ,9 g5]al ,! ,gov]nor 
( a ,/ate1 9 consultation ) ! applicable
 ,/ate au?ority 7z def9$ 9 section      
#bgia7;d77#a7 ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4                    
#cjj;gg-#ia7;d77#a777 ( a ,/ate may make
 a det]m9ation t tempor>y access to     
af=dable private heal? insurance options
 outside ( an ,ex*ange e/abli%$ "u title
 ,i ( ! ,pati5t ,protection & ,af=dable 
,c>e ,act is necess>y to ensure t       
resid5ts ( ! ,/ate h access to an       
adequate numb] ( af=dable private heal? 
insurance options 9 ! individual or     
small gr\p m>kets 9 su* ,/ate4  7#b7    
,c]tification ,9 mak+ a det]m9ation "u  
p>agraph 7#a71 ! ,gov]nor %all c]tify to

 ! ,secret>y ( ,heal? & ,human          
,s]vices--  7,a7 t !re is at lea/ "o    
c\nty 7or1 9 ! case ( a ,/ate t does n h
 c\nties1 an equival5t municipality7 9 !
 ,/ate 9 :i* none or only "o heal?      
insurance issu] (f]s1 or is expect$ to  
(f]1 cov]age ?r\gh ! ,/ate ,ex*ange 7or 
,f$]al ,ex*ange 9 ! case ( a ,/ate t is 
n op]at+ su* an ,ex*ange7 = ! #bjag plan
 ye>2 or  7,b7 ! exi/5ce ( o!r factors 9
 ! ,/ate1 su* z increas$ rates or       
premiums = private heal? insurance      
cov]age (f]$1 or expect$ to be (f]$1    
?r\gh ! ,/ate ,ex*ange 7or ,f$]al       
,ex*ange 9 ! case ( a ,/ate t is n      
op]at+ su* an ,ex*ange7 = ! #bjag plan  
ye>4  7#c7 ,notification ,a ,/ate %all  
notify ! ,secret>y ( ,heal? & ,human    
,s]vices ( a det]m9ation "u ?is         
subsection n lat] ?an ,novemb] #a1      
#bjaf4  7c7 ,nonapplication ( individual
 m&ate ,section #ejjj;,a ( ! ,int]nal   
,rev5ue ,code ( #aihf %all n apply )    
respect to resid5ts ( a ,/ate t has made
 a det]m9ation "u subsection 7b7 = !    

#bjag plan ye>4  7d7 ,application (     
provision ,! provisions ( ?is section   
%all only apply dur+ ! #bjag plan ye>4  
,septemb] #ae1 #bjaf,read ! second "t & 
plac$ on ! cal5d>