,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #bghh  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #f1 #bjag,ms4   
,mi*elle ,lujan ,gri%am ( ,new ,mexico  
7= h]self1 ,mr4 ,mc,govern1 ,mr4        
,espaillat1 ,mr4 ,takano1 ,ms4 ,moore1  
,mrs4 ,napolitano1 ,ms4 ,bonamici1 ,mr4 
,gallego1 ,mr4 ,veasey1 ,ms4 ,b>ragn1   
,mr4 ,gutirrez1 ,ms4 ,s*ak[sky1 ,mrs4   
,torres1 ,ms4 ,roybal-,all>d1 ,mr4      
,ellison1 ,mr4 ,soto1 ,ms4 ,cl>ke ( ,new
 ,york1 ,ms4 ,p+ree1 ,ms4 ,wilson (     
,florida1 ,ms4 ,norton1 ,mr4 ,grijalva1 
,mr4 ,s]rano1 ,ms4 ,cl>k (              
,massa*usetts1 ,ms4 ,jayapal1 ,ms4      
,hanabusa1 ,mr4 ,johnson ( ,georgia1    
,mr4 ,ha/+s1 ,ms4 ,sn*ez1 ,ms4 ,l(gr51 &
 ,ms4 ,lee7 introduc$ ! foll[+ bill2 :i*
 0 ref]r$ to ! ,committee on ,en]gy &   
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to exp& access to  

heal? c>e s]vices1 includ+ sexual1      
reproductive1 & mat]nal heal? s]vices1 =
 immigrant wom51 m51 & families by      
remov+ legal b>ri]s to heal? insurance  
cov]age1 & = o!r purposes4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,heal?  
,equity & ,access "u ! ,law = ,immigrant
 ,wom5 & ,families ,act ( #bjag or z !  
,,heal = ,immigrant ,wom5 & ,families   
,act ( #bjag4  #b4 ,f9d+s2 purpose  7a7 
,f9d+s ,congress f9ds z foll[s3  7#a7   
,insurance cov]age r$uces h>mful heal?  
disp>ities by alleviat+ co/ b>ri]s to & 
increas+ utilization ( basic prev5tive  
heal? s]vices1 especially among         
l[-income & und]s]v$ populations1 &     
especially among wom54  7#b7 ,bas$      
solely on _! immigration /atus1 _m      
immigrants & _! families face legal     
re/rictions on _! ability to obta9 heal?
 insurance cov]age ?r\gh ,m$icaid1      
,,*ip1 & ,heal? ,insurance ,ex*anges4   
7#c7 ,lack ( heal? insurance contributes
 to p]si/5t disp>ities 9 ! prev5tion1   
diagnosis1 & treatm5t ( negative heal?  

outcomes borne by immigrants & _!       
families4  7#d7 ,immigrant wom5 are     
disproportionately ( reproductive age1  
l[-income1 & lack+ heal? insurance      
cov]age4 ,legal b>ri]s to af=dable heal?
 insurance cov]age !re=e p>ticul>ly     
exac]bate _! risk ( negative sexual1    
reproductive1 & mat]nal heal? outcomes1 
) la/+ heal? & economic consequ5ces =   
immigrant wom51 _! families1 & society z
 a :ole4  7#e7 ,d5y+ cov]age or impos+  
wait+ p]iods = cov]age unfairly h9d]s ! 
ability ( immigrants to take            
responsibility = _! own heal? & economic
 well-be+ & t ( _! families4 ,to fully &
 productively p>ticipate 9 society1     
access to heal? c>e is fundam5tal1 :i* =
 wom5 includes access to ! s]vices      
necess>y to plan :e!r & :5 to h a *ild4 
7#f7 ,! population ( immigrant families 
9 ! ,unit$ ,/ates is expect$ to cont9ue 
to gr[4 ,inde$ "o 9 f\r *ildr5 9 !      
,unit$ ,/ates is "p ( an immigrant      
family4 ,x is !re=e 9 ! ,nation's %>$   
public heal? & economic int]e/ to remove

 legal b>ri]s to af=dable heal?         
insurance cov]age bas$ on immigration   
/atus4  7#g7 ,al?\gh ,def]r$ ,action =  
,*ildhood ,arrivals 7,,daca7 recipi5ts  
are au?oriz$ to live & "w 9 ! ,unit$    
,/ates1 !y h be5 unfairly exclud$ f !   
def9ition ( lawfully pres5t & lawfully  
resid+ = purposes ( heal? insurance     
cov]age by ! ,dep>tm5t ( ,heal? & ,human
 ,s]vices1 includ+ ,m$icaid & !         
,*ildr5's ,heal? ,insurance ,program    
7,,*ip74  7#h7 ,immigration law is      
con/antly evolv+ & new immigration      
categories = individuals ) f$]ally      
au?oriz$ pres5ce 9 ! ,unit$ ,/ates may  
be creat$4  7b7 ,purpose ,x is ! purpose
 ( ?is ,act to ensure t all individuals 
:o are grant$ f$]ally au?oriz$ pres5ce  
are treat$ z be+ lawfully pres5t 9 !    
,unit$ ,/ates = purposes ( eligibility  
"u all f$]ally fund$ heal? c>e programs4
  #c4 ,remov+ b>ri]s to heal? cov]age = 
lawfully pres5t individuals  7a7        
,m$icaid ,section #aijc7v77#d7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   

#acif;b7v77#d77 is am5d$--  7#a7 by     
am5d+ subp>agraph 7,a7 to read z foll[s3
  7,a7 ,not)/&+ sections #dja7;a71      
#djb7;b71 #djc1 & #dba ( ! ,p]sonal     
,responsibility & ,"w ,opportunity      
,reconciliation ,act ( #aiif1 paym5t    
%all be made "u ?is section = c>e &     
s]vices t are furni%$ to ali5s1 includ+ 
^? describ$ 9 p>agraph 7#a71 if !y      
o!rwise meet ! eligibility requirem5ts =
 m$ical assi/ance "u ! ,/ate plan       
approv$ "u ?is title 7o!r ?an !         
requirem5t ( ! receipt ( aid or         
assi/ance "u title ,,iv1 supplem5tal    
security income b5efits "u title ,,xvi1 
or a ,/ate supplem5t>y paym5t71 & are   
lawfully pres5t 9 ! ,unit$ ,/ates       
7includ+ su* an individual :o is grant$ 
def]r$ action or o!r f$]ally au?oriz$   
pres5ce o!r ?an z a nonimmigrant74  2   
7#b7 9 subp>agraph 7,b7-- 7,a7 by /rik+ 
a ,/ate t has elect$ to provide m$ical  
assi/ance to a category ( ali5s "u      
subp>agraph 7,a7 & ins]t+ ali5s provid$ 
m$ical assi/ance pursuant to subp>agraph

 7,a72 &  7,b7 by /rik+ to su* category 
& ins]t+ to su* ali52 &  7#c7 9         
subp>agraph 7,c7--  7,a7 by /rik+ an    
election by ! ,/ate "u subp>agraph 7,a7 
& ins]t+ ! application ( subp>agraph    
7,a72  7,b7 by ins]t+ or be lawfully    
pres5t aft] lawfully reside2 &  7,c7 by 
ins]t+ or pres5t aft] lawfully resid+   
ea* place x appe>s4  7b7 ,,*ip          
,subp>agraph 7,m7 ( section             
#bajg7;e77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acig;gg7e77#a77 is     
am5d$ to read z foll[s3  7,m7 ,p>agraph 
7#d7 ( section #aijc7v7 7relat+ to      
lawfully pres5t individuals74  4  7c7   
,effective date  7#a7 ,9 g5]al ,except z
 provid$ 9 p>agraph 7#b71 ! am5dm5ts    
made by ?is section %all take effect on 
! date ( ! enactm5t ( ?is ,act & %all   
apply to s]vices furni%$ on or aft] !   
date t is #ij days aft] su* date ( !    
enactm5t4  7#b7 ,exception if /ate      
legislation requir$ ,9 ! case ( a ,/ate 
plan = m$ical assi/ance "u title ,,xix1 
or a ,/ate *ild heal? plan "u title     

,,xxi1 ( ! ,social ,security ,act :i* ! 
,secret>y ( ,heal? & ,human ,s]vices    
det]m9es requires ,/ate legislation 7o!r
 ?an legislation appropriat+ funds7 9   
ord] = ! plan to meet ! additional      
requirem5ts impos$ by ! am5dm5ts made by
 ?is section1 ! respective ,/ate plan   
%all n be reg>d$ z fail+ to comply ) !  
requirem5ts ( su* title solely on !     
basis ( its failure to meet ^!          
additional requirem5ts be=e ! fir/ day (
 ! fir/ cal5d> qu>t] beg9n+ aft] ! close
 ( ! fir/ regul> session ( ! ,/ate      
legislature t beg9s aft] ! date ( !     
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 su* session %all be deem$ to be a      
sep>ate regul> session ( ! ,/ate        
legislature4  #d4 ,consi/5cy 9 heal?    
cov]age = individuals ) f$]ally au?oriz$
 pres5ce1 includ+ def]r$ action  7a7 ,9 
g5]al ,= ! purposes ( eligibility "u any
 ( ! provisions ref]r$ to 9 subsection  
7b71 all individuals grant$ f$]ally     

au?oriz$ pres5ce 9 ! ,unit$ ,/ates o!r  
?an z a nonimmigrant %all be consid]$ to
 be lawfully pres5t 9 ! ,unit$ ,/ates4  
7b7 ,provisions describ$ ,! provisions  
describ$ 9 ?is subsection are ! foll[+3 
7#a7 ,ex*ange eligibility ,section #acaa
 ( ! ,pati5t ,protection & ,af=dable    
,c>e ,act 7#db ,u4,s4,c4 #ahjca74  7#b7 
,r$uc$ co/-%>+ eligibility ,section     
#adjb ( ! ,pati5t ,protection &         
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjga74  7#c7 ,premium subsidy         
eligibility ,section #cf;,b ( ! ,int]nal
 ,rev5ue ,code ( #aihf4  7#d7 ,m$icaid &
 ,,*ip eligibility ,titles ,,xix & ,,xxi
 ( ! ,social ,security ,act1 includ+ "u 
section #aijc7v7 ( su* ,act 7#db        
,u4,s4,c4 #acif;b7v774  7c7 ,effective  
date  7#a7 ,9 g5]al ,subsection 7a7 %all
 take effect on ! date ( ! enactm5t (   
?is ,act4  7#b7 ,transition ?r\gh       
special enrollm5t p]iod ,9 ! case ( an  
individual describ$ 9 subsection 7a7 :o1
 be=e ! fir/ day ( ! fir/ annual op5    
enrollm5t p]iod "u subp>agraph 7,b7 (   

section #acaa7;c77#f7 ( ! ,pati5t       
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjca7;c77#f77 beg9n+ aft] ! 
date ( ! enactm5t ( ?is ,act1 is grant$ 
f$]ally au?oriz$ pres5ce 9 ! ,unit$     
,/ates describ$ 9 subsection 7a7 & :o1 z
 a result ( su* subsection1 qualifies = 
a subsidy describ$ 9 p>agraph 7#b7 or   
7#c7 ( su* subsection1 ! ,secret>y (    
,heal? & ,human ,s]vices %all e/abli% a 
special enrollm5t p]iod "u section      
#acaa7;c77#f77;,c7 ( su* ,act dur+ :i*  
su* individual may enroll 9 qualifi$    
heal? plans ?r\gh ,ex*anges "u title ,i 
( su* ,act & qualify = su* a subsidy4 ,=
 su* an individual :o has be5 grant$    
f$]ally au?oriz$ pres5ce 9 ! ,unit$     
,/ates z ( ! date ( ! enactm5t ( ?is    
,act1 su* special enrollm5t p]iod %all  
beg9 n lat] ?an #ij days aft] su* date (
 enactm5t4 ,no?+ 9 ?is p>agraph %all be 
con/ru$ z affect+ ! au?ority ( !        
,secret>y to e/abli% additional special 
enrollm5t p]iods "u section             
#acaa7;c77#f77;,c7 ( ! ,pati5t          

,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjca7;c77#f77;,c774