,i #aae? ,,congress #a/ ,session ,h4 ,r4 #dabh ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,octob] #be1 #bjag,ms4 ,mi*elle ,lujan ,gri%am ( ,new ,mexico 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 am5d title ,,xix ( ! ,social ,security ,act to all[ ,/ates ) ,ex*anges ) l[-insur] p>ticipation to (f] a ,m$icaid buy-9 plan1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ at ! ,heal? ,c>e ,*oice & ,af=dability ,act4 #b4 ,m$icaid buy-9 plans 7a7 ,9 g5]al 7#a7 ,(f]+ on an ,ex*ange ,= a plan ye> beg9n+ on or aft] ,janu>y #a1 #bjah1 not)/&+ any o!r provision ( law1 a ,m$icaid buy-9 ,/ate may (f] to eligible individuals ) respect to a plan ye> a ,m$icaid buy-9 plan 9 ! individual m>ket ?r\gh an ,ex*ange e/abli%$ "u title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act = su* plan ye>4 7#b7 ,premium rates 7,a7 ,9 g5]al ,a ,m$icaid buy-9 ,/ate t (f]s a ,m$icaid buy-9 plan "u p>agraph 7#a7 %all e/abli% premium rates "u su* plan at a level calculat$ to produce rev5ue equal to ! sum (-- 7i7 ! co/s ( heal? b5efits provid$ by ! plan2 plus 7ii7 #aj p]c5t ( ! adm9i/rative co/s relat$ to op]at+ ! plan4 7,b7 ,prohibit+ discrim9atory premiums ,9 ! case ( a ,m$icaid buy-9 plan1 premiums may only v>y to ! ext5t p]mitt$ "u section #bgja7;a77#a7 ( ! ,public ,heal? ,s]vice ,act4 7#c7 ,enrollm5t ,! enrollm5t p]iod = a ,m$icaid buy-9 plan (f]$ "u p>agraph 7#a7 %all1 to ! ext5t practicable1 con=m ) ! enrollm5t p]iod = qualifi$ heal? plans (f]$ ?r\gh an ,ex*ange4 7#d7 ,f$]al paym5t = adm9i/rative exp5ses ,9 ! case ( a ,m$icaid buy-9 ,/ate t (f]s a ,m$icaid buy-9 plan "u p>agraph 7#a71 ! ,secret>y ( ,heal? & ,human ,s]vices %all pay to su* ,/ate = ea* cal5d> qu>t] beg9n+ on or aft] ,janu>y #a1 #bjah1 an am\nt equal to #ij p]c5t ( s mu* ( ! sums exp5d$ dur+ su* qu>t] z are attributable to adm9i/]+ ! ,m$icaid buy-9 plan 9 su* ,/ate4 7b7 ,premium tax cr$its 7#a7 ,9 g5]al ,section #cf;,b ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new subsection3 7h7 ,application to individuals pur*as+ ,m$icaid cov]age ,9 ! case ( any individual enroll$ 9 a ,m$icaid buy-9 plan subsection 7a7 %all be appli$ by sub/itut+ = premium assi/ance cr$it am\nt ( ! taxpay] = ! taxable ye> ! foll[+3 ! less] (-- 7#a7 ! mon?ly premiums *>g$ by a ,m$icaid buy-9 ,/ate = a ,m$icaid buy-9 plan t cov]s ! taxpay]1 ! taxpay]'s sp\se1 or any dep5d5t 7z def9$ 9 section #aeb7 ( ! taxpay]1 or 7#b7 ! excess 7if any7 (-- 7,a7 su* mon?ly premium1 ov] 7,b7 an am\nt equal to #a_/ab ( ! product ( ! applicable p]c5tage & ! taxpay]'s h\sehold income = ! taxable ye>4 4 4 7#b7 ,exception = m9imum ess5tial cov]age ,subp>agraph 7,b7 ( section #cf;,b7c77#b7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by ins]t+ be=e ! p]iod at ! end ! foll[+3 or eligibility = cov]age "u a ,m$icaid buy-9 plan 7z def9$ 9 section #b7;c7 ( ! ,heal? ,c>e ,*oice & ,af=dability ,act74 7#c7 ,individual m&ate ,clause 7ii7 ( section #ejjj;,a7f77#a77;,a7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by ins]t+ be=e ! comma ! foll[+3 includ+ "u a ,m$icaid buy-9 plan 7z def9$ 9 section #b7;c7 ( ! ,heal? ,c>e ,*oice & ,af=dability ,act74 7#d7 ,advance paym5t ( cr$it 7,a7 ,9 g5]al ,advance det]m9ations & paym5ts ( premium tax cr$its all[able "u section #cf;,b ( ! ,int]nal ,rev5ue ,code ( #aihf ) respect to an individual enroll$ 9 a ,m$icaid buy-9 plan %all be all[$1 subject to rules simil> to ! rules 9 section #adab ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7appli$ )\t reg>d to :e!r su* plan is a qualifi$ heal? plan74 7,b7 ,coord9ation ) cr$it ,section #cf;,b7f7 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,m$icaid buy-9 plans ,= purposes ( ?is subsection1 advance paym5ts "u section #b7;b77#d77;,a7 ( ! ,heal? ,c>e ,*oice & ,af=dability ,act %all be treat$ z advance paym5ts "u section #adab ( ! ,pati5t ,protection & ,af=dable ,c>e ,act4 4 7#e7 ,con=m+ am5dm5t relat+ to employ] responsibility ,section #dihj;,h7c77#f7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by ins]t+ 1 except t = purposes ( subsections 7a77#b7 & 7b77#a77;,b71 ! t]m qualifi$ heal? plan %all include a ,m$icaid buy-9 plan 7z def9$ 9 section #b7;c7 ( ! ,heal? ,c>e ,*oice & ,af=dability ,act aft] su* ,act4 7c7 ,def9itions ,9 ?is section3 7#a7 ,eligible individual ,! t]m eligible individual means an individual :o w h access to only qualifi$ heal? plans issu$ by "o heal? insurance issu] 7z def9$ 9 section #bgia ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ia77 or w h access to no qualifi$ heal? plans ) respect to a plan ye>4 7#b7 ,m$icaid buy-9 ,/ate ,! t]m ,m$icaid buy-9 ,/ate means a ,/ate t has at lea/ "o political subdivision 9 :i* few] ?an two heal? insurance issu]s p>ticipate 9 ! ,f$]al1 ,f$]ally facilitat$1 or ,/ate ,ex*ange e/abli%$ "u title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7,public ,law #aaa-adh7 = su* political subdivision4 7#c7 ,m$icaid buy-9 plan ,! t]m ,m$icaid buy-9 plan means a heal? insurance plan t-- 7,a7 is adm9i/]$ by ! ,/ate ag5cy adm9i/]+ ! ,/ate plan "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 7or a waiv] ( su* plan72 & 7,b7 consi/s ( b5*m>k cov]age describ$ 9 subsection 7b77#a7 ( section #aicg ( su* ,act 7#db ,u4,s4,c4 #acifu-#g7;b77#a77 or b5*m>k-equival5t cov]age describ$ 9 subsection 7b77#b7 ( su* section4 7#d7 ,qualifi$ heal? plan ,! t]m qualifi$ heal? plan has ! mean+ giv5 su* t]m 9 section #acja ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjba74