,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #dfff  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #ah1         
#bjag,mr4 ,co/ello ( ,p5nsylvania       
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce  ,a  
,,bill  ,to am5d ! ,public ,heal?       
,s]vice ,act to provide = a ,pati5t &   
,/ate ,/ability ,fund4  #a4 ,%ort title 
,?is ,act may be cit$ z ! ,premium      
,relief ,act ( #bjag4  #b4 ,pati5t &    
,/ate ,/ability  7a7 ,pati5t & ,/ate    
,/ability ,fund ,! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4 #bja et     
seq47 is am5d$ by add+ at ! end ! foll[+
 new title3  ,,xxxiv ,pati5t & ,/ate    
,/ability ,fund  #cdja4 ,e/abli%m5t (   
program ,!re is h]eby e/abli%$ ! ,pati5t
 & ,/ate ,/ability ,fund to be adm9i/]$ 
by ! ,secret>y1 act+ ?r\gh !            
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices 79 ?is title ref]r$ to
 z ! ,adm9i/rator71 to provide heal?    
b5efits cov]age fund+1 9 accordance )   
?is title1 to ! #ej ,/ates & ! ,di/rict 

( ,columbia 7ea* ref]r$ to 9 ?is section
 z a ,/ate7 dur+ ! p]iod1 subject to    
section #cdjd7;c71 beg9n+ on ,janu>y #a1
 #bjai1 & end+ on ,decemb] #ca1 #bjba1 =
 ! purposes describ$ 9 section #cdjb4   
#cdjb4 ,use ( funds ,a ,/ate may use !  
funds allocat$ to ! ,/ate "u ?is title =
 any ( ! foll[+ purposes3  7#a7 ,help+1 
?r\gh ! provision ( f9ancial assi/ance1 
high-risk individuals :o d n h access to
 heal? insurance cov]age (f]$ ?r\gh an  
employ] enroll 9 heal? insurance cov]age
 9 ! individual m>ket 9 ! ,/ate1 z su*  
m>ket is def9$ by ! ,/ate 7:e!r ?r\gh ! 
e/abli%m5t ( a new me*anism or ma9t5ance
 ( an exi/+ me*anism = su* purpose74    
7#b7 ,provid+ inc5tives to appropriate  
entities to ent] into arrangem5ts ) !   
,/ate to help /abilize premiums = heal? 
insurance cov]age 9 ! individual m>ket1 
z su* m>kets are def9$ by ! ,/ate4  7#c7
 ,r$uc+ ! co/ = provid+ heal? insurance 
cov]age 9 ! individual m>ket & small    
gr\p m>ket1 z su* m>kets are def9$ by ! 
,/ate1 to individuals :o h1 or are      

project$ to h1 a high rate ( utilization
 ( heal? s]vices 7z measur$ by co/7 & to
 individuals :o h high co/s ( heal?     
insurance cov]age due to ! l[ d5sity    
population ( ! ,/ate 9 :i* !y reside4   
7#d7 ,promot+ p>ticipation 9 !          
individual m>ket & small gr\p m>ket 9 ! 
,/ate & increas+ heal? insurance options
 available ?r\gh su* m>ket4  7#e7       
,promot+ access to prev5tive s]vices2   
d5tal c>e s]vices 7:e!r prev5tive or    
m$ically necess>y72 vision c>e s]vices  
7:e!r prev5tive or m$ically necess>y72  
or any comb9ation ( su* s]vices4  7#f7  
,mat]nity cov]age & newborn c>e4  7#g7  
,prev5tion1 treatm5t1 or recov]y support
 s]vices = individuals ) m5tal or       
sub/ance use disord]s1 focus$ on ei!r or
 bo? ( ! foll[+3  7,a7 ,direct inpati5t 
or outpati5t cl9ical c>e = treatm5t (   
addiction & m5tal illness4  7,b7 ,e>ly  
id5tification & int]v5tion = *ildr5 & "y
 adults ) s]i\s m5tal illness4  7#h7    
,provid+ paym5ts1 directly or           
indirectly1 to heal? c>e provid]s = !   

provision ( su* heal? c>e s]vices z are 
specifi$ by ! ,adm9i/rator4  7#i7       
,provid+ assi/ance to r$uce out-(-pocket
 co/s1 su* z copaym5ts1 co9surance1     
premiums1 & d$uctibles1 ( individuals   
enroll$ 9 heal? insurance cov]age 9 !   
,/ate4  #cdjc4 ,/ate eligibility &      
approval2 ,default safegu>d  7a7        
,enc\rag+ ,/ate options = allocations   
7#a7 ,9 g5]al ,to be eligible = an      
allocation ( funds "u ?is title = a ye> 
dur+ ! p]iod describ$ 9 section #cdja = 
use = "o or m purposes describ$ 9       
section #cdjb1 a ,/ate %all submit to ! 
,adm9i/rator an application at su* "t 7b
 n lat] ?an ,m>* #ca ( ! previ\s ye>7 & 
9 su* =m & mann] z specifi$ by !        
,adm9i/rator & conta9+--  7,a7 a        
description ( h[ ! funds w be us$ = su* 
purposes2 &  7,b7 su* o!r in=mation z ! 
,adm9i/rator may require4  7#b7         
,automatic approval ,an application s   
submitt$ is approv$ unless !            
,adm9i/rator notifies ! ,/ate submitt+ !
 application1 n lat] ?an #fj days aft] !

 date ( ! submission ( su* application1 
t ! application has be5 d5i$ = n be+ 9  
compliance ) any requirem5t ( ?is title 
& ( ! reason = su* d5ial4  7#c7 ,"o-"t  
application ,if an application ( a ,/ate
 is approv$ = a ye>1 ) respect to a     
purpose describ$ 9 section #cdjb1 su*   
application %all be treat$ z approv$1 ) 
respect to su* purpose1 = ea* subsequ5t 
ye> ?r\gh #bjba4  7b7 ,default ,f$]al   
safegu>d  7#a7 ,9 g5]al ,9 ! case ( a   
,/ate t does n h 9 effect an approv$    
application "u ?is section = #bjai1     
#bjbj1 or #bjba1 ! ,adm9i/rator1 9      
consultation ) ! ,/ate insurance        
commission]1 %all use ! allocation t    
w\ld o!rwise be provid$ to ! ,/ate "u   
?is title = su* ye>1 9 accordance )     
p>agraph 7#b71 = su* ,/ate4  7#b7       
,requir$ use = m>ket /abilization       
paym5ts to issu]s ,subject to section   
#cdjd7;a71 an allocation = a ,/ate made 
pursuant to p>agraph 7#a7 = a ye> %all  
be us$ to c>ry out ! purpose describ$ 9 
section #cdjb7b7 9 su* ,/ate by provid+ 

paym5ts to appropriate entities describ$
 9 su* section ) respect to claims t    
exce$ #ej1jjj 7or1 ) respect to         
allocations made "u ?is title = #bjbj or
 a subsequ5t ye> dur+ ! p]iod specifi$ 9
 section #cdja1 su* doll> am\nt specifi$
 by ! ,adm9i/rator71 b d n exce$        
#cej1jjj 7or1 ) respect to allocations  
made "u ?is title = #bjbj or a subsequ5t
 ye> dur+ su* p]iod1 su* doll> am\nt    
specifi$ by ! ,adm9i/rator71 9 an am\nt 
equal to #ge p]c5t 7or1 ) respect to    
allocations made "u ?is title = #bjbj or
 a subsequ5t ye> dur+ su* p]iod1 su*    
p]c5tage specifi$ by ! ,adm9i/rator7 ( !
 am\nt ( su* claims4  #cdjd4            
,allocations  7a7 ,appropriation ,= !   
purpose ( provid+ allocations = ,/ates  
7includ+ pursuant to section #cdjc7;b77 
"u ?is title !re is appropriat$1 out (  
any money 9 ! ,treasury n o!rwise       
appropriat$--  7#a7 = #bjai1            
#aj1jjj1jjj1jjj2  7#b7 = #bjbj1         
#aj1jjj1jjj1jjj2 &  7#c7 = #bjba1       
#aj1jjj1jjj1jjj4  7b7 ,allocations  7#a7

 ,paym5t ,f am\nts appropriat$ "u       
subsection 7a7 = a ye> 7beg9n+ ) #bjai &
 end+ ) #bjba71 ! ,adm9i/rator %all1 )  
respect to a ,/ate & n lat] ?an ,janu>y 
#a ( su* ye>1 allocate = su* ,/ate      
7includ+ pursuant to section #cdjc7;b77 
! am\nt det]m9$ = su* ,/ate & ye> "u    
p>agraph 7#b74  7#b7 ,allocation am\nt  
det]m9ations ,= purposes ( p>agraph     
7#a71 ! am\nt det]m9$ "u ?is p>agraph = 
a ye> = a ,/ate is an am\nt det]m9$ 9   
accordance ) an allocation me?odology   
specifi$ by ! ,adm9i/rator4  7c7 ,annual
 di/ribution ( previ\s ye>'s rema9+     
funds ,9 c>ry+ out subsection 7b71 !    
,adm9i/rator %all1 ) respect to a ye>   
7beg9n+ ) #bjbj & end+ ) #bjbb71 n lat] 
?an ,m>* #ca ( su* ye>--  7#a7 det]m9e !
 am\nt ( funds1 if any1 f ! am\nts      
appropriat$ "u subsection 7a7 = !       
previ\s ye> b n allocat$ = su* previ\s  
ye>2 &  7#b7 if ! ,adm9i/rator det]m9es 
t any funds 7 n s allocat$ = su* previ\s
 ye>1 allocate su* rema9+ funds1 9      
accordance ) ! allocation me?odology    

specifi$ pursuant to subsection         
7b77#b7--  7,a7 to ,/ates t h submitt$  
an application approv$ "u section       
#cdjc7;a7 = su* previ\s ye> = any       
purpose = :i* su* an application 0      
approv$2 &  7,b7 = ,/ates = :i*         
allocations 7 made pursuant to section  
#cdjc7;b7 = su* previ\s ye>1 to be us$  
by ! ,adm9i/rator = su* ,/ates1 to c>ry 
out ! purpose describ$ 9 section        
#cdjb7b7 9 su* ,/ate by provid+ paym5ts 
to appropriate entities describ$ 9 su*  
section #cdjb7b7 ) respect to claims t  
exce$ #a1jjj1jjj1  )1 respect to a ye>  
be=e #bjbb1 any rema9+ funds be+ made   
available = allocations to ,/ates = !   
subsequ5t ye>4  7d7 ,availability       
,am\nts appropriat$ "u subsection 7a7 = 
a ye> & allocat$ to ,/ates 9 accordance 
) ?is section %all rema9 available =    
exp5diture ?r\gh ,decemb] #ca1 #bjbb4   
7e7 ,limitation ,am\nts appropriat$ "u  
subsection 7a7 = a ye> 7beg9n+ ) #bjai &
 end+ ) #bjba7 are subject to !         
requirem5ts & limitations "u sections   

#ejf & #ejg ( division ,h ( ,public ,law
 #aae-ca 9 ! same mann] & to ! same     
ext5t z if su* am\nts = su* ye> 7       
appropriat$ "u su* division4  4  7b7    
,co/-,%>+ r$uction paym5ts ,section     
#adjb ( ! ,pati5t ,protection &         
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjga7 is am5d$ by add+ at ! end !     
foll[+ new subsection3  7g7 ,fund+  7#a7
 ,appropriations ,!re is appropriat$1 f 
any money 9 ! ,treasury n o!rwise       
appropriat$1 su* sums z may be necess>y 
to1 subject to p>agraph 7#b71 provide   
heal? b5efits cov]age ?r\gh paym5t to   
issu]s 7"u ?is section or ?r\gh advance 
paym5t by ! ,secret>y ( ! ,treasury "u  
section #adab7;c77#c77 ( ! am\nts       
comput$ "u ?is section = ! la/ qu>t] (  
plan ye> #bjag & ea* ( plan ye>s #bjai &
 #bjbj4  7#b7 ,adju/m5ts ,not)/&+ any   
o!r provision ( law1 paym5ts & o!r      
actions = adju/m5ts to obligations      
incurr$ prior to ,decemb] #ca1 #bjbj1   
may be made ?r\gh ,decemb] #ca1 #bjba4  
7#c7 ,limitation ,am\nts appropriat$ "u 

p>agraph 7#a7 = ! la/ qu>t] ( plan ye>  
#bjag & ea* ( plan ye>s #bjai & #bjbj   
are subject to ! requirem5ts &          
limitations "u sections #ejf & #ejg (   
division ,h ( ,public ,law #aae-ca 9 !  
same mann] & to ! same ext5t z if su*   
am\nts = su* qu>t] & ea* su* ye> 7      
appropriat$ "u su* division4  4