,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #eaee  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #e1 #bjah,mr4    
,pallone 7= himself1 ,mr4 ,scott (      
,virg9ia1 & ,mr4 ,neal7 introduc$ !     
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce1 & 9    
addition to ! ,committees on ,ways &    
,means1 & ,education & ! ,work=ce1 = 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 
! ,pati5t ,protection & ,af=dable ,c>e  
,act to improve af=dability (1 undo     
sabotage ) respect to1 & increase access
 to heal? insurance cov]age1 & = o!r    
purposes4  #a4 ,%ort title2 table (     
cont5ts  7a7 ,%ort title ,?is ,act may  
be cit$ z ! ,undo ,sabotage & ,exp&     
,af=dability ( ,heal? ,insurance ,act ( 
#bjah4  7b7 ,table ( cont5ts ,! table ( 
cont5ts ( ?is ,act is z foll[s3  ,sec4  
#a4 ,%ort title2 table ( cont5ts4 ,title
 ,i--,exp&+ ,af=dability ,sec4 #aja4    

,improve af=dability & r$uce premium    
co/s = consum]s4 ,sec4 #ajb4 ,l[]       
out-(-pocket co/s = consum]s4 ,sec4     
#ajc4 ,exp& af=dability = work+         
families4 ,title ,,ii--,undo+ ,sabotage 
,sec4 #bja4 ,protect compreh5sive       
cov]age = small bus9esses & work]s4     
,sec4 #bjb4 ,prev5t junk plans & cont9ue
 protections = consum]s ) preexi/+      
conditions4 ,sec4 #bjc4 ,ensure plans   
provide compreh5sive b5efits4 ,sec4     
#bjd4 ,undo ,adm9i/ration sabotage by   
requir+ op5 enrollm5t outrea*1          
education1 & fund+ = navigators4 ,sec4  
#bje4 ,improve m>ketplace /ability to   
prev5t sabotage f rais+ premiums4 ,title
 ,,iii--,/ate ,innovation & ,transp>5cy 
,sec4 #cja4 ,fund ,/ate heal? insurance 
education programs = consum]s4 ,sec4    
#cjb4 ,fund ,/ate innovations to exp&   
cov]age4 ,sec4 #cjc4 ,pres]ve ,/ate     
option to implem5t heal? c>e            
m>ketplaces4 ,sec4 #cjd4 ,promote       
transp>5cy & acc\ntability 9 !          
,adm9i/ration's exp5ditures ( ,ex*ange  

us] fees4  ,i ,exp&+ ,af=dability  #aja4
 ,improve af=dability & r$uce premium   
co/s = consum]s  7a7 ,9 g5]al ,section  
#cf;,b7b77#c77;,a7 ( ! ,int]nal ,rev5ue 
,code ( #aihf is am5d$ to read z foll[s3
  7,a7 ,applicable p]c5tage ,!          
applicable p]c5tage = any taxable ye>   
%all be ! p]c5tage su* t ! applicable   
p]c5tage = any taxpay] ^: h\sehold      
income is )9 an income ti] specifi$ 9 ! 
foll[+ table %all increase1 on a slid+  
scale 9 a l9e> mann]1 f ! initial       
premium p]c5tage to ! f9al premium      
p]c5tage specifi$ 9 su* table = su*     
income ti]3 ,9 ! case ( h\sehold income 
7express$ z a p]c5t ( pov]ty l9e7 )9 !  
foll[+ income ti]3,! initial            
premiump]c5tage is--,! f9al premium     
p]c5tage is--,ov] #ajj4j up to          
#acc4jj4ja4jacc4j up to                 
#aej4ja4jb4jaej4j up to                 
#bjj4jb4jd4jbjj4j up to                 
#bej4jd4jf4jbej4j up to                 
#cjj4jf4jg4jcjj4j up to                 
#djj4jg4jh4edjj4j & high]#h4eh4e  4  7b7

 ,con=m+ am5dm5t ,section               
#cf;,b7c77#a77;,a7 ( ! ,int]nal ,rev5ue 
,code ( #aihf is am5d$ by /rik+ b does n
 exce$ #djj p]c5t4  7c7 ,effective date 
,! am5dm5ts made by ?is section %all    
apply to taxable ye>s beg9n+ aft]       
,decemb] #ca1 #bjai4  #ajb4 ,l[]        
out-(-pocket co/s = consum]s  7a7       
,expansion ( eligibility  7#a7 ,9 g5]al 
,section #adjb7;c7 ( ! ,pati5t          
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjga7;c77 is am5d$-- 7,a7 by
 /rik+ p>agraphs 7#a7 & 7#b7 & ins]t+ ! 
foll[+3  7#a7 ,9 g5]al ,! r$uction 9    
co/-%>+ "u ?is subsection %all be       
a*iev$1 ) respect to an issu] ( a       
qualifi$ heal? plan to :i* ?is section  
applies1 by r$uc+ co/-%>+ "u ! plan 7& !
 applicable out-( pocket limit "u       
section #acjb7;c77#a77 9 a mann] & am\nt
 suffici5t to--  7,a7 9 ! case ( an     
eligible insur$ ^: h\sehold income is n 
less ?an #ajj p]c5t b n m ?an #bej p]c5t
 ( ! pov]ty l9e = a family ( ! size     
involv$1 increase ! plan's %>e ( ! total

 all[$ co/s ( b5efits provid$ "u ! plan 
to #id p]c5t ( su* co/s2 &  7,b7 9 !    
case ( an eligible insur$ ^: h\sehold   
income is m ?an #bej p]c5t b n m ?an    
#djj p]c5t ( ! pov]ty l9e = a family ( !
 size involv$1 increase ! plan's %>e ( !
 total all[$ co/s ( b5efits provid$ "u !
 plan to #hg p]c5t ( su* co/s4  2 &     
7,b7 by r$esignat+ p>agraphs 7#c71 7#d71
 & 7#e7 z p>agraphs 7#b71 7#c71 & 7#d71 
respectively4  7#b7 ,effective date ,!  
am5dm5ts made by p>agraph 7#a7 %all     
apply ) respect to plan ye>s beg9n+ aft]
 ,decemb] #ca1 #bjai4  7b7 ,fund+ co/   
%>+ r$uctions ,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+
 ,out ( any funds 9 ! ,treasury n       
o!rwise appropriat$1 !re is h]eby       
appropriat$ to ! ,secret>y su* sums z   
may be necess>y = paym5ts "u ?is        
section4  4  #ajc4 ,exp& af=dability =  
work+ families  7a7 ,9 g5]al ,clause 7i7
 ( section #cf;,b7c77#b77;,c7 ( !       

,int]nal ,rev5ue ,code ( #aihf is am5d$ 
to read z foll[s3  7i7 ,cov]age mu/ be  
af=dable  7,i7 ,employees ,an employee  
%all n be treat$ z eligible = m9imum    
ess5tial cov]age if su* cov]age consi/s 
( an eligible employ]-sponsor$ plan 7z  
def9$ 9 section #ejjj;,a7f77#b77 & !    
employee's requir$ contribution 7)9 !   
mean+ ( section #ejjj;,a7e77#a77;,b77 ) 
respect to ! plan exce$s #i4e p]c5t ( ! 
employee's h\sehold income4  7,,ii7     
,family memb]s ,an individual :o is     
eligible to enroll 9 an eligible        
employ]-sponsor$ plan 7z def9$ 9 section
 #ejjj;,a7f77#b77 by reason ( a         
relation%ip ! individual be>s to !      
employee %all n be treat$ z eligible =  
m9imum ess5tial cov]age by reason ( su* 
eligibility to enroll if ! employee's   
requir$ contribution 7)9 ! mean+ (      
section #ejjj;,a7e77#a77;,b71 det]m9$ by
 sub/itut+ family = self-only7 ) respect
 to ! plan exce$s #i4e p]c5t ( !        
employee's h\sehold income4  4  7b7     
,con=m+ am5dm5ts  7#a7 ,clause 7ii7 (   

section #cf;,b7c77#b77;,c7 ( ! ,int]nal 
,rev5ue ,code ( #aihf is am5d$ by /rik+ 
,except z provid$ 9 clause 7iii71 an    
employee & ins]t+ ,an individual4  7#b7 
,clause 7iii7 ( section                 
#cf;,b7c77#b77;,c7 ( su* ,code is am5d$ 
by /rik+ ! la/ s5t5ce ( clause 7i7 &    
ins]t+ clause 7i77,,ii74  7#c7 ,clause  
7iv7 ( section #cf;,b7c77#b77;,c7 ( su* 
,code is am5d$ by /rik+ #i4e p]c5t "u   
clause 7i77,,ii7 & ins]t+ ! #i4e p]c5t  
"u clauses 7i77,i7 & 7i77,,ii74  7c7    
,effective date ,! am5dm5ts made by ?is 
section %all apply to taxable ye>s      
beg9n+ aft] ,decemb] #ca1 #bjai4  ,,ii  
,undo+ ,sabotage  #bja4 ,protect        
compreh5sive cov]age = small bus9esses &
 work]s ,not)/&+ any o!r provision (    
law1 ! ,secret>y ( ,labor may n take any
 action to implem5t1 f9alize1 or en=ce !
 propos$ rule publi%$ on ,janu>y #e1    
#bjah1 on pages #fad ?r\gh #fcf ( volume
 #hc ( ! ,f$]al ,regi/]1 or any         
sub/antially simil> propos$ rule4  #bjb4
 ,prev5t junk plans & cont9ue           

protections = consum]s ) preexi/+       
conditions  7a7 ,includ+ %ort-,t]m      
limit$ duration insurance z individual  
heal? insurance cov]age ,section        
#bgia7;b77#e7 ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;g-#ia7;b77#e77
 is am5d$ by /rik+ b does n include     
%ort-t]m limit$ duration insurance &    
ins]t+ 1 includ+ %ort-t]m limit$        
duration insurance4  7b7 ,effective date
 ,! am5dm5ts made by ?is section %all   
apply ) respect to plan ye>s beg9n+ aft]
 ,decemb] #ca1 #bjah4  #bjc4 ,ensure    
plans provide compreh5sive b5efits  7a7 
,ess5tial heal? b5efits ,section        
#acjb7;b77#d7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjbb7;b77#d77 is am5d$--  7#a7 9      
subp>agraph 7,a71 by ins]t+ & s t       
b5efits are includ$ )9 ea* ( su*        
categories2  7#b7 9 subp>agraph 7,g71 by
 /rik+ at ! end &2  7#c7 9 subp>agraph  
7,h71 by /rik+ ! p]iod at ! end & ins]t+
 2 &2 &  7#d7 by add+ at ! end ! foll[+ 
new subp>agraph3  7,i7 ensure t1 beg9n+ 

,janu>y #a1 #bjai-- 7i7 9 ! case ( heal?
 b5efits t are e/abli%$ z ess5tial heal?
 b5efits1 !re %all n be sub/itution (   
su* b5efits across b5efit categories2   
7ii7 a qualifi$ heal? plan %all n be    
treat$ z provid+ cov]age = ! ess5tial   
heal? b5efits unless "u su* plan--  7,i7
 cov]age ( prescription drugs provides =
 access to a wide v>iety ( classes (    
drugs )9 ! prescription drug =mul>y (   
su* plan2 &  7,,ii7 9 ! case t a drug t 
is m$ically necess>y = an enrollee "u   
su* plan is n includ$ )9 su* =mul>y1 su*
 individual has access to su* drug ?r\gh
 an exceptions process e/abli%$ by !    
plan2 &  7iii7 habilitative s]vices are 
cov]$ at p>ity ) rehabilitative s]vices4
  4  7b7 ,/&>d b5efit plans ,section    
#acjb7;d7 ( ! ,pati5t ,protection &     
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjbb7;d77 is am5d$ by add+ at ! end ! 
foll[+ new p>agraph3  7#e7 ,/&>d b5efit 
plans  7,a7 ,9 g5]al ,= purposes (      
provid+ individuals ) ! opportunity to  
make simpl] comp>isons ( heal? plans    

(f]$ by diff]5t heal? insurance issu]s &
 simplify ! selection process1 !        
,secret>y %all1 = ea* plan ye> beg9n+ ) 
plan ye> #bjbj1 ?r\gh rulemak+1 specify 
a /ructure describ$ 9 subp>agraph       
7,b77i7 = a /&>d b5efit plan = su* plan 
ye> = ea* ( ! bronze1 silv]1 & gold     
levels ( cov]age & = ea* actu>ial value 
v>iation ( a silv] plan result+ f !     
application ( section #adjb7;c74 ,a /&>d
 b5efit plan = a plan ye> = a level (   
cov]age or actu>ial value v>iation ( a  
silv] plan %all be model$ on ! mo/      
commonly pur*as$ plans 7det]m9$ by      
enrollm5ts 9 su* plans7 dur+ ! previ\s  
#b plan ye>s (f]$ 9 ! f$]ally facilitat$
 ,ex*ange op]at$ pursuant to section    
#acba7;c7 9 su* level or v>iation & %all
 include cov]age ( d$uctible-exempt     
s]vices consi/5t ) actual pur*as+       
patt]ns ( consum]s 9 ! previ\s two plan 
ye>s4  7,b7 ,/&>d b5efit plan ,=        
purposes ( ?is p>agraph1 ! t]m /&>d     
b5efit plan means a qualifi$ heal? plan 
to be (f]$ ?r\gh an ,ex*ange on !       

individual m>ket t has ei!r--  7i7 a    
/&>diz$ co/-%>+ /ructure specifi$ by !  
,secret>y pursuant to rulemak+2 or  7ii7
 a /&>diz$ co/-%>+ /ructure specifi$ by 
! ,secret>y pursuant to rulemak+ t is   
modifi$ by ! heal? insurance issu] ( su*
 plan only to ! ext5t necess>y to align 
) high d$uctible heal? plan requirem5ts 
"u section #bbc ( ! ,int]nal ,rev5ue    
,code ( #aihf or ! applicable annual    
limitation on co/ %>+ "u subsection 7c7 
& actu>ial value requirem5ts specifi$ by
 ! ,secret>y4  4  #bjd4 ,undo           
,adm9i/ration sabotage by requir+ op5   
enrollm5t outrea*1 education1 & fund+ = 
navigators  ,section #acba7;c7 ( !      
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjda7;c77 is am5d$
 by add+ at ! end ! foll[+ new p>agraph3
  7#c7 ,navigator program & outrea* &   
enrollm5t activities  7,a7 ,navigator   
program  7i7 ,9 g5]al ,9 ! case ( an    
,ex*ange e/abli%$ or op]at$ by !        
,secret>y pursuant to ?is subsection1 ! 
,secret>y %all e/abli% a program "u :i* 

x aw>ds grants to entities t w\ld be    
describ$ 9 p>agraph 7#b7 ( section      
#acaa7;i7 to c>ry out ! duties t w\ld be
 describ$ 9 p>agraph 7#c7 ( su* section 
if ! ref]5ces 9 su* section #acaa7;i7 to
 ?is subsection & p>agraph 7#a7 7 ea*   
in/ead a ref]5ce to p>agraph 7#c77;,a7 (
 section #acba7;c74  7ii7 ,application (
 ,/ate ,ex*ange navigator provisions ,= 
purposes ( c>ry+ out ?is subp>agraph1 ! 
provisions ( p>agraphs 7#b7 ?r\gh 7#e7 (
 section #acaa7;i7 %all apply to !      
,secret>y ) respect to an ,ex*ange      
describ$ 9 clause 7i7 & ! program "u ?is
 subp>agraph 9 ! same mann] z su*       
provisions apply to a ,/ate ) respect to
 an ,ex*ange describ$ 9 section         
#acaa7;i7 & ! program e/abli%$ "u su*   
section4  7iii7 ,fund+ ,= purposes (    
c>ry+ out ?is subp>agraph1 ! ,secret>y  
%all obligate #ajj1jjj1jjj out ( am\nts 
collect$ ?r\gh ! us] fees on p>ticipat+ 
heal? insurance issu]s pursuant to      
section #aef4ej ( title #de1 ,code (    
,f$]al ,regulations 7or any successor   

regulations7 = ea* ( fiscal ye>s #bjai  
?r\gh #bjba4 ,su* am\nt %all rema9      
available )\t fiscal ye> limitation     
until exp5d$4  7,b7 ,outrea* &          
educational activities  7i7 ,9 g5]al ,9 
! case ( an ,ex*ange e/abli%$ or op]at$ 
by ! ,secret>y pursuant to ?is          
subsection1 ! ,secret>y %all c>ry out   
outrea* & educational activities =      
purposes ( in=m+ pot5tial enrollees 9   
qualifi$ heal? plans (f]$ ?r\gh !       
,ex*ange ( ! availability ( cov]age "u  
su* plans & f9ancial assi/ance = cov]age
 "u su* plans4  7ii7 ,fund+ ,= purposes 
( c>ry+ out ?is subp>agraph1 ! ,secret>y
 %all obligate #ajj1jjj1jjj out ( !     
am\nts collect$ ?r\gh ! us] fees on     
p>ticipat+ heal? insurance issu]s       
pursuant to section #aef4ej ( title #de1
 ,code ( ,f$]al ,regulations 7or any    
successor regulations7 = ea* ( fiscal   
ye>s #bjai ?r\gh #bjba4 ,su* am\nt %all 
rema9 available )\t fiscal ye>          
limitation until exp5d$4  4  #bje4      
,improve ,m>ketplace /ability to prev5t 

sabotage f rais+ premiums  7a7 ,fund    
7#a7 ,9 g5]al ,!re is h]eby e/abli%$ !  
,national ,re9surance ,program ,fund to 
be adm9i/]$ by ! ,secret>y ( ,heal? &   
,human ,s]vices = purposes ( c>ry+ out a
 national re9surance program to make    
re9surance paym5ts1 9 accordance ) ?is  
section4  7#b7 ,appropriation ,!re is   
h]eby appropriat$ to ! ,fund e/abli%$ "u
 p>agraph 7#a71 out ( any funds 9 !     
,treasury n o!rwise appropriat$1 su*    
sums z are necess>y = c>ry+ out !       
purpose describ$ 9 su* p>agraph4  7b7   
,paym5ts  7#a7 ,9 g5]al ,! ,secret>y (  
,heal? & ,human ,s]vices %all use am\nts
 available 9 ! ,fund to e/abli% a       
national re9surance program "u :i* !    
,secret>y makes re9surance paym5ts to   
heal? insurance issu]s ) respect to     
claims = individuals enroll$ "u qualify+
 re9surance plans (f]$ by su* issu]s =  
plan ye> #bjai or a subsequ5t plan ye> t
 exce$1 subject to p>agraph 7#b71       
#ej1jjj 9 an am\nt equal to #ge p]c5t ( 
! am\nt ( su* claims1 b n to exce$      

#a1jjj1jjj4  7#b7 ,index+ ,= plan ye>   
#bjbj or subsequ5t plan ye>1 9 lieu (   
ea* doll> am\nt specifi$ 9 p>agraph     
7#a71 ea* su* doll> am\nt appli$ "u ?is 
subsection = su* plan ye> %all be !     
doll> am\nt appli$ "u ?is subsection = !
 previ\s ye>1 increas$ by ! annual      
p]c5tage increase 9 ! ,consum] ,price   
,index = ,all ,urban ,consum]s 7all     
items2 ,unit$ ,/ates city av]age z (    
,june ( ! previ\s fiscal ye>74  7#c7    
,me?ods ,paym5ts "u ?is subsection %all 
be bas$ on su* a me?od z ! ,secret>y    
det]m9es4 ,! ,secret>y may e/abli% a    
paym5t me?od by :i* int]im paym5ts (    
am\nts "u ?is subsection are made dur+ a
 plan ye> bas$ on ! ,secret>y's be/     
e/imate ( am\nts t w be payable aft]    
obta9+ all ( necess>y in=mation4  7c7   
,qualify+ re9surance plan  7#a7 ,9 g5]al
 ,= purposes ( ?is section1 ! t]m       
qualify+ re9surance plan means1 )       
respect to a heal? insurance issu] a    
qualifi$ heal? plan 7z def9$ 9 section  
#acja ( ! ,pati5t ,protection &         

,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjba77 (f]$ by su* issu] on !         
individual m>ket4 ,su* t]m does n       
include a gr&fa!r$ heal? plan 7z def9$ 9
 section #abea ( su* ,act 7#db ,u4,s4,c4
 #ahjaa771 transitional heal? plan1 or a
 /&>d heal? plan (f]$ 9 connection ) a  
basic heal? program e/abli%$ "u section 
#acca ( su* ,act 7#db ,u4,s4,c4 #ahjea74
  7#b7 ,transitional heal? plan ,=      
purposes ( p>agraph 7#a71 ! t]m         
transitional heal? plan means a plan    
cont9u$ "u ! lett] issu$ by ! ,c5t]s =  
,m$ic>e  ,m$icaid ,s]vices on ,novemb]  
#ad1 #bjac1 to ! ,/ate ,insurance       
,commission]s outl9+ a transitional     
policy = cov]age 9 ! individual & small 
gr\p m>kets to :i* section #abea ( !    
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjaa7 does n      
apply1 & "u ! ext5sion ( ! transitional 
policy = su* cov]age set =? 9 !         
,insurance ,/&>ds ,bullet9 ,s]ies       
guidance issu$ by ! ,c5t]s = ,m$ic>e    
,m$icaid ,s]vices on ,m>* #e1 #bjad1    

,febru>y #bi1 #bjaf1 & ,febru>y #ac1    
#bjag1 or "u any subsequ5t ext5sions    
!re(4  7d7 ,coord9ation ) risk adju/m5t 
,! ,secret>y %all make adju/m5ts to !   
risk adju/m5t program op]at$ "u section 
#acdc ( ! ,pati5t ,protection &         
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjfc71 z appropriate1 to acc\nt = !   
effects ( ?is section on ! actu>ial risk
 ( enrollees4  ,,iii ,/ate ,innovation &
 ,transp>5cy  #cja4 ,fund ,/ate heal?   
insurance education programs = consum]s 
,section #bgic7;e7 ( ! ,public ,heal?   
,s]vice ,act 7#db ,u4,s4,c4             
#cjj;gg-#ic7;e77 is am5d$ by add+ at !  
end ! foll[+ new p>agraph3  7#c7        
,appropriations ,= purposes ( c>ry+ out 
?is section1 !re is h]eby appropriat$ to
 ! ,secret>y1 out ( any funds 9 !       
,treasury n o!rwise appropriat$1        
#ajj1jjj1jjj = ea* ( ! fiscal ye>s #bjai
 ?r\gh #bjba4 ,su* am\nt %all rema9     
available until exp5d$4  4  #cjb4 ,fund 
,/ate innovations to exp& cov]age  7a7  
,9 g5]al ,subject to subsection 7d71 !  

,secret>y ( ,heal? & ,human ,s]vices    
%all aw>d grants to eligible ,/ate      
ag5cies to enable su* ,/ates to explore 
innovative solutions to promote great]  
enrollm5t 9 heal? insurance cov]age 9 ! 
individual & small gr\p m>kets1 includ+ 
activities describ$ 9 subsection 7c74   
7b7 ,eligibility ,= purposes (          
subsection 7a71 eligible ,/ate ag5cies  
are ,ex*anges e/abli%$ by a ,/ate "u    
title ,i ( ! ,pati5t ,protection &      
,af=dable ,c>e ,act & ,/ate ag5cies )   
prim>y responsibility ov] heal? & human 
s]vices = ! ,/ate involv$4  7c7 ,use (  
funds ,= purposes ( subsection 7a71 !   
activities describ$ 9 ?is subsection are
 ! foll[+3 7#a7 ,/ate ef=ts to /reaml9e 
heal? insurance enrollm5t proc$ures 9   
ord] to r$uce burd5s on consum]s &      
facilitate great] enrollm5t 9 heal?     
insurance cov]age 9 ! individual & small
 gr\p m>kets1 includ+ automatic         
enrollm5t & re5rollm5t (1 or            
pre-populat$ applications =1 individuals
 )\t heal? insurance :o are eligible =  

tax cr$its "u section #cf;,b ( !        
,int]nal ,rev5ue ,code ( #aihf1 ) !     
ability to opt out ( su* enrollm5t4     
7#b7 ,/ate inve/m5t 9 te*nology to      
improve data %>+ & collection = !       
purposes ( facilitat+ great] enrollm5t 9
 heal? insurance cov]age 9 su* m>kets4  
7#c7 ,implem5tation ( a ,/ate v]sion (  
an individual m&ate to be enroll$ 9     
heal? insurance cov]age4  7#d7          
,feasibility /udies to develop          
compreh5sive & coh]5t ,/ate plan =      
increas+ enrollm5t 9 ! individual &     
small gr\p m>ket4  7d7 ,fund+ ,=        
purposes ( c>ry+ out ?is section1 !re is
 h]eby appropriat$1 out ( any funds 9 ! 
,treasury n o!rwise appropriat$1        
#bjj1jjj1jjj = ea* ( ! fiscal ye>s #bjai
 ?r\gh #bjba4 ,su* am\nt %all rema9     
available until exp5d$4  #cjc4 ,pres]ve 
,/ate option to implem5t heal? c>e      
,m>ketplaces ,section #acaa7;a77#d7 ( ! 
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjca7;a77#d77 is  
am5d$--  7#a7 by /rik+ subp>agraph 7,b72

  7#b7 by /rik+ ,r5ewability ( grant &  
all t foll[s ?r\gh ,subject to          
subsection 7d77#d7 & ins]t+ ,r5ewability
 ( grant4--,subject to subsection       
7d77#d72  7#c7 by r$esignat+ clauses 7i7
 & 7ii7 z subp>agraphs 7,a7 & 7,b71     
respectively1 ) appropriate ind5tation2 
&  7#d7 9 subp>agraph 7,a71 z r$esignat$
 by p>agraph 7#c71 by r$esignat+        
subclauses 7,i7 & 7,,ii7 z clauses 7i7 &
 7ii71 respectively1 ) appropriate      
ind5tation4  #cjd4 ,promote transp>5cy &
 acc\ntability 9 ! ,adm9i/ration's      
exp5ditures ( ,ex*ange us] fees ,= ea* (
 plan ye>s #bjah1 #bjai1 & #bjbj1 n lat]
 ?an ! date t is #c mon?s aft] ( ! end (
 su* fiscal ye>1 ! ,secret>y ( ,heal? & 
,human ,s]vices %all submit to !        
appropriate committees ( ,congress &    
make available to ! public an annual    
report on ! exp5diture by ! ,dep>tm5t ( 
,heal? & ,human ,s]vices ( us] fees     
collect$ pursuant to section #aef4ej (  
title #de1 ,code ( ,f$]al ,regulations  
7or any successor regulations74 ,ea* su*

 report = a plan ye> %all include a     
detail$ acc\nt+ ( ! am\nt ( su* us] fees
 collect$ dur+ su* plan ye> & ( ! am\nt 
( su* exp5ditures us$ dur+ su* plan ye> 
= ! f$]ally facilitat$ ,ex*ange op]at$  
pursuant to section #acba7;c7 ( !       
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjda7;c77 on      
outrea* & enrollm5t activities1         
navigators1 ma9t5ance ( ,heal?c>e4gov1 &
 op]ation ( call c5t]s4