,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #fcaa  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,july #f1 #bjah,mr4   
,roskam 7= himself & ,mr4 ,burgess7     
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 ! ,int]nal ,rev5ue    
,code ( #aihf & ! ,pati5t ,protection & 
,af=dable ,c>e ,act to modify !         
def9ition ( qualifi$ heal? plan =       
purposes ( ! heal? insurance premium tax
 cr$it & to all[ individuals pur*as+    
heal? insurance 9 ! individual m>ket to 
pur*ase a l[] premium copp] plan4  #a4  
,modification ( def9ition ( qualifi$    
heal? plan  7a7 ,9 g5]al ,section       
#cf;,b7c77#c77;,a7 ( ! ,int]nal ,rev5ue 
,code ( #aihf is am5d$-- 7#a7 by ins]t+ 
7det]m9$ )\t reg>d to subp>agraphs 7,a71
 7,c77ii71 & 7,c77iv7 ( p>agraph 7#a7   

!re( & )\t reg>d to :e!r ! plan is (f]$ 
on an ,ex*ange7 aft] #acja7;a7 ( !      
,pati5t ,protection & ,af=dable ,c>e    
,act1 &  7#b7 by /rik+ %all n include & 
all t foll[s & ins]t+ %all n include any
 heal? plan t-- 7i7 is a gr&fa!r$ heal? 
plan or a gr&mo!r$ heal? plan1 or  7ii7 
includes cov]age = abortions 7o!r ?an   
any abortion necess>y to save ! life ( !
 "m or any abortion ) respect to a      
pregnancy t is ! result ( an act ( rape 
or ince/74  4  7b7 ,def9ition ( gr&mo!r$
 heal? plan ,section #cf;,b7c77#c7 ( su*
 ,code is am5d$ by add+ at ! end !      
foll[+ new subp>agraph3  7,c7 ,gr&mo!r$ 
heal? plan  7i7 ,9 g5]al ,! t]m gr&mo!r$
 heal? plan means heal? insurance       
cov]age :i* is (f]$ 9 ! individual heal?
 insurance m>ket z ( ,octob] #a1 #bjac1 
& is p]mitt$ to be (f]$ 9 su* m>ket aft]
 ,janu>y #a1 #bjad1 z a result ( ,,cciio
 guidance4  7ii7 ,,cciio guidance def9$ 
,! t]m ,,cciio guidance means ! 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 = non-gr&fa!r$      
cov]age 9 ! individual heal? insurance  
m>ket1 z subsequ5tly ext5d$ & modifi$   
7includ+ by a communication entitl$     
,insurance ,/&>ds ,bullet9              
,s]ies--,,in=mation--,ext5sion (        
,transitional ,policy ?r\gh #bjai issu$ 
on ,april #i1 #bjah1 by ! ,director ( ! 
,c5t] = ,consum] ,in=mation & ,insurance
 ,ov]sight ( su* ,c5t]s74  7iii7        
,individual heal? insurance m>ket ,! t]m
 individual heal? insurance m>ket means 
! m>ket = heal? insurance cov]age 7z    
def9$ 9 section #ihcb7;b77 (f]$ to      
individuals o!r ?an 9 connection ) a    
gr\p heal? plan 7)9 ! mean+ ( section   
#ejjj7;b77#a774  4  7c7 ,con=m+ am5dm5t 
relat$ to abortion cov]age ,section     
#cf;,b7c77#c7 ( su* ,code1 z am5d$ by   
p>agraph 7#b71 is am5d$ by add+ at ! end
 ! foll[+ new subp>agraph3  7,d7 ,c]ta9 
rules relat$ to abortion  7i7 ,option to
 pur*ase sep>ate cov]age or plan ,no?+ 9
 subp>agraph 7,a7 %all be con/ru$ z     

prohibit+ any individual f pur*as+      
sep>ate cov]age = abortions describ$ 9  
su* subp>agraph1 or a heal? plan t      
includes su* abortions1 s long z no     
cr$it is all[$ "u ?is section ) respect 
to ! premiums = su* cov]age or plan4    
7ii7 ,option to (f] cov]age or plan     
,no?+ 9 subp>agraph 7,a7 %all re/rict   
any heal? insurance issu] (f]+ a heal?  
plan f (f]+ sep>ate cov]age = abortions 
describ$ 9 su* subp>agraph1 or a plan t 
includes su* abortions1 s long z        
premiums = su* sep>ate cov]age or plan  
are n paid = ) any am\nt attributable to
 ! cr$it all[$ "u ?is section 7or !     
am\nt ( any advance paym5t ( ! cr$it "u 
section #adab ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act74  7iii7 ,o!r       
treatm5ts ,! treatm5t ( any infection1  
injury1 disease1 or disord] t has be5   
caus$ by or exac]bat$ by ! p]=mance ( an
 abortion %all n be treat$ z an abortion
 = purposes ( subp>agraph 7,a74  4  7d7 
,con=m+ am5dm5ts relat$ to (f-,ex*ange  
cov]age  7#a7 ,advance paym5t n         

applicable ,section #adab ( ! ,pati5t   
,protection & ,af=dable ,c>e ,act is    
am5d$ by add+ at ! end ! foll[+ new     
subsection3  7f7 ,exclusion (           
(f-,ex*ange cov]age ,advance paym5ts "u 
?is section1 & advance det]m9ations "u  
section #adaa1 ) respect to any cr$it   
all[$ "u section #cf;,b %all n be made )
 respect to any heal? plan :i* is n     
enroll$ 9 ?r\gh an ,ex*ange4  4  7#b7   
,report+ ,section #fjee7;b7 ( ! ,int]nal
 ,rev5ue ,code ( #aihf is am5d$ by add+ 
at ! end ! foll[+ new p>agraph3  7#c7   
,in=mation relat+ to (f-,ex*ange premium
 cr$it eligible cov]age ,if m9imum      
ess5tial cov]age provid$ to an          
individual "u subsection 7a7 consi/s ( a
 qualifi$ heal? plan 7z def9$ 9 section 
#cf;,b7c77#c77 :i* is n enroll$ 9 ?r\gh 
an ,ex*ange e/abli%$ "u title ,i ( !    
,pati5t ,protection & ,af=dable ,c>e    
,act1 a return describ$ 9 ?is subsection
 %all include--  7,a7 a /atem5t t su*   
plan is a qualifi$ heal? plan 7z def9$ 9
 section #cf;,b7c77#c771  7,b7 !        

premiums paid ) respect to su* cov]age1 
7,c7 ! mon?s dur+ :i* su* cov]age is    
provid$ to ! individual1  7,d7 ! adju/$ 
mon?ly premium = ! applicable second    
l[e/ co/ silv] plan 7z def9$ 9 section  
#cf;,b7b77#c77 = ea* su* mon? ) respect 
to su* individual1 &  7,e7 su* o!r      
in=mation z ! ,secret>y may prescribe4  
4  7#c7 ,o!r con=m+ am5dm5ts  7,a7      
,section #cf;,b7b77#b77;,a7 ( su* ,code 
is am5d$ by /rik+ & :i* 7 enroll$ & all 
t foll[s & ins]t+ 1 or4  7,b7 ,section  
#cf;,b7b77#c77;,b77i7 ( su* ,code is    
am5d$ by /rik+ ! same ,ex*ange & all t  
foll[s & ins]t+ ! ,ex*ange ?r\gh :i* su*
 taxpay] is p]mitt$ to obta9 cov]age1 &4
  7,c7 ,section #cf;,b7c77#b77;,a77i7 ( 
su* ,code is am5d$ by /rik+ t 0 enroll$ 
9 ?r\gh an ,ex*ange e/abli%$ by ! ,/ate 
"u section #acaa ( ! ,pati5t ,protection
 & ,af=dable ,c>e ,act4  7e7 ,effective 
date  7#a7 ,9 g5]al ,except z o!rwise   
provid$ 9 ?is subsection1 ! am5dm5ts    
made by ?is subsection %all apply to    
taxable ye>s beg9n+ aft] ,decemb] #ca1  

#bjah4  7#b7 ,advance paym5t n          
applicable to (f-,ex*ange cov]age ,!    
am5dm5t made by subsection 7d77#a7 %all 
take effect on ,janu>y #a1 #bjai4  7#c7 
,report+ ,! am5dm5t made by subsection  
7d77#b7 %all apply to cov]age provid$ = 
mon?s beg9n+ aft] ,decemb] #ca1 #bjah4  
#b4 ,all[+ all individuals pur*as+ heal?
 insurance 9 ! individual m>ket ! option
 to pur*ase a l[] premium copp] plan    
7a7 ,9 g5]al ,section #acjb7;e7 ( !     
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjbb7;e77 is      
am5d$-- 7#a7 9 p>agraph 7#a7--  7,a7 by 
r$esignat+ clauses 7i7 & 7ii7 (         
subp>agraph 7,b7 z subp>agraphs 7,a7 &  
7,b71 respectively1 & adju/+ ! m>g9s    
accord+ly2  7,b7 by /rik+ plan ye> if-- 
& all t foll[s ?r\gh ! plan provides-- &
 ins]t+ plan ye> if ! plan provides--2 &
  7,c7 9 subp>agraph 7,a71 z r$esignat$ 
by p>agraph 7#a71 by /rik+ clause 7ii7 &
 ins]t+ subp>agraph 7,b72  7#b7 by /rik+
 p>agraph 7#b72 &  7#c7 by r$esignat+   
p>agraph 7#c7 z p>agraph 7#b74  7b7     

,risk pools ,section #acab7;c77#a7 ( !  
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjcb7;c77#a77 is  
am5d$ by ins]t+ & enrollees 9           
cata/rophic plans describ$ 9 section    
#acjb7;e7 aft] ,ex*ange4  7c7 ,con=m+   
am5dm5t ,section #acab7;d77#c77;,c7 ( ! 
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjcb7;d77#c77;,c77
 is am5d$ by /rik+ 1 except t 9 ! case (
 a cata/rophic plan describ$ 9 section  
#acjb7;e71 a qualifi$ individual may    
enroll 9 ! plan only if ! individual is 
eligible to enroll 9 ! plan "u section  
#acjb7;e77#b74  7d7 ,effective date ,!  
am5dm5ts made by ?is section %all apply 
to plan ye>s beg9n+ aft] ,decemb] #ca1  
#bjah4