,,ii  #aaeth ,,congress  #ast ,session  
,s4 #aifg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,october #ag1  
#bjag,mr4 ,cotton 7for himself and ,mr4 
,toomey7 introduced the following bill2 
which was read twice and referred to the
 ,committee on ,finance  ,a ,,bill  ,to 
amend the ,internal ,revenue ,code of   
#aihf to provide additional exemptions  
to the individual mandate1 and for other
 purposes4  #a4 ,short title ,this ,act 
may be cited as the ,mandate ,relief    
,act of #bjag4  #b4 ,modifications to   
exemption to requirement to maintain    
health coverage  7a7 ,exemption for     
individuals with a household income less
 than the national median and for       
individuals with excessive premium      
increases ,section #ejjj;,a7e7 of the   
,internal ,revenue ,code of #aihf is    
amended by striking paragraphs 7#a7 and 
7#b7 and inserting the following3  7#a7 
,individuals with household incomes     
below the national median ,any          
applicable individual for any month if  

the applicable individual has a         
household income for the taxable year   
which is less than the national median  
household income for the most recent    
calendar year4  7#b7 ,individuals with  
excessive premium increases ,any        
applicable individual for any month     
during a calendar year if such          
applicable individual resides in a      
,state in which either--  7,a7 the      
average premium for self-only coverage  
for the second lowest cost silver plan  
within the ,state for such calendar year
 is more than #aj percent greater than  
the average premium for self-only       
coverage for the second lowest cost     
silver plan within the ,state for the   
preceding calendar year1 or  7,b7 the   
average premium for family coverage for 
the second lowest cost silver plan      
within the ,state for such calendar year
 is more than #aj percent greater than  
the average premium for family coverage 
for the second lowest cost silver plan  
within the ,state for the preceding     

calendar year4  4  7b7 ,additional      
exemptions ,section #ejjj;,a7e7 of the  
,internal ,revenue ,code of #aihf is    
amended by adding at the end the        
following new paragraph3  7#f7          
,individuals in areas with fewer than #b
 issuers offering plans on an exchange  
7,a7 ,in general ,any applicable        
individual for any period during a      
calendar year if there are fewer than #b
 health insurance issuers offering      
qualified health plans on an ,exchange  
for such period in the county in which  
the applicable individual resides4  7,b7
 ,aggregation rules ,for purposes of    
subparagraph 7,a71 all health insurance 
issuers treated as a single employer    
under subsection 7a7 or 7b7 of section  
#eb1 or subsection 7m7 or 7o7 of section
 #dad1 shall be treated as a single     
health insurance issuer4  4  7c7        
,effective date ,the amendments made by 
this section shall apply to months      
beginning after the date of the         
enactment of this ,act4  #c4 ,repeal of 

distributions for medicine qualified    
only if for prescribed drug or insulin  
7a7 ,h,s,as ,subparagraph 7,a7 of       
section #bbc7;d77#b7 of the ,internal   
,revenue ,code of #aihf is amended by   
striking the last sentence4  7b7 ,archer
 ,m,s,as ,subparagraph 7,a7 of section  
#bbj7;d77#b7 of the ,internal ,revenue  
,code of #aihf is amended by striking   
the last sentence4  7c7 ,health flexible
 spending arrangements and health       
reimbursement arrangements ,section #ajf
 of the ,internal ,revenue ,code of     
#aihf is amended by striking subsection 
7f74  7d7 ,effective dates  7#a7        
,distributions from savings accounts    
,the amendments made by subsections 7a7 
and 7b7 shall apply to amounts paid with
 respect to taxable years beginning     
after ,december #ca1 #bjaf4  7#b7       
,reimbursements ,the amendment made by  
subsection 7c7 shall apply to expenses  
incurred with respect to taxable years  
beginning after ,december #ca1 #bjag4   
#d4 ,repeal of limitation on health     

flexible spending arrangements under    
cafeteria plans  7a7 ,in general        
,section #abe of the ,internal ,revenue 
,code of #aihf is amended-- 7#a7 by     
striking subsection 7i72 and  7#b7 by   
redesignating subsections 7j71 7k71 and 
7l7 as subsections 7i71 7j71 and 7k71   
respectively4  7b7 ,effective date ,the 
amendments made by this section shall   
apply to taxable years beginning after  
,december #ca1 #bjag4  #e4 ,repeal of   
tax on health savings accounts  7a7     
,h,s,as ,section #bbc7;f77#d77;,a7 of   
the ,internal ,revenue ,code of #aihf is
 amended by striking #bj percent and    
inserting #aj percent4  7b7 ,archer     
,m,s,as ,section #bbj7;f77#d77;,a7 of   
the ,internal ,revenue ,code of #aihf is
 amended by striking #bj percent and    
inserting #ae percent4  7c7 ,effective  
date ,the amendments made by this       
section shall apply to distributions    
made after ,december #ca1 #bjag4