,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #bghi  ,,in ,,the ,,house ,,of  
,,representatives  ,may #af1 #bjai,mr4  
,schweikert 7for himself1 ,mr4          
,fortenberry1 and ,mr4 ,webster of      
,florida7 introduced the following bill2
 which was referred to the ,committee on
 ,energy and ,commerce  ,a ,,bill  ,to  
amend the ,public ,health ,service ,act 
to establish a health insurance ,federal
 ,invisible ,risk ,sharing ,program4    
#a4 ,health ,insurance ,federal         
,invisible ,risk ,sharing ,program ,the 
,public ,health ,service ,act is amended
 by adding at the end the following new 
title3  ,,xxxiv ,health ,insurance      
,federal ,invisible ,risk ,sharing      
,program  #cdja4 ,establishment of      
,federal ,invisible ,risk ,sharing      
,program  7a7 ,in general ,there is     
established a ,federal ,invisible ,risk 
,sharing ,program 7in this section      
referred to as the ,program71 to be     
administered by the ,secretary1 acting  
through the ,administrator of the       

,centers for ,medicare  ,medicaid       
,services 7in this section referred to  
as the ,administrator71 to provide      
payments to health insurance issuers    
with respect to claims for eligible     
individuals for the purpose of lowering 
premiums for health insurance coverage  
offered in the individual market4  7b7  
,funding  7#a7 ,appropriations ,for the 
purpose of providing funding for the    
,program there is appropriated1 out of  
any money in the ,treasury not otherwise
 appropriated1 #ae1jjj1jjj1jjj for the  
period beginning on ,january #a1 #bjba1 
and ending on ,december #ca1 #bjcj4     
,such funds shall be available to the   
,secretary for such purpose in such     
amounts and at such times during such   
period as specified by the ,secretary4  
7#b7 ,additional funding ,in addition to
 amounts appropriated under paragraph   
7#a71 out of any money in the ,treasury 
not otherwise appropriated1 there shall 
be appropriated to the ,secretary for   
each year 7after #bjba7 during the      

period specified in paragraph 7#a71 for 
purposes of carrying out the ,program1  
an amount equal to the amount by which  
the actual sum of the premium assistance
 credits calculated for all taxpayers   
under section #cf;,b7a7 of the ,internal
 ,revenue ,code of #aihf for the        
previous year was less than the         
projected sum of the premium assistance 
credits calculated for all taxpayers    
under such section for such previous    
year4 ,amounts appropriated pursuant to 
the previous sentence shall remain      
available until expended4  7#c7         
,limitation ,amounts appropriated under 
this subsection are subject to the      
requirements and limitations under      
sections #ejf and #ejg of division ,h of
 ,public ,law #aae-ca in the same manner
 and to the same extent as if such      
amounts were appropriated under such    
division4  7c7 ,operation of program    
7#a7 ,in general ,the ,administrator    
shall establish1 after consultation with
 health care consumers1 health insurance

 issuers1 ,state insurance              
commissioners1 and other stakeholders1  
and after taking into consideration     
high-cost health conditions and other   
health trends that generate high cost1  
parameters for the operation of the     
,program consistent with this section4  
7#b7 ,expediting initial operation  7,a7
 ,deadline for initial operation ,not   
later than #fj days after the date of   
the enactment of this title1 the        
,administrator shall establish          
sufficient parameters to specify how the
 ,program will operate for plan year    
#bjba4  7,b7 ,secretarial discretion ,to
 ensure the operation of the ,program in
 plan year #bjba1 notwithstanding       
paragraph 7#a71 the ,secretary may in   
lieu of basing eligibility for          
participation in the ,program on the    
parameters described in paragraphs 7#a7 
and 7#b7 of subsection 7d7 and without  
consultation described in paragraph     
7#a71 base such eligibility on dollar   
amounts of claims and specify actuarial 

values to be applied for such amounts4  
7#c7 ,state operation of program  7,a7  
,in general ,the ,administrator shall   
establish a process for a ,state to     
operate the ,program in such ,state     
beginning with plan year #bjbc4  7,b7   
,immediate waivers ,such process shall  
allow a ,state that1 as of ,march #a1   
#bjbj1 had in place a fully established 
high risk sharing pool or fully         
established reinsurance program 7as     
defined by the ,secretary7 to continue  
to operate such pool or program and not 
have the ,program administered by the   
,secretary under this section apply to  
such ,state4  7d7 ,details of program   
,the parameters for the ,program shall  
include the following3 7#a7 ,eligible   
individuals ,a definition for eligible  
individuals4  7#b7 ,standards for       
qualification  7,a7 ,automatic          
qualification ,the identification of    
health conditions that automatically    
qualify individuals as eligible         
individuals4  7,b7 ,voluntary           

qualification ,a process under which    
health insurance issuers may voluntarily
 qualify individuals1 who do not        
automatically qualify under subparagraph
 7,a71 as eligible individuals4  7#c7   
,percentage of insurance premiums to be 
applied ,the percentage of the premiums 
paid1 to health insurance issuers for   
health insurance coverage by eligible   
individuals1 that shall be collected and
 deposited to the credit 7and available 
for the use7 of the ,program4  7#d7     
,attachment dollar amount and payment   
proportion ,the dollar amount of claims 
for eligible individuals after which the
 ,program will provide payments to      
health insurance issuers and the        
proportion of such claims above such    
dollar amount that the ,program will    
pay4  4