,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #hegc  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,octob] #i1 #bjbj,ms4 
,s*ri] introduc$ ! foll[+ bill2 :i* 0   
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committees 
on ,ways & ,means1 ,education & ,labor1 
& ,arm$ ,s]vices1 = 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 prohibit gr\p   
heal? plans1 heal? insurance issu]s (f]+
 gr\p or individual heal? insurance     
cov]age1 ,/ate plans "u title ,,xix ( ! 
,social ,security ,act1 ,/ate *ild heal?
 plans "u title ,,xxi ( su* ,act1 & !   
,,tric>e program f apply+ a d$uctible to
 outpati5t p$iatric s]vices4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,help+  
,families ,access ,p$iatric ,c>e ,act ( 
#bjbj4  #b4 ,prohibit+ c]ta9 heal? plans
 f apply+ a d$uctible to outpati5t      
p$iatric s]vices  7a7 ,,erisa  7#a7 ,9  
g5]al ,subp>t ,b ( "p #g ( title ,i ( ! 

,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #aahe et    
seq47 is am5d$ by add+ at ! end ! foll[+
 new section3  #gaf4 ,prohibition on    
application ( d$uctible to outpati5t    
p$iatric s]vices  7a7 ,9 g5]al ,a gr\p  
heal? plan & a heal? insurance issu]    
(f]+ gr\p heal? insurance cov]age may n 
impose any d$uctible "u su* plan or     
cov]age 7z applicable7 ) respect to     
outpati5t p$iatric s]vices 7z def9$ 9   
subsection 7b77 = :i* b5efits are       
provid$ "u su* plan or cov]age4  7b7    
,outpati5t p$iatric s]vices def9$ ,=    
purposes ( subsection 7a71 ! t]m        
outpati5t p$iatric s]vices means any    
item or s]vice furni%$ to an individual 
"u ! age ( #ah z an outpati5t by a heal?
 c>e provid] act+ )9 ! scope ( su*      
provid]'s lic5se1 reg>dless ( :e!r su*  
s]vice is furni%$ 9-p]son or ?r\gh use (
 a telecommunications sy/em4  4  7#b7   
,cl]ical am5dm5t ,! table ( cont5ts ( ! 
,employee ,retirem5t ,income ,security  
,act ( #aigd is am5d$ by ins]t+ aft] !  

item relat+ to section #gad ! foll[+3   
,sec4 #gae4 ,additional m>ket re=ms4    
,sec4 #gaf4 ,prohibition on application 
( d$uctible to outpati5t p$iatric       
s]vices4  4  7b7 ,,phsa ,subp>t ,,ii (  
"p ,a ( title ,,xxvii ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aa
 et seq47 is am5d$ by add+ at ! end !   
foll[+ new section3  #bgcj4 ,prohibition
 on application ( d$uctible to outpati5t
 p$iatric s]vices  7a7 ,9 g5]al ,a gr\p 
heal? plan & a heal? insurance issu]    
(f]+ gr\p or individual heal? insurance 
cov]age may n impose any d$uctible "u   
su* plan or cov]age 7z applicable7 )    
respect to outpati5t p$iatric s]vices 7z
 def9$ 9 subsection 7b77 = :i* b5efits  
are provid$ "u su* plan or cov]age4  7b7
 ,outpati5t p$iatric s]vices def9$ ,=   
purposes ( subsection 7a71 ! t]m        
outpati5t p$iatric s]vices means any    
item or s]vice furni%$ to an individual 
"u ! age ( #ah z an outpati5t by a heal?
 c>e provid] act+ )9 ! scope ( su*      
provid]'s lic5se1 reg>dless ( :e!r su*  

s]vice is furni%$ 9-p]son or ?r\gh use (
 a telecommunications sy/em4  4  7c7    
,,irc  7#a7 ,9 g5]al ,sub*apt] ,b (     
*apt] #ajj ( ! ,int]nal ,rev5ue ,code ( 
#aihf is am5d$ by add+ at ! end ! foll[+
 new section3  #ihaf4 ,prohibition on   
application ( d$uctible to outpati5t    
p$iatric s]vices  7a7 ,9 g5]al ,a gr\p  
heal? plan may n impose any d$uctible "u
 su* plan ) respect to outpati5t        
p$iatric s]vices 7z def9$ 9 subsection  
7b77 = :i* b5efits are provid$ "u su*   
plan4  7b7 ,outpati5t p$iatric s]vices  
def9$ ,= purposes ( subsection 7a71 !   
t]m outpati5t p$iatric s]vices means any
 item or s]vice furni%$ to an individual
 "u ! age ( #ah z an outpati5t by a     
heal? c>e provid] act+ )9 ! scope ( su* 
provid]'s lic5se1 reg>dless ( :e!r su*  
s]vice is furni%$ 9-p]son or ?r\gh use (
 a telecommunications sy/em4  4  7#b7   
,cl]ical am5dm5t ,! table ( sections =  
sub*apt] ,b ( *apt] #ajj ( ! ,int]nal   
,rev5ue ,code ( #aihf is am5d$ by add+  
at ! end ! foll[+ new items3  ,sec4     

#ihae4 ,additional m>ket re=ms4 ,sec4   
#ihaf4 ,prohibition on application (    
d$uctible to outpati5t p$iatric s]vices4
  4  7d7 ,m$icaid ,section #aiaf;,a ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acifo-#a7 is am5d$-- 7#a7 9 subsection 
7a7-- 7,a7 9 p>agraph 7#a71 by /rik+    
p>agraph 7#b7 & ins]t+ p>agraphs 7#b7 & 
7#d72 &  7,b7 by add+ at ! end ! foll[+ 
new p>agraph3  7#d7 ,prohibition on     
application ( d$uction to outpati5t     
p$iatric s]vices ,a ,/ate may n impose a
 d$uction "u ! plan ) respect to        
outpati5t p$iatric s]vices 7z def9$ 9   
subsection 7f774  2 &  7#b7 by add+ at !
 end ! foll[+ new subsection3  7f7      
,outpati5t p$iatric s]vices def9$ ,=    
purposes ( ?is section1 ! t]m outpati5t 
p$iatric s]vices means any item or      
s]vice furni%$ to an individual "u ! age
 ( #ah z an outpati5t by a heal? c>e    
provid] act+ )9 ! scope ( su* provid]'s 
lic5se1 reg>dless ( :e!r su* s]vice is  
furni%$ 9-p]son or ?r\gh use ( a        
telecommunications sy/em4  4  7e7 ,,*ip 

,section #bajc7;e7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acig;cc7 is am5d$ 
by add+ at ! end ! foll[+ new p>agraph3 
7#e7 ,prohibition on application (      
d$uction to outpati5t p$iatric s]vices  
7,a7 ,9 g5]al ,! ,/ate *ild heal? plan  
may n impose a d$uctible ) respect to   
outpati5t p$iatric s]vices 7z def9$ 9   
subp>agraph 7,b774  7,b7 ,outpati5t     
p$iatric s]vices def9$ ,= purposes ( ?is
 p>agraph1 ! t]m outpati5t p$iatric     
s]vices means any item or s]vice furni%$
 to an individual "u ! age ( #ah z an   
outpati5t by a heal? c>e provid] act+ )9
 ! scope ( su* provid]'s lic5se1        
reg>dless ( :e!r su* s]vice is furni%$  
9-p]son or ?r\gh use ( a                
telecommunications sy/em4  4  7f7       
,fir/-,doll> cov]age all[ance =         
outpati5t p$iatric s]vices = high       
d$uctible plans ,section #bbf7;c77#b7 ( 
! ,int]nal ,rev5ue ,code ( #aihf is     
am5d$ by add+ at ! end ! foll[+ new     
subp>agraph3  7,f7 ,safe h>bor = abs5ce 
( d$uctible = outpati5t p$iatric s]vices

 ,a plan %all n fail to be treat$ z a   
high d$uctible heal? plan by reason (   
fail+ to h a d$uctible = outpati5t      
p$iatric s]vices 7z def9$ 9 section     
#ihaf7;b774  4  7g7 ,,tric>e program    
7#a7 ,9 g5]al ,section #ajie;d ( title  
#aj1 ,unit$ ,/ates ,code1 is am5d$--    
7,a7 9 ! section head+1 by ins]t+       
prohibition on & be=e waiv]2  7,b7 by   
r$esignat+ subsections 7a7 & 7b7 z      
subsections 7b7 & 7c71 respectively2    
7,c7 by ins]t+ be=e subsection 7b71 z s 
r$esignat$1 ! foll[+ new subsection 7a73
  7a7 ,prohibition on application (     
d$uctible to outpati5t p$iatric s]vices 
,! ,secret>y ( ,def5se may n impose any 
d$uctible "u ! ,,tric>e program = m$ical
 c>e provid$ to a cov]$ b5efici>y :o is 
"u ! age ( #ah z an outpati5t1 reg>dless
 ( :e!r su* c>e is furni%$ 9-p]son or   
?r\gh use ( a telecommunications sy/em4 
2 &  7,d7 9 subsection 7b71 z s         
r$esignat$1 by /rik+ ,! ,secret>y &     
ins]t+ ,9 addition to ! requirem5t "u   
subsection 7a71 ! ,secret>y4  7#b7      

,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( *apt] #ee ( title #aj1 ,unit$
 ,/ates ,code1 is am5d$ by /rik+ ! item 
relat+ to section #ajie;d & ins]t+ !    
foll[+ new item3  #ajie;d4 ,,tric>e     
program3 prohibition on & waiv] ( c]ta9 
d$uctibles4  4  7#c7 ,con=m+ am5dm5t    
,section #ajge7;d7 ( su* title is am5d$ 
by add+ at ! end ! foll[+ new p>agraph3 
7#e7 ,! ,secret>y may n impose any      
d$uctible am\nts = outpati5t p$iatric   
s]vices pursuant to section #ajie;d (   
?is title4  4  7h7 ,,gao /udy ,n lat]   
?an #d ye>s aft] ! date ( ! enactm5t (  
?is ,act1 ! ,comptroll] ,g5]al ( !      
,unit$ ,/ates %all conduct a /udy &     
submit to ,congress a report on !       
effects ( ! am5dm5ts made by ?is ,act on
 premiums1 d$uctibles1 & copaym5t &     
co9surance requirem5ts ) respect to gr\p
 heal? plans & gr\p & individual heal?  
insurance cov]age 7z su* t]ms are def9$ 
9 section #bgia ( ! ,public ,heal?      
,s]vice ,act 7#db ,u4,s4,c4             
#cjj;gg-#ia774  7i7 ,effective date ,!  

am5dm5t 7or am5dm5ts7 made by-- 7#a7    
subsections 7a7 ?r\gh 7c7 & subsections 
7f7 & 7g7 %all apply ) respect to plan  
ye>s beg9n+ on or aft] ! date t is #b   
ye>s aft] ! date ( ! enactm5t ( ?is     
,act2  7#b7 subsection 7d7 %all apply ) 
respect to m$ical assi/ance furni%$ 9   
cal5d> qu>t]s beg9n+ on or aft] ! date t
 is #b ye>s aft] ! date ( ! enactm5t (  
?is ,act2 &  7#c7 subsection 7c7 %all   
apply ) respect to *ild heal? assi/ance 
furni%$ cal5d> qu>t]s describ$ 9        
p>agraph 7#b74