,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #ahgh  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #ab1 #bjba,ms4   
,craig 7= h]self & ,mr4 ,pet]s7         
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce  ,a  
,,bill  ,to am5d ! ,pati5t ,protection &
 ,af=dable ,c>e ,act to e/abli% a heal? 
insurance af=dability fund1 & = o!r     
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,/ate ,heal? ,c>e ,premium 
,r$uction ,act ( #bjba4  #b4 ,e/abli%+ a
 heal? insurance af=dability fund  7a7  
,9 g5]al ,subtitle ,d ( title ,i ( !    
,pati5t ,protection & ,af=dable ,c>e    
,act is am5d$ by ins]t+ aft] "p #e 7#db 
,u4,s4,c4 #ahjfa et seq47 ! foll[+ new  
"p3  #f ,improve ,heal? ,insurance      
,af=dability ,fund  #acea4 ,e/abli%m5t (
 program ,!re is h]eby e/abli%$ !       
,improve ,heal? ,insurance ,af=dability 
,fund to be adm9i/]$ by ! ,secret>y (   
,heal? & ,human ,s]vices1 act+ ?r\gh !  
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices 79 ?is section ref]r$ 

to z ! ,adm9i/rator71 to provide fund+1 
9 accordance ) ?is "p1 to ! #ej ,/ates &
 ! ,di/rict ( ,columbia 7ea* ref]r$ to 9
 ?is section z a ,/ate7 beg9n+ on       
,janu>y #a1 #bjbc1 = ! purposes describ$
 9 section #aceb4  #aceb4 ,use ( funds  
7a7 ,9 g5]al ,a ,/ate %all use ! funds  
allocat$ to ! ,/ate "u ?is "p = "o ( !  
foll[+ purposes3 7#a7 ,to provide       
re9surance paym5ts to heal? insurance   
issu]s ) respect to individuals enroll$ 
"u individual heal? insurance cov]age   
7o!r ?an ?r\gh a plan describ$ 9        
subsection 7b77 (f]$ by su* issu]s4     
7#b7 ,to provide assi/ance 7o!r ?an     
?r\gh paym5ts describ$ 9 p>agraph 7#a77 
to r$uce out-(-pocket co/s1 su* z       
copaym5ts1 co9surance1 premiums1 &      
d$uctibles1 ( individuals enroll$ "u    
qualifi$ heal? plans (f]$ on !          
individual m>ket ?r\gh an ,ex*ange & (  
individuals enroll$ "u /&>d heal? plans 
(f]$ ?r\gh a basic heal? program        
e/abli%$ "u section #acca4  7b7         
,exclusion ( c]ta9 gr&fa!r$ &           

transitional plans ,= purposes (        
subsection 7a71 a plan describ$ 9 ?is   
subsection is ! foll[+3 7#a7 ,a gr&fa!r$
 heal? plan 7z def9$ 9 section #abea74  
7#b7 ,a plan 7commonly ref]r$ to z a    
transitional plan7 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 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 ,april #i1 #bjah1  
,m>* #be1 #bjai1 & ,janu>y #ca1 #bjbj1  
or "u any subsequ5t ext5sions !re(4     
7#c7 ,/ud5t heal? insurance cov]age 7z  
def9$ 9 section #adg4ade ( title #de1   
,code ( ,f$]al ,regulations74  #acec4   
,/ate eligibility & approval2 ,default  
safegu>d  7a7 ,enc\rag+ ,/ate options = 

allocations  7#a7 ,9 g5]al ,to be       
eligible = an allocation ( funds "u ?is 
"p = a ye> 7beg9n+ ) #bjbc71 a ,/ate    
%all submit to ! ,adm9i/rator an        
application at su* "t 7b1 9 ! case (    
allocations = #bjbc1 n lat] ?an #ij days
 aft] ! date ( ! enactm5t ( ?is "p &1 9 
! case ( allocations = a subsequ5t ye>1 
n lat] ?an ,m>* #a ( ! previ\s ye>7 & 9 
su* =m & mann] z specifi$ by !          
,adm9i/rator conta9+-- 7,a7 a           
description ( h[ ! funds w be us$2 &    
7,b7 su* o!r in=mation z ! ,adm9i/rator 
may require4  7#b7 ,automatic approval  
,an application s submitt$ is approv$   
unless ! ,adm9i/rator notifies ! ,/ate  
submitt+ ! application1 n lat] ?an #fj  
days aft] ! date ( ! submission ( su*   
application1 t ! application has be5    
d5i$ = n be+ 9 compliance ) any         
requirem5t ( ?is "p & ( ! reason = su*  
d5ial4  7#c7 #e-ye> application approval
 ,if an application ( a ,/ate is approv$
 = a purpose describ$ 9 section #aceb = 
a ye>1 su* application %all be treat$ z 

approv$ = su* purpose = ea* ( !         
subsequ5t #d ye>s4  7#d7 ,revocation (  
approval ,! approval ( an application ( 
a ,/ate1 ) respect to a purpose describ$
 9 section #aceb1 may be revok$ if !    
,/ate fails to use funds provid$ to !   
,/ate "u ?is section = su* purpose or   
o!rwise fails to comply ) ! requirem5ts 
( ?is section4  7b7 ,default ,f$]al     
safegu>d  7#a7 #bjbc ,= #bjbc1 9 ! case 
( a ,/ate t does n submit an application
 "u subsection 7a7 by ! #ij-;day        
submission date applicable to su* ye> "u
 subsection 7a77#a7 & 9 ! case ( a ,/ate
 t does submit su* an application by su*
 date t is n approv$1 ! ,adm9i/rator1 9 
consultation ) ! ,/ate insurance        
commission]1 %all1 f ! am\nt calculat$  
"u p>agraph 7#d7 = su* ye>1 c>ry out !  
purpose describ$ 9 p>agraph 7#c7 9 su*  
,/ate = su* ye>4  7#b7 #bjbd & subsequ5t
 ye>s ,= #bjbd or a subsequ5t ye>1 9 !  
case ( a ,/ate t does n h 9 effect an   
approv$ application "u ?is section = su*
 ye>1 ! ,adm9i/rator1 9 consultation ) !

 ,/ate insurance commission]1 %all1 f ! 
am\nt calculat$ "u p>agraph 7#d7 = su*  
ye>1 c>ry out ! purpose describ$ 9      
p>agraph 7#c7 9 su* ,/ate = su* ye>4    
7#c7 ,specifi$ use ,! am\nt describ$ 9  
p>agraph 7#d71 ) respect to #bjbc or a  
subsequ5t ye>1 %all be us$ to c>ry out !
 purpose describ$ 9 section             
#aceb7;a77#a7 9 ea* ,/ate describ$ 9    
p>agraph 7#a7 or 7#b7 = su* ye>1 z      
applicable1 by provid+ re9surance       
paym5ts to heal? insurance issu]s )     
respect to atta*m5t range claims 7z     
def9$ 9 section #aced7;b77#b771 us+ !   
doll> am\nts specifi$ 9 subp>agraph 7,b7
 ( su* section = su* ye>7 9 an am\nt    
equal to1 subject to p>agraph 7#e71 !   
p]c5tage 7specifi$ = su* ye> by !       
,secret>y "u su* subp>agraph7 ( ! am\nt 
( su* claims4  7#d7 ,am\nt describ$ ,!  
am\nt describ$ 9 ?is p>agraph1 ) respect
 to #bjbc or a subsequ5t ye>1 is ! am\nt
 equal to ! total sum ( am\nts t !      
,secret>y w\ld o!rwise e/imate "u       
section #aced7;b77#b77;,a77i7 = su* ye> 

= ea* ,/ate describ$ 9 p>agraph 7#a7 or 
7#b7 = su* ye>1 z applicable1 if ea* su*
 ,/ate 7 n s describ$ = su* ye>4  7#e7  
,adju/m5t ,= purposes ( ?is subsection1 
! ,secret>y may apply a p]c5tage "u     
p>agraph 7#c7 ) respect to a ye> t is   
less ?an ! p]c5tage o!rwise specifi$ 9  
section #aced7;b77#b77;,b7 = su* ye>1 if
 ! co/ ( pay+ ! total eligible atta*m5t 
range claims = ,/ates describ$ 9 ?is    
subsection = su* ye> at su* p]c5tage    
o!rwise specifi$ w\ld exce$ ! am\nt     
calculat$ "u p>agraph 7#d7 = su* ye>4   
#aced4 ,allocations  7a7 ,appropriation 
,= ! purpose ( provid+ allocations =    
,/ates "u subsection 7b7 & paym5ts "u   
section #acec7;b7 !re is appropriat$1   
out ( any money 9 ! ,treasury n o!rwise 
appropriat$1 #aj1jjj1jjj1jjj = #bjbc &  
ea* subsequ5t ye>4  7b7 ,allocations    
7#a7 ,paym5t  7,a7 ,9 g5]al ,f am\nts   
appropriat$ "u subsection 7a7 = a ye>1 !
 ,secret>y %all1 ) respect to a ,/ate n 
describ$ 9 section #acec7;b7 = su* ye> &
 n lat] ?an ! date specifi$ "u          

subp>agraph 7,b7 = su* ye>1 allocate =  
su* ,/ate ! am\nt det]m9$ = su* ,/ate & 
ye> "u p>agraph 7#b74  7,b7 ,specifi$   
date ,= purposes ( subp>agraph 7,a71 !  
date specifi$ 9 ?is subp>agraph is-- 7i7
 = #bjbc1 ! date t is #de days aft] !   
date ( ! enactm5t ( ?is "p2 &  7ii7 =   
#bjbd or a subsequ5t ye>1 ,janu>y #a ( !
 respective ye>4  7,c7 ,notifications ( 
allocation am\nts ,= #bjbd & ea*        
subsequ5t ye>1 ! ,secret>y %all notify  
ea* ,/ate ( ! am\nt det]m9$ = su* ,/ate 
"u p>agraph 7#b7 = su* ye> by n lat] ?an
 ,janu>y #a ( ! previ\s ye>4  7#b7      
,allocation am\nt det]m9ations  7,a7 ,9 
g5]al ,= purposes ( p>agraph 7#a71 !    
am\nt det]m9$ "u ?is p>agraph = a ye> = 
a ,/ate describ$ 9 p>agraph 7#a77;,a7 = 
su* ye> is ! am\nt equal to-- 7i7 !     
am\nt t ! ,secret>y e/imates w\ld be    
exp5d$ "u ?is "p = su* ye> on atta*m5t  
range claims ( individuals resid+ 9 su* 
,/ate if su* ,/ate us$ su* funds only = 
! purpose describ$ 9 p>agraph 7#a7 (    
section #aceb7;a7 at ! doll> am\nts &   

p]c5tage specifi$ "u subp>agraph 7,b7 = 
su* ye>2 m9us  7ii7 ! am\nt1 if any1 by 
:i* ! ,secret>y det]m9es-- 7,i7 !       
e/imat$ am\nt ( premium tax cr$its "u   
section #cf;,b ( ! ,int]nal ,rev5ue     
,code ( #aihf t w\ld be attributable to 
individuals resid+ 9 su* ,/ate = su* ye>
 )\t application ( ?is "p2 exce$s       
7,,ii7 ! e/imat$ am\nt ( premium tax    
cr$its "u section #cf;,b ( ! ,int]nal   
,rev5ue ,code ( #aihf t w\ld be         
attributable to individuals resid+ 9 su*
 ,/ate = su* ye> if su* ,/ate 7 a ,/ate 
describ$ 9 section #acec7;b7 = su* ye>4 
,= purposes ( ! previ\s s5t5ce & section
 #acec7;b77#c71 ! t]m atta*m5t range    
claims means1 ) respect to an           
individual1 ! claims = su* individual t 
exce$ a doll> am\nt specifi$ by !       
,secret>y = a ye>1 b d n exce$ a ceil+  
doll> am\nt specifi$ by ! ,secret>y =   
su* ye>1 "u subp>agraph 7,b74  7,b7     
,specifications ,= purposes (           
subp>agraph 7,a7 & section              
#acec7;b77#c71 ! ,secret>y %all det]m9e 

! doll> am\nts & ! p]c5tage to be       
specifi$ "u ?is subp>agraph = a ye> 9 a 
mann] to ensure t ! total am\nt (       
exp5ditures "u ?is "p = su* ye> is      
e/imat$ to equal ! total am\nt          
appropriat$ = su* ye> "u subsection 7a7 
if su* exp5ditures 7 us$ solely = !     
purpose describ$ 9 p>agraph 7#a7 (      
section #aceb7;a7 = atta*m5t range      
claims at ! doll> am\nts & p]c5tage s   
specifi$ = su* ye>4  7#c7 ,availability 
,funds allocat$ to a ,/ate "u ?is       
subsection = a ye> %all rema9 available 
?r\gh ! end ( ! subsequ5t ye>4  4  7b7  
,basic ,heal? ,program fund+ adju/m5ts  
,section #acca ( ! ,pati5t ,protection &
 ,af=dable ,c>e ,act 7#db ,u4,s4,c4     
#ahjea7 is am5d$-- 7#a7 9 subsection    
7a71 by add+ at ! end ! foll[+ new      
p>agraph3  7#c7 ,provision ( in=mation  
on qualifi$ heal? plan premiums  7,a7 ,9
 g5]al ,! program describ$ 9 p>agraph   
7#a7 %all provide t a ,/ate may n       
e/abli% a basic heal? program unless su*
 ,/ate furni%es to ! ,secret>y1 )       

respect to ea* qualifi$ heal? plan (f]$ 
9 su* ,/ate dur+ a ye> t receives any   
re9surance paym5t f funds made available
 "u "p #f = su* ye>1 ! adju/$ premium   
am\nt 7z def9$ 9 subp>agraph 7,b77 = ea*
 su* plan & ye>4  7,b7 ,adju/$ premium  
am\nt def9$ ,= purposes ( subp>agraph   
7,a71 ! t]m adju/$ premium am\nt means1 
) respect to a qualifi$ heal? plan & a  
ye>1 ! mon?ly premium = su* plan & ye> t
 w\ld h appli$ _h su* plan n receiv$ any
 paym5ts describ$ 9 subp>agraph 7,a7 =  
su* ye>4  2 &  7#b7 9 subsection        
7d77#c77;,a77ii71 by add+ at ! end !    
foll[+ new s5t5ce3 ,9 mak+ su*          
det]m9ation1 ! ,secret>y %all calculate 
! value ( su* premium tax cr$its t w\ld 
h be5 provid$ to su* individuals enroll$
 ?r\gh a basic heal? program e/abli%$ by
 a ,/ate dur+ a ye> us+ ! adju/$ premium
 am\nts 7z def9$ 9 subsection           
7a77#c77;,b77 = qualifi$ heal? plans    
(f]$ 9 su* ,/ate dur+ su* ye>44