,i  #aag? ,,congress  #b;d ,session  ,h4
 ,r4 #hbde  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #bh1 #bjbb ,mr4 
,huiz5ga introduc$ ! foll[+ bill2 :i* 0 
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committee  
on ,education & ,labor1 = 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 require !       
,secret>y ( ,heal? & ,human ,s]vices to 
aw>d grants to support community-bas$   
cov]age entities to c>ry out a          
compreh5sive cov]age program t provides 
to qualify+ individuals & small         
bus9esses heal? cov]age & integrat$     
social det]m9ant ( heal? support s]vices
 to small bus9ess work]s t promote      
improv$ heal?1 long-t]m economic        
self-suffici5cy1 employm5t & ret5tion1 &
 = o!r purposes4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,community         
,multi-,%>e ,cov]age ,program ,act4  #b4
 ,grants to e/abli% ,community          

,multi-,%>e ,cov]age ,programs to enable
 small bus9esses to provide af=dable    
heal? cov]age & support s]vices to      
employees ) limit$ income & assets  7a7 
,9 g5]al ,n lat] ?an #ahj days aft] !   
date ( ! enactm5t ( ?is ,act1 !         
,secret>y %all aw>d at lea/ #c & n m ?an
 #e grants to support ,community        
,multi-,%>e ,cov]age programs4 ,su*     
programs %all--  7#a7 r$uce ! numb] (   
un9sur$ individuals ?r\gh               
hospital-community p>tn]%ip initiatives 
t provide an af=dable heal? cov]age     
option = su* individuals & provide a    
cov]age transition = ^? limit$ to       
cov]age ?r\gh gov]nm5t-sponsor$         
programs2  7#b7 promote work=ce         
developm5t = small bus9ess by address+ !
 influ5c]s ( heal? t directly impact    
employm5t success & create b>ri]s to    
exit+ ,m$icaid1 result+ 9 bett] heal? & 
workplace success2 &  7#c7 support small
 bus9ess economic recov]y by all[+ small
 bus9esses to be competitive 9 _! hir+1 
& to provide high quality1 af=dable     

heal? cov]age to work]s :o are o!rwise  
hesitant to lose ,m$icaid eligibility4  
7b7 ,community multi-,%>e cov]age       
program requirem5ts ,= purposes ( ?is   
section1 ! t]m ,community ,multi-,%>e   
,cov]age ,program means a program t     
satisfies ea* ( ! foll[+ program        
requirem5ts--  7#a7 ,physical pres5ce 9 
! community ,! program ma9ta9s a        
physical pres5ce )9 close geographic    
proximity to ! enrollees x is s]v+1 ) a 
focus on mitigat+ b>ri]s to engagem5t by
 enabl+ face-to-face int]actions betwe5 
! program /aff1 enrollees1 & community  
organizations4  7#b7 ,heal? cov]age ,!  
program provides enroll$ qualify+       
individuals ) heal? cov]age t satisfies 
! foll[+3  7,a7 ,s]vices cov]$ ,provides
 cov]age = ! foll[+ categories ( s]vices
 :5 furni%$ by network provid]s &       
community res\rces-- 7i7 physician      
s]vices2  7ii7 inpati5t & outpati5t     
hospital s]vices2  7iii7 behavioral     
heal? s]vices1 includ+ s]vices =        
sub/ance use disord] prev5tion &        

treatm5t2  7iv7 prev5tative s]vices2    
7v7 diagno/ic laboratory te/s & x-rays2 
7vi7 prescription drugs2  7vii7 em]g5cy 
ambulance s]vices t are provid$ by gr\nd
 transportation2  7viii7 em]g5cy s]vices
 7z def9$ 9 section #bgai;,a7b77#b77;,b7
 ( ! ,public ,heal? ,s]vice ,act 7#db   
,u4,s4,c4 #cjj;gg-#agai;a7b77#b77;,b7772
 &  7ix7 population heal? improvem5t    
s]vices4  7,b7 ,co/-%>+ ,imposes no     
d$uctible on cov]$ s]vices provid$ by   
network provid]s & community res\rces1 &
 limits co-paym5ts = 9-network cov]$    
s]vices to levels t d n create a b>ri]  
to pati5t access4  7,c7 ,network        
provid]s ,e/abli%es agreem5ts )         
hospitals & heal? c>e provid]s locat$ )9
 ! community to provide c>e = qualify+  
individuals4  7#c7 ,integrat$ cont9u\s  
heal? improvem5t s]vices ,! program     
provides1 ei!r directly or ?r\gh        
contract1 integrat$ cont9u\s heal?      
improvem5t s]vices t satisfy ! foll[+3  
7,a7 ,regul> assessm5ts ( community     
factors & res\rces t pot5tially impact  

enrollees' physical1 emotional1 &       
economic heal?4  7,b7 ,a community-bas$ 
plann+ process to id5tify & address any 
negative influ5ces id5tifi$ pursuant to 
subp>agraph 7,a71 & promote well-be+    
?r\gh p>tn]%ips & alignm5t ef=ts betwe5 
! community-bas$ cov]age entity &-- 7i7 
local small employ]s2  7ii7 entities t  
provide educational & occupational tra9+
 7includ+ classes1 work%ops1 m5tor%ips1 
& appr5tice%ips7 design$ to enhance     
prep>ation = "w & support economic      
self-suffici5cy2  7iii7 community heal? 
initiatives2  7iv7 inve/ors2  7v7 local1
 ,/ate1 & ,f$]al gov]nm5tal ag5cies2 &  
7vi7 organizations describ$ 9 section   
#eja7;c77#c7 ( ! ,int]nal ,rev5ue ,code 
( #aihf t focus on human s]vice ne$s    
relat+ to physical heal?1 behavioral    
heal?1 pov]ty1 education1 access to     
heal? c>e1 & safety4  7,c7              
,individualiz$ assessm5t ( ea* enrollee 
to id5tify any negative influ5ces on _! 
physical1 emotional1 & economic heal?1 &
 ability to a*ieve economic             

self-suffici5cy4 ,?is %all include--    
7i7 an assessm5t ( any ( ! enrollee's   
social det]m9ants ( heal?1 heal? risks1 
b>ri]s to long-t]m employm5t1 & b>ri]s  
to increas+ income2 &  7ii7 a           
det]m9ation ( ! enrollee's heal? doma9  
score1 :i* is a measurem5t ( specific   
influ5ces ( physical1 emotional1 &      
f9ancial heal? ) respect to a qualify+  
individual4  7,d7 ,e/abli%m5t ( an      
individualiz$ plan to support ea*       
enrollee 9 a*iev+ bett] heal? & economic
 self-suffici5cy4 ,ea* individualiz$    
plan %all-- 7i7 id5tify community       
res\rces t w support ! enrollee 9       
improv+ _! physical1 behavioral1 or     
economic heal?4 ,^! may include1 b are n
 limit$ to--  7,i7 gr\p classes t       
address b>ri]s to physical1 emotional1 &
 economic heal?2 &  7,,ii7 educational &
 occupational tra9+ opportunities t     
enhance "w prep>$ness & support economic
 self-suffici5cy2 &  7ii7 conta9        
engagem5t mile/ones1 ) a goal ( id5tify+
 & ov]com+ ob/acles to engagem5t 9      

p]sonal heal? improvem5t & mitigation ( 
root-cause b>ri]s4 ,^! mile/ones %all   
include1 b are n limit$ to-- 7,i7       
p>ticipation 9 individualiz$ heal? coa*+
 s]vices to address ! enrollee's social 
det]m9ants ( heal? & to support _!      
physical1 emotional1 & f9ancial heal?2 &
  7,,ii7 engagem5t ) community res\rces1
 su* z p>ticipat+ 9 gr\p classes1 z     
recomm5d$ by ! heal? coa*4  7#d7 ,fund+ 
/ructure ,! direct co/s ( ! program are 
%>$ among ! foll[+ entities1 ea* ( :i*  
makes a direct f9ancial contribution--  
7,a7 ! public sector2  7,b7 local heal? 
c>e provid]s2  7,c7 enrollees2 &  7,d7  
enrollees' employ]s or skill$ trade     
organizations4  7#e7 ,enrollees  7,a7 ,9
 ! ev5t t a ,program is unable to       
provide s]vices to all qualify+         
individuals 9 its cat*m5t area1 !       
,program has a writt5 policy = det]m9+  
:i* qualify+ individuals are (f]$       
enrollm5t4 ,?is policy is publicly      
available & does n discrim9ate bas$ on  
age1 race1 e?nicity1 religion1 g5d]1 or 

sexual ori5tation4  7,b7 ,! program may 
resc9d a qualify+ individual's enrollm5t
 due to su/a9$ failure to meet m9imum   
engagem5t ?re%olds1 :i* %all be         
p>ticipatory & n heal?-cont+5t1 &       
provide = reasonable alt]natives1 9 _!  
individual plan describ$ 9 subsection   
7b77#b77;,c74  7#f7 ,evaluation ,!      
program =mally evaluates its impact on  
enrollees' employm5t /atus1 physical &  
behavioral heal?1 income1 & economic    
self-suffici5cy4  7c7 ,qualify+         
individual ,! t]m qualify+ individual   
means an individual :o--  7#a7 resides  
or works )9 ! cat*m5t area ( a p>tn]    
hospital describ$ 9 subsection          
7e77#a77;,a72  7#b7 subject to any      
modification made by su* program to n>r[
 ! income eligibility range1 has a      
h\sehold income t exce$s ! ,m$icaid     
eligibility limit applicable to !       
qualify+ individual 9 _! ,/ate (        
resid5ce b does n exce$ #djj p]c5t ( !  
,f$]al pov]ty l9e applicable to _!      
h\sehold size2  7#c7 is n enroll$ 9 a   

qualifi$ heal? plan dur+ ! #ahj-;day    
p]iod prec$+ ! date on :i* su* qualify+ 
individual seeks to enroll 9 !          
,community ,multi-,%>e ,cov]age         
,program1 unless a su* cov]age is       
t]m9at$ due to a qualify+ special ev5t2 
7#d7 is ineligible = enrollm5t 9 a      
,f$]al heal? c>e program o!r ?an        
,af=dable ,c>e ,act ,plans1 7includ+ b n
 limit$ to ineligibility to receive     
heal? s]vices ?r\gh ! ,indian ,heal?    
,s]vice or ,vet]ans ,adm9i/ration72     
7#e7 works = a small employ] :i* does n 
(f] its employees cov]age 9 a qualifi$  
heal? plan "u :i* ! comb9$ premium plus 
d$uctible co/ to cov] ! employee's      
h\sehold is less ?an sev5 p]c5t ( !     
employee's h\sehold income2 &  7#f7 o!r 
requirem5ts ! ,secret>y det]m9es        
appropriate4  7d7 ,grant t]ms  7#a7     
,duration ,a grant aw>d$ "u ?is section 
%all be made = a p]iod ( #d ye>s4  7#b7 
,am\nt ,! ,secret>y %all det]m9e !      
maximum am\nt ( ea* grant aw>d$ "u      
subsection 7a74  7#c7 ,numb] ,at lea/ "o

 aw>d mu/ be made to a ,community       
,multi-,%>e ,cov]age ,program t is      
op]at+ at ! "t t ?is section is enact$4 
7e7 ,applications  7#a7 ,9 g5]al ,to be 
eligible to be aw>d$ a grant "u         
subsection 7a71 an applicant mu/--  7,a7
 be a nonpr(it entity ) docum5t$        
commitm5ts f local p>tn] hospitals &    
small employ]s to p>ticipate 9 a        
,community ,multi-,%>e ,cov]age ,plan2 &
  7,b7 submit to ! ,secret>y an         
application at su* "t1 9 su* mann]1 &   
conta9+ ! c]tification describ$ 9       
p>agraph 7#b7 & su* o!r in=mation z !   
,secret>y may require4  7#b7            
,c]tification ,to be eligible = fund+ "u
 ?is section1 an application describ$ 9 
p>agraph 7#a7 %all include c]tifications
 t ! program-- 7,a7 w n impose any      
preexi/+ condition exclusion 7z su* t]m 
is def9$ 9 section #bgjd7;b77#a77;,a77 (
 ! ,public ,heal? ,s]vice ,act 7#db     
,u4,s4,c4 #cjj;gg-#c7;b77#a77;,a77 )    
respect to ! heal? cov]age describ$ 9   
subsection 7b77#b72  7,b7 has or w      

e/abli% a network ( heal? c>e provid]s &
 community res\rces suffici5t to provide
 s]vices to qualify+ individuals enroll$
 "u ! heal? cov]age describ$ 9          
subsection 7b77#b72  7,c7 w seek to     
enroll eligible individuals ^: h\sehold 
income is less ?an ! basic co/ ( liv+ 7z
 det]m9$ 9 a mann] consi/5t ) ! ,asset  
,limit$1 ,income ,con/ra9$1 ,employ$ or 
,,alice me?odology72  7,d7 select an    
entity to c>ry out adm9i/rative &       
acc\nt+ responsibilities 7includ+ mon?ly
 bill+1 v]ification ( eligibility (     
qualify+ individuals1 enrollm5t (       
qualify+ individuals1 ma9t5ance ( a li/ 
( active enrollees1 & op]ation ( a      
b5efit utilization managem5t program7   
necess>y ) respect to ! heal? cov]age   
describ$ 9 subsection 7b77#b72 &  7,e7  
%all submit writt5 reports to !         
,secret>y on an annual basis evaluat+ ! 
progress on advanc+ access to heal? c>e1
 increas+ economic self-suffici5cy1 &   
o!r elem5ts t ! ,secret>y requires4  7f7
 ,def9itions ,9 ?is section3 7#a7 ,ag5cy

 ,! t]m ag5cy means a local1 ,/ate1 or  
,f$]al ag5cy4  7#b7 ,f$]al heal? c>e    
program ,! t]m ,f$]al heal? c>e program 
has ! mean+ giv5 su* t]m 9 section      
#aabh;,b7f7 ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acbj;a-#g;b7f774  7#c7  
,heal? coa* ,! t]m heal? coa* means an  
individual :o is a memb] ( ! /aff ( !   
community-bas$ cov]age entity t has     
receiv$ tra9+ to provide heal? coa*+    
s]vices 7includ+ heal? improvem5t       
program s]vices74  7#d7 ,hospital ,! t]m
 hospital means an in/itution t-- 7,a7  
meets ! requirem5ts ( section #ahfa7;e7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciex7e772 &  7,b7 is an     
organization describ$ 9 subsections     
7c77#c7 & 7r77#c7 ( section #eja ( !    
,int]nal ,rev5ue ,code ( #aihf & is     
exempt f taxation "u section #eja7;a7 ( 
su* ,code4  7#e7 ,qualifi$ heal? plan ,!
 t]m qualifi$ heal? plan has ! mean+    
giv5 su* t]m 9 section #acja7;a7 ( !    
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjba7;a774  7#f7  

,secret>y ,! t]m ,secret>y means !      
,secret>y ( ,heal? & ,human ,s]vices4   
7#g7 ,small employ] ,! t]m small employ]
 has ! mean+ giv5 su* t]m 9 section     
#acjd7;b77#b7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjbd7;b77#b774  7#h7 ,social          
det]m9ants ( heal? ,! t]m social        
det]m9ants ( heal? has ! mean+ giv5 su* 
t]m by ! ,director ( ! ,c5t]s = ,disease
 ,control & ,prev5tion4  7g7            
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section--  7#a7 #d1hjj1jjj = fiscal 
ye> #bjbb2  7#b7 #g1bjj1jjj = fiscal ye>
 #bjbc2 &  7#c7 #ab1jjj1jjj = ea* (     
fiscal ye>s #bjbd & #bjbe4