,,ii  #aah? ,,congress  #a/ ,session    
,s4 #bcgd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #ai1 #bjbc,mr4   
,vance introduc$ ! foll[+ bill2 :i* 0   
read twice & ref]r$ to ! ,committee on  
,f9ance  ,a ,,bill  ,to exclude c]ta9   
individuals subject to c]ta9 def]r$     
action f eligibility = heal? plans (f]$ 
on ! ,ex*anges1 advance paym5ts ( !     
premium tax cr$it1 co/-%>+ r$uctions1 a 
,basic ,heal? ,program1 & = ,m$icaid & !
 ,*ildr5's ,heal? ,insurance ,programs1 
& = o!r purposes4  #a4 ,%ort title ,?is 
,act may be cit$ z ! ,no ,obamac>e =    
,illegal ,ali5s ,act4  #b4 ,treatm5t (  
individuals subject to c]ta9 def]r$     
action = purposes ( enrollm5t 9 heal?   
plans (f]$ on ! ,ex*anges  7a7          
,enrollm5t ineligibility ,section       
#acab7;f77#c7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjcb7;f77#c77 is am5d$ by add+ at !   
end ! foll[+3 ,any ali5 :o is lawfully  
pres5t solely because su* individual 0  
grant$ def]r$ action pursuant to !      

memor&um ( ! ,dep>tm5t ( ,homel&        
,security entitl$ ,ex]cis+              
,prosecutorial ,discretion ) ,respect to
 ,individuals ,:o ,came to ! ,unit$     
,/ates z ,*ildr5 issu$ on ,june #ae1    
#bjab1 %all n be treat$ z lawfully      
pres5t = purposes ( ! prec$+ s5t5ce44   
7b7 ,ineligibility = cr$it = cov]age "u 
a qualifi$ heal? plan ,p>agraph 7#b7 (  
section #cf;,b7e7 ( ! ,int]nal ,rev5ue  
,code ( #aihf is am5d$ by add+ at ! end 
! foll[+3 ,any ali5 :o is lawfully      
pres5t solely because su* individual 0  
grant$ def]r$ action pursuant to !      
memor&um ( ! ,dep>tm5t ( ,homel&        
,security entitl$ ,ex]cis+              
,prosecutorial ,discretion ) ,respect to
 ,individuals ,:o ,came to ! ,unit$     
,/ates z ,*ildr5 issu$ on ,june #ae1    
#bjab1 %all n be treat$ z lawfully      
pres5t = purposes ( ! prec$+ s5t5ce44   
#c4 ,ensur+ t taxpay] funds = heal?     
insurance cov]age are available only to 
au?oriz$ individuals  7a7 ,basic heal?  
programs  7#a7 ,9 g5]al ,section        

#acca7;e77 ( ! ,pati5t ,protection &    
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjea7;e77 is am5d$-- 7,a7 by          
r$esignat+ p>agraph 7#b7 z p>agraph     
7#c72  7,b7 9 p>agraph 7#a71 by /rik+ ! 
second s5t5ce2 &  7,c7 by ins]t+ aft]   
p>agraph 7#a71 ! foll[+ new p>agraph3   
7#b7 ,exclusions ,su* t]m %all n include
 ! foll[+3 7,a7 ,any individual :o is n 
a qualifi$ individual "u section #acab  
:o is eligible to be cov]$ by a qualifi$
 heal? plan (f]$ ?r\gh an ,ex*ange4     
7,b7 ,any individual :o is nei!r a      
citiz5 or national ( ! ,unit$ ,/ates nor
 an ali5 lawfully pres5t 9 ! ,unit$     
,/ates4 ,any ali5 :o is lawfully pres5t 
solely because su* individual 0 grant$  
def]r$ action pursuant to ! memor&um ( !
 ,dep>tm5t ( ,homel& ,security entitl$  
,ex]cis+ ,prosecutorial ,discretion )   
,respect to ,individuals ,:o ,came to ! 
,unit$ ,/ates z ,*ildr5 issu$ on ,june  
#ae1 #bjab1 %all n be treat$ z lawfully 
pres5t = purposes ( ! prec$+ s5t5ce4  4 
7#b7 ,limitation on use ( funds ,section

 #acca7;d77 ( ! ,pati5t ,protection &   
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjea7;d77 is am5d$ by add+ at ! end ! 
foll[+ new p>agraph3  7#e7 ,prohibition 
on use ( pass-,?r\gh fund+ = c]ta9      
individuals ,no am\nts transf]r$ to a   
,/ate "u ?is section may be us$ to (fset
 ! co/ ( heal? insurance cov]age        
7includ+ ?r\gh premium or co/ %>+       
r$uctions7 or to provide any o!r b5efit 
) respect to an individual :o is n an   
eligible individual 7z def9$ 9          
subsection 7e774  4  7b7 ,/ate          
innovation waiv]s  7#a7 ,9 g5]al        
,section #accb7;a77#b77;,b7 ( ! ,pati5t 
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjeb7;a77#b77;,b77 is am5d$ 
by ins]t+ 7o!r ?an ! requirem5t describ$
 9 section #acab7;f77#c77 be=e ! p]iod4 
7#b7 ,prohibition on use ( pass-,?r\gh  
fund+ = c]ta9 individuals ,section      
#accb7;a77#c7 ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjeb7;a77#c77 is am5d$ by add+ at !   
end ! foll[+ new s5t5ce3 ,no am\nts paid

 to a ,/ate "u ?is p>agraph may be us$  
to (fset ! co/ ( heal? insurance cov]age
 7includ+ ?r\gh premium or co/ %>+      
r$uctions7 or to provide any o!r b5efit 
) respect to an individual :o is n a    
citiz5 or national ( ! ,unit$ ,/ates or 
an ali5 lawfully pres5t 9 ! ,unit$      
,/ates4 ,any ali5 :o is lawfully pres5t 
solely because su* individual 0 grant$  
def]r$ action pursuant to ! memor&um ( !
 ,dep>tm5t ( ,homel& ,security entitl$  
,ex]cis+ ,prosecutorial ,discretion )   
,respect to ,individuals ,:o ,came to ! 
,unit$ ,/ates z ,*ildr5 issu$ on ,june  
#ae1 #bjab1 %all n be treat$ z lawfully 
pres5t = purposes ( ! prec$+ s5t5ce44   
7c7 ,m$icaid & ,,*ip  7#a7 ,exclusion f 
def9ition ( qualifi$ ali5 "u ,,prwora   
,section #dca ( ! ,p]sonal              
,responsibility & ,"w ,opportunity      
,reconciliation ,act ( #aiif 7#h        
,u4,s4,c4 #afda7 is am5d$ by add+ at !  
end ! foll[+ new subsection3  7d7       
,treatm5t ( c]ta9 def]r$ action "u      
,m$icaid & ,,*ip ,= purposes ( ?is      

title1 ! t]m qualifi$ ali5 %all n       
include any ali5 :o is lawfully pres5t  
solely because su* individual 0 grant$  
def]r$ action pursuant to ! memor&um ( !
 ,dep>tm5t ( ,homel& ,security entitl$  
,ex]cis+ ,prosecutorial ,discretion )   
,respect to ,individuals ,:o ,came to ! 
,unit$ ,/ates z ,*ildr5 issu$ on ,june  
#ae1 #bjab1 b only ) respect to !       
designat$ ,f$]al program def9$ 9 section
 #djb7;b77#c77;,c7 7relat+ to ! ,m$icaid
 program7 & ! ,/ate ,*ildr5's ,heal?    
,insurance ,program e/abli%$ "u title   
,,xxi ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acig;aa et seq474 ,an        
individual grant$ def]r$ action pursuant
 to ! memor&um describ$ 9 ! prec$+      
s5t5ce %all n be treat$ z lawfully      
pres5t or lawfully resid+ = purposes ( !
 designat$ ,f$]al program def9$ 9       
section #djb7;b77#c77;,c7 7relat+ to !  
,m$icaid program7 or ! ,/ate ,*ildr5's  
,heal? ,insurance ,program e/abli%$ "u  
title ,,xxi ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acig;aa et seq474  4    

7#b7 ,exclusion f ,,*ipra cov]age option
  7,a7 ,m$icaid ,section #aijc7v77#d7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acif;b7v77#d77 is am5d$-- 7i7 9        
subp>agraph 7,a71 by /rik+ ,a ,/ate may 
& ins]t+ ,subject to subp>agraph 7,d71 a
 ,/ate may2 &  7ii7 by add+ at ! end !  
foll[+ new subp>agraph3  7,d7 ,any ali5 
:o is lawfully pres5t 9 ! ,unit$ ,/ates 
solely because su* individual 0 grant$  
def]r$ action pursuant to ! memor&um ( !
 ,dep>tm5t ( ,homel& ,security entitl$  
,ex]cis+ ,prosecutorial ,discretion )   
,respect to ,individuals ,:o ,came to ! 
,unit$ ,/ates z ,*ildr5 issu$ on ,june  
#ae1 #bjab1 %all n be treat$ z lawfully 
pres5t or lawfully resid+ = purposes (  
an election by a ,/ate to provide m$ical
 assi/ance to a category ( ali5s "u     
subp>agraph 7,a7 & %all n be consid]$ to
 be describ$ )9 ei!r or bo? ( !         
eligibility categories describ$ 9 su*   
subp>agraph4  4  7,b7 ,,*ip ,section    
#bajg7;e77#a77,o7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acig;gg7e77#a77,o77

 is am5d$ by ins]t+ 1 & subject to      
subp>agraph 7,d7 ( su* p>agraph aft]    
title ,,xix4  7#c7 ,exclusion f o!r     
pregnancy-relat$ cov]age options "u     
,,*ip  7,a7 ,def9ition ( *ild ,section  
#baaj7;c77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acig;jj7c77#a77 is     
am5d$ by add+ at ! end ! foll[+ new     
s5t5ce3 ,su* t]m1 includ+ z appli$ "u   
section #deg4aj ( title #db1 ,code (    
,f$]al ,regulations 7z 9 effect on !    
date ( enactm5t ( ?is s5t5ce71 %all n   
include any ali5 :o is lawfully pres5t  
solely because su* individual 0 grant$  
def]r$ action pursuant to ! memor&um ( !
 ,dep>tm5t ( ,homel& ,security entitl$  
,ex]cis+ ,prosecutorial ,discretion )   
,respect to ,individuals ,:o ,came to ! 
,unit$ ,/ates z ,*ildr5 issu$ on ,june  
#ae1 #bjab1 & any su* individual %all n 
be treat$ z lawfully pres5t or lawfully 
resid+ 9 ! ,unit$ ,/ates = purposes (   
eligibility = *ild heal? assi/ance "u a 
,/ate plan "u ?is title44  7,b7 ,t>get$ 
l[-income pregnant wom5 ,section #baab (

 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acigll7 is am5d$-- 7i7 9 subsection   
7d77#b71 by ins]t+ aft] & bel[          
subp>agraph 7,c71 ! foll[+ new flu%     
s5t5ce3 ,su* t]m %all n include any ali5
 :o is lawfully pres5t solely because   
su* individual 0 grant$ def]r$ action   
pursuant to ! memor&um ( ! ,dep>tm5t (  
,homel& ,security entitl$ ,ex]cis+      
,prosecutorial ,discretion ) ,respect to
 ,individuals ,:o ,came to ! ,unit$     
,/ates z ,*ildr5 issu$ on ,june #ae1    
#bjab1 & any su* individual %all n be   
treat$ z lawfully pres5t or lawfully    
resid+ 9 ! ,unit$ ,/ates = purposes (   
eligibility = pregnancy-relat$ assi/ance
 or *ild heal? assi/ance "u a ,/ate plan
 "u ?is title4 2 &  7ii7 9 subsection   
7f71 by add+ at ! end ! foll[+ new      
p>agraph3  7#d7 ,limitation ,not)/&+    
p>agraph 7#c71 a ,/ate %all n provide   
*ild heal? assi/ance "u any au?ority    
describ$ 9 p>agraph 7#a77;,a7 or        
pregnancy-relat$ s]vices "u a waiv]     
specifi$ 9 p>agraph 7#a77;,b7 to any    

ali5 :o is lawfully pres5t solely       
because su* individual 0 grant$ def]r$  
action pursuant to ! memor&um ( !       
,dep>tm5t ( ,homel& ,security entitl$   
,ex]cis+ ,prosecutorial ,discretion )   
,respect to ,individuals ,:o ,came to ! 
,unit$ ,/ates z ,*ildr5 issu$ on ,june  
#ae1 #bjab1 & any su* individual %all n 
be treat$ z lawfully pres5t or lawfully 
resid+ 9 ! ,unit$ ,/ates = purposes (   
eligibility = pregnancy-relat$ assi/ance
 or *ild heal? assi/ance "u a ,/ate plan
 "u ?is title4  4  7d7 ,rescission (    
c]ta9 waiv]s ,n lat] ?an #cj days aft] !
 date ( ! enactm5t ( ?is ,act1 !        
,secret>y ( ,heal? & ,human ,s]vices    
%all resc9d any waiv] approv$ "u section
 #acca or #accb ( ! ,pati5t ,protection 
& ,af=dable ,c>e ,act 7#db ,u4,s4,c4    
#ahjea1 #ahjeb7 or "u title ,,xix or    
,,xxi ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acif et seq41 #acig;aa et    
seq17 be=e su* date t w\ld n h be5 s    
approv$ _h ! am5dm5ts made by ?is       
section be5 9 effect at ! "t ( su*      

approval4