,i #aai? ,,congress #b;d ,session ,h4 ,r4 #ajhge ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,octob] #bb1 #bjbf,ms4 ,jayapal 7= h]self1 ,mr4 ,deluzio1 ,mrs4 ,d+ell1 ,mr4 ,ryan1 ,mr4 ,blair1 ,ms4 ,bonamici1 ,ms4 ,bynum1 ,mr4 ,c>bajal1 ,mr4 ,cas>1 ,ms4 ,*u1 ,mr4 ,coh51 ,mr4 ,correa1 ,ms4 ,dext]1 ,ms4 ,escob>1 ,mr4 ,g>ca ( ,ill9ois1 ,ms4 ,hoyle ( ,oregon1 ,ms4 ,jacobs1 ,mr4 ,johnson ( ,georgia1 ,mr4 ,khanna1 ,mr4 ,lieu1 ,mr4 ,mc,govern1 ,mrs4 ,mc,iver1 ,ms4 ,m5g1 ,mr4 ,m\lton1 ,mr4 ,neguse1 ,ms4 ,norton1 ,ms4 ,ocasio-,cortez1 ,ms4 ,p+ree1 ,mr4 ,pocan1 ,ms4 ,ross1 ,ms4 ,s*ak[sky1 ,mr4 ,smi? ( ,wa%+ton1 ,mr4 ,?an$>1 ,mr4 ,?ompson ( ,cali=nia1 ,ms4 ,tlaib1 ,mr4 ,tonko1 ,ms4 ,wat]s1 ,ms4 ,wass]man ,s*ultz1 ,mrs4 ,watson ,coleman1 ,ms4 ,williams ( ,georgia1 ,ms4 ,cl>ke ( ,new ,york1 ,mr4 ,cr[1 ,ms4 ,ans>i1 ,mrs4 ,grijalva1 & ,mrs4 ,trahan7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ,ways & ,means1 = 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 am5d titles ,,ii & ,,xviii ( ! ,social ,security ,act to l[] ! ,m$ic>e eligibility age to #ej1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,improv+ ,m$ic>e ,cov]age ,act4 #b4 ,m$ic>e ,eligibility ,expansion 7a7 ,9 g5]al ,section #bbf ( ! ,social ,security ,act 7#db ,u4,s4,c4 #dbf7 is am5d$-- 7#a7 by /rik+ #fe ea* place x appe>s & ins]t+ #ej2 & 7#b7 9 subsection 7a7-- 7,a7 9 p>agraph 7#b77;,a7-- 7i7 by ins]t+ w\ld be entitl$ to ^? b5efits b = age1 aft] section #bjb12 & 7ii7 by ins]t+ 7n includ+ age7 aft] meets all ! crit]ia2 & 7,b7 9 ! matt] at ! end-- 7i7 by ins]t+ 1 9 ! case ( an individual :o has atta9$ age #fe be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 aft] beg9n+ )2 & 7ii7 by ins]t+ &1 9 ! case ( an individual :o has n atta9$ age #fe be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 ! fir/ mon? aft] ! mon? t is #e mon?s aft] su* date ( enactm5t = :i* ! individual meets ! conditions specifi$ 9 p>agraphs 7#a7 & 7#b7 aft] & 7#b74 7b7 ,enrollm5t p]iods = "p ,b b5efits ,section #ahcg7;d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciep7d77 is am5d$-- 7#a7 by /rik+ 7d7 ,9 ! case ( & ins]t+ 7d77#a7 ,subject to p>agraph 7#b71 9 ! case (2 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#b7 ,9 ! case ( an individual describ$ 9 p>agraph 7#a7 :o has atta9$ ! age ( #ej b n atta9$ ! age ( #fe be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 su* individual's initial enrollm5t p]iod %all beg9 on ! date t is #c mon?s aft] su* date ( enactm5t1 & %all end on ! date t is #aa mon?s aft] su* date ( enactm5t4 4 7c7 ,con=m+ am5dm5ts 7#a7 ,hospital insurance b5efits = ! ag$ ,section #ahaa ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;c7 is am5d$-- 7,a7 by /rik+ #fe ea* place x appe>s & ins]t+ #ej2 & 7,b7 by /rik+ 7or w\ld be eligible = su* b5efits if c]ta9 gov]nm5t employm5t 7 cov]$ employm5t "u su* title7 & ins]t+ 7or w\ld be eligible = su* b5efits if c]ta9 gov]nm5t employm5t 7 cov]$ employm5t "u su* title1 or w\ld be eligible = su* b5efits b = age74 7#b7 ,hospital insurance b5efits = un9sur$ eld]ly individuals n o!rwise eligible ,section #ahah ( su* ,act 7#db ,u4,s4,c4 #acie;i-#b7 is am5d$-- 7,a7 9 subsection 7a77#a71 by /rik+ #fe & ins]t+ #ej2 & 7,b7 9 subsection 7d7-- 7i7 9 p>agraph 7#a71 by /rik+ #fe & ins]t+ #ej2 & 7ii7 9 p>agraph 7#c71 by /rik+ #fe & ins]t+ #ej4 7#c7 ,hospital insurance b5efits = disabl$ individuals :o h exhau/$ o!r entitlem5t ,section #ahah;,a7a77#a7 ( su* ,act 7#db ,u4,s4,c4 #acie;i-#b;a7a77#a77 is am5d$ by /rik+ #fe & ins]t+ #ej4 7#d7 ,eligible individuals ,section #ahcf7b7 ( su* ,act 7#db ,u4,s4,c4 #acieo7#b77 is am5d$ by /rik+ #fe & ins]t+ #ej4 7#e7 ,enrollm5t p]iods ,section #ahcg ( su* ,act 7#db ,u4,s4,c4 #aciep71 z am5d$ by subsection 7b71 is fur!r am5d$ by /rik+ #fe ea* place x appe>s & ins]t+ #ej4 7#f7 ,cov]age p]iod ,section #ahch ( su* ,act 7#db ,u4,s4,c4 #acieq7 is am5d$-- 7,a7 by /rik+ #fe ea* place x appe>s & ins]t+ #ej2 & 7,b7 9 subsection 7a77#b7-- 7i7 by /rik+ subsection 7d7 ea* place x appe>s & ins]t+ subsection 7d77#a72 7ii7 9 subp>agraph 7,d71 by /rik+ 2 or & ins]t+ 1 or2 & 7iii7 by add+ at ! end ! foll[+ new subp>agraph3 7,e7 9 ! case ( an individual :o enrolls pursuant to subsection 7d77#b7 ( section #ahcg1 on ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act2 or 4 7#g7 ,am\nts ( premiums ,section #ahci ( su* ,act 7#db ,u4,s4,c4 #acier7 is am5d$-- 7,a7 9 subsection 7a77#a7-- 7i7 by /rik+ ! fir/ s5t5ce & ins]t+ ,! ,secret>y %all1 dur+ ,septemb] ( #aihc ?r\gh ,septemb] ( #bjbe1 det]m9e ! mon?ly actu>ial rate = enrollees age #fe & ov] :i* %all be applicable = ! succe$+ cal5d> ye> 7includ+1 = #bjbf1 ) respect to individuals :o enroll pursuant to subsection 7d77#b7 ( section #ahcg7 &1 dur+ ,septemb] ( #bjbf & ( ea* ye> !reaft]1 det]m9e ! mon?ly actu>ial value = enrollees age #ej & ov] :i* %all be applicable = ! succe$+ cal5d> ye>42 & 7ii7 by ins]t+ = ye>s be=e #bjbg & ) respect to ^? enrollees age #ej or old] 7= #bjbg & subsequ5t ye>s7 aft] age #fe & old]2 7,b7 9 subsection 7a77#c7-- 7i7 by /rik+ = enrollees age #fe & ov]1 det]m9$ accord+ to p>agraph 7#a71 & ins]t+ det]m9$ accord+ to p>agraph 7#a72 & 7ii7 by /rik+ age #fe & old]2 7,c7 9 subsection 7a77#d7-- 7i7 by /rik+ ! fir/ s5t5ce & ins]t+ ,! ,secret>y %all1 dur+ ,septemb] ( #aihc ?r\gh ,septemb] ( #bjbe1 det]m9e ! mon?ly actu>ial rate = disabl$ enrollees "u age #fe :i* %all be applicable = ! succe$+ cal5d> ye> &1 dur+ ,septemb] ( #bjbf & ( ea* ye> !reaft]1 det]m9e ! mon?ly actu>ial value = disabl$ enrollees "u age #ej :i* %all be applicable = ! succe$+ cal5d> ye>42 & 7ii7 by ins]t+ 7= ye>s be=e #bjbg7 & ) respect to ^? disabl$ enrollees "u age #ej 7= #bjbg & subsequ5t ye>s7 aft] to disabl$ enrollees "u age #fe2 7,d7 9 subsection 7b71 by ins]t+ 79 ! case ( an individual :o atta9$ ! age ( #fe be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act7 or ! age ( #ej 79 ! case ( an individual :o did n atta9 ! age ( #fe be=e ! date t is #f mon?s aft] su* date ( enactm5t7 aft] ! age ( #fe2 7,e7 9 subsection 7d71 by ins]t+ 79 ! case ( an individual :o atta9$ ! age ( #fe be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act7 or ! age ( #ej 79 ! case ( an individual :o did n atta9 ! age ( #fe be=e ! date t is #f mon?s aft] su* date ( enactm5t7 aft] age #fe2 7,f7 9 subsection 7i77#c77;,a71 by ins]t+ 7= ye>s be=e #bjbg7 or = enrollees age #ej & old] 7= #bjbg & subsequ5t ye>s7 aft] age #fe & old]2 & 7,g7 9 subsection 7j71 by ins]t+ 7= ye>s be=e #bjbg7 or = enrollees age #ej & old] 7= #bjbg & subsequ5t ye>s7 aft] age #fe & old]4 7#h7 ,appropriations to cov] gov]nm5t contributions & cont+5cy res]ve ,section #ahdd7;a7 ( su* ,act 7#db ,u4,s4,c4 #aciew7a77 is am5d$ by /rik+ #fe ea* place x appe>s & ins]t+ #ej4 7#i7 ,eligibility1 election1 & enrollm5t ,section #ahea7;e77#d7 ( su* ,act 7#db ,u4,s4,c4 #aciew-#ba7;e77#d77 is am5d$ 9 ! matt] at ! end by /rik+ #fe & ins]t+ #ej4 7#aj7 ,premiums2 late enrollm5t p5alty ,section #ahfj;,d-#ac7;b77#g77;,b77i7 ( su* ,act 7#db ,u4,s4,c4 #aciew-#aac7;b77#g77;,b77i77 is am5d$ by ins]t+ 79 ! case ( an individual :o atta9$ ! age ( #fe be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act7 or age #ej 79 ! case ( an individual :o did n atta9 ! age ( #fe be=e ! date t is #f mon?s aft] su* date ( enactm5t7 aft] #fe4 7#aa7 ,individuals at risk = diabetes ,section #ahfa7yy77#b77;,f77iv7 ( su* ,act 7#db ,u4,s4,c4 #aciex7yy77#b77;,f77iv77 is am5d$ by /rik+ #fe & ins]t+ #ej4 7#ab7 ,exclusions f cov]age & ,m$ic>e z a second>y pay] ,section #ahfb7;b77#a77;,a77i77,,ii7 ( su* ,act 7#db ,u4,s4,c4 #aciey7b77#a77;,a77i77,,ii77 is am5d$ by /rik+ #fe ea* place x appe>s & ins]t+ #ej4 7#ac7 ,c]tification ( ,m$ic>e supplem5tal heal? insurance policies ,section #ahhb7s7 ( su* ,act 7#db ,u4,s4,c4 #aciess7s77 is am5d$-- 7,a7 9 p>agraph 7#b7-- 7i7 9 subp>agraph 7,a71 by /rik+ #fe ye>s ( age or old] & ins]t+ entitl$ to b5efits "u "p ,a "u subsection 7a7 ( section #bbf1 or w\ld be entitl$ to b5efits "u su* subsection b = p>agraph 7#b7 ( su* subsection12 & 7ii7 9 subp>agraph 7,d71 by ins]t+ 79 ! case ( an individual :o atta9$ ! age ( #fe be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act7 or #ej ye>s ( age or old] 79 ! case ( an individual :o did n atta9 ! age ( #fe be=e ! date t is #f mon?s aft] su* date ( enactm5t7 aft] old]2 & 7,b7 9 p>agraph 7#c77;,b7-- 7i7 9 clause 7ii71 by ins]t+ 79 ! case ( an individual :o atta9$ ! age ( #fe be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act7 or #ej ye>s ( age or old] 79 ! case ( an individual :o did n atta9 ! age ( #fe be=e ! date t is #f mon?s aft] su* date ( enactm5t7 aft] old]2 & 7ii7 9 clause 7vi71 by /rik+ eligible = b5efits "u "p ,a at age #fe & ins]t+ entitl$ to "p ,a b5efits "u section #bbf7;a74 7#ad7 ,hospital provid]s ( ext5d$ c>e s]vices ,section #ahhc7z77#b77;,a7 ( su* ,act 7#db ,u4,s4,c4 #aciett7z77#b77;,a77 is am5d$ by ins]t+ 79 ! case ( an individual :o atta9$ ! age ( #fe be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act or age #ej 79 ! case ( an individual :o did n atta9 ! age ( #fe be=e ! date t is #f mon?s aft] su* date ( enactm5t7 aft] #fe4 7#ae7 ,m$ic>e subv5tion demon/ration project = milit>y retirees ,section #ahif7;a77#d7 ( su* ,act 7#db ,u4,s4,c4 #acie;ggg7a77#d77 is am5d$-- 7,a7 9 subp>agraph 7,b7-- 7i7 9 clause 7i71 by /rik+ b5efits "u "p ,a ( ?is title & ins]t+ "p ,a b5efits "u section #bbf7;a72 & 7ii7 9 clause 7ii71 by /rik+ ! semicolon at ! end & ins]t+ 2 &2 7,b7 9 subp>agraph 7,c71 by /rik+ 2 & & ins]t+ a p]iod2 & 7,c7 by /rik+ subp>agraph 7,d74 7d7 ,eligibility = premium assi/ance ,cov]age provid$ "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act pursuant to ?is section 7relat+ to cov]age ( individuals :o h atta9$ ! age ( #ej b h n atta9$ ! age ( #fe7 %all be treat$ z cov]age "u a qualifi$ heal? plan 9 ! individual m>ket enroll$ 9 ?r\gh an ,ex*ange :]e ! individual resides = purposes ( section #cf;,b ( ! ,int]nal ,rev5ue ,code ( #aihf o!r ?an subsection 7c77#b77;,b7 !re(4 7e7 ,automatic enrollm5t ( individuals entitl$ to "p ,a ,! ,secret>y ( ,heal? & ,human ,s]vices %all e/abli% proc$ures to provide = ! automatic enrollm5t ( individuals :o become entitl$ to b5efits "u "p ,a ( title ,,xviii ( ! ,social ,security ,act z ( ! date t is #f mon?s aft] ! date ( ! enactm5t ( ?is ,act pursuant to ?is section 9 desc5d+ ord] ( age ) enrollm5t ( su* individuals beg9n+ n lat] ?an #c mon?s aft] su* date ( enactm5t & complet$ n lat] ?an #aa mon?s aft] su* date ( enactm5t4 7f7 ,cl>ification reg>d+ cov]age ( dep5d5ts ,no?+ 9 ?is section %all be con/ru$ to-- 7#a7 provide cov]age "u ! ,m$ic>e program ( a dep5d5t :o is n o!rwise eligible = su* cov]age z an individual2 or 7#b7 affect a dep5d5t's eligibility "u a gr\p heal? plan1 qualifi$ heal? plan (f]$ on an ,ex*ange1 or any o!r heal? plan = :i* ! dep5d5t is o!rwise eligible4 7g7 ,cl>ification ( ,m$ic>e z second>y pay] ,no?+ 9 ?is section %all affect ! requirem5ts "u section #ahfb7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciey7b77 7relat+ to ,m$ic>e z second>y pay]74 7h7 ,effective date 7#a7 ,9 g5]al ,subject to p>agraph 7#b71 ! am5dm5ts made by ?is section %all take effect on ! date t is #f mon?s aft] ! date ( ! enactm5t ( ?is ,act4 7#b7 ,exceptions ,! am5dm5ts made by subsection 7b7 & subsection 7c77#a77;,g7 %all take effect on ! date ( enactm5t ( ?is ,act4 #c4 ,m$ic>e ,co/ ,assi/ance ,program 7a7 ,9 g5]al ,title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 is am5d$ by add+ at ! end ! foll[+ new section3 #ahii;,c4 ,m$ic>e ,co/ ,assi/ance ,program 7a7 ,9 g5]al ,effective beg9n+ on ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 9 ! case ( a ,m$ic>e ,co/ ,assi/ance ,program eligible individual 7z def9$ 9 subsection 7b77#a771 ! ,secret>y %all provide ,m$ic>e co/ assi/ance = ! foll[+ co/s incurr$ ) respect to ! individual3 7#a7 7,a7 premiums "u section #ahah2 & 7,b7 premiums "u section #ahci4 7#b7 ,co9surance "u ?is title 7includ+ co9surance describ$ 9 section #ahac74 7#c7 ,d$uctibles e/abli%$ "u ?is title 7includ+ ^? describ$ 9 section #ahac & section #ahcc7;b774 7#d7 ,! diff]5ce betwe5 ! am\nt t is paid "u section #ahcc7;a7 & ! am\nt t w\ld be paid "u su* section if any ref]5ce to a p]c5t less ?an #ajj p]c5t !re9 7 deem$ a ref]5ce to #ajj p]c5t4 7b7 ,det]m9ation ( eligibility 7#a7 ,m$ic>e ,co/ ,assi/ance ,program eligible individual def9$ ,! t]m ,m$ic>e ,co/ ,assi/ance ,program eligible individual means an individual :o-- 7,a7 is eligible = & is receiv+ m$ical assi/ance = ! paym5t ( m$ic>e co/-%>+ "u a ,/ate ,m$icaid program pursuant to clause 7i71 7iii71 or 7iv7 ( section #aijb7;a77#aj77;,e7 z ( ! day prior to ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act2 or 7,b7 7i7 is entitl$ to hospital insurance b5efits "u "p ,a 7includ+ an individual entitl$ to su* b5efits pursuant to an enrollm5t "u section #ahah72 & 7ii7 has income at or bel[ #bjj p]c5t ( ! pov]ty l9e applicable to a family ( ! size involv$4 7#b7 ,jo9t det]m9ation by ,commission] ( ,social ,security = ,,lis & ,m$ic>e co/ assi/ance 7,a7 ,9 g5]al ,! det]m9ation ( :e!r an individual is a ,m$ic>e ,co/ ,assi/ance ,program eligible individual describ$ 9 p>agraph 7#a7 %all be det]m9$ by ! ,commission] ( ,social ,security jo9tly ) ! det]m9ation ( :e!r an individual is a subsidy eligible individual describ$ 9 section #ahfj;,d-#ad7;a77#c74 ,su* det]m9ation %all be made ) respect to eligibility = ,m$ic>e co/ assi/ance "u ?is section & premium & co/-%>+ subsidies "u section #ahfj;,d-#ad ^u application ( an individual = a det]m9ation ) respect to eligibility = ei!r su* assi/ance or su* subsidies4 ,!re are au?oriz$ to be appropriat$ to ! ,social ,security ,adm9i/ration su* sums z may be necess>y = ! det]m9ation ( eligibility "u ?is p>agraph4 7,b7 ,effective p]iod ,det]m9ations "u ?is p>agraph ) respect to eligibility = ea* ( su* assi/ance or su* subsidies %all be effective beg9n+ ) ! mon? 9 :i* ! individual applies = a det]m9ation describ$ 9 subp>agraph 7,a7 & %all rema9 9 effect until su* "t z ! ,secret>y det]m9es ! individual is no long] eligible z det]m9$ "u subp>agraph 7,c77ii74 7,c7 ,r$et]m9ations ,) respect to eligibility det]m9ations "u ?is p>agraph-- 7i7 r$et]m9ations %all be made at ! same "t ) respect to eligibility = ,m$ic>e co/ assi/ance "u ?is section & co/-%>+ subsidies "u section #ahfj;,d-#ad1 b n m frequ5tly ?an once e #ab mon?s2 7ii7 a r$et]m9ation %all automatically det]m9e t an individual rema9s eligible = su* assi/ance or subsidies unless-- 7,i7 ! ,commission] has in=mation indicat+ t ! individual's circum/ances h *ang$ su* t ! individual is no long] eligible = su* assi/ance or subsidies2 7,,ii7 ! ,commission] s5ds notice to ! individual reg>d+ su* in=mation t reque/s a response ei!r confirm+ or correct+ su* in=mation2 & 7,,iii7 ! individual ei!r confirms su* in=mation or fails to provide docum5tation indicat+ t su* circum/ances h n *ang$ )9 #fj days ( receiv+ ! notice describ$ 9 subclause 7,,ii72 7iii7 ! ,commission] %all e/abli% proc$ures = appeals ( su* det]m9ations t are simil> to ! proc$ures describ$ 9 ! ?ird s5t5ce ( section #afca7;c77#a77;,a72 & 7iv7 judicial review ( ! f9al decision ( ! ,commission] made aft] a he>+ %all be available to ! same ext5t1 & ) ! same limitations1 z provid$ 9 subsections 7g7 & 7h7 ( section #bje4 7,d7 ,treatm5t ( m$icaid b5efici>ies ,! ,secret>y %all provide t individuals :o are full-b5efit dual eligible individuals 7z def9$ 9 section #aice7;c77#f77 or :o are recipi5ts ( supplem5tal security income b5efits "u title ,,xvi %all be treat$ z a ,m$ic>e ,co/ ,assi/ance ,program eligible individual describ$ 9 p>agraph 7#a7 &1 9 ! case ( su* individual :o is a "p ,d eligible individual1 a subsidy eligible individual describ$ 9 section #ahfj;,d-#ad7;a77#c74 7,e7 ,simplifi$ application =m 7i7 ,9 g5]al ,! ,secret>y %all develop & di/ribute a simplifi$ application =m = use by individuals 9 apply+ = ,m$ic>e co/ assi/ance "u ?is section & premium & co/-%>+ subsidies "u section #ahfj;,d-#ad4 ,su* =m %all be easily readable by applicants & uni=m nationally4 ,! ,secret>y %all provide = ! translation ( su* application =m into at lea/ ! #aj languages 7o!r ?an ,engli%7 t are mo/ (t5 us$ by individuals apply+ = hospital insurance b5efits "u section #bbf or #bbf;,a & %all make ! translat$ =ms available to ! ,commission] ( ,social ,security4 7ii7 ,consultation ,9 develop+ su* =m1 ! ,secret>y %all consult ) b5efici>y gr\ps4 7#c7 ,income det]m9ations ,= purposes ( apply+ ?is section-- 7,a7 9 ! case ( an individual :o is n treat$ z a ,m$ic>e ,co/ ,assi/ance ,program eligible individual or a subsidy eligible individual "u p>agraph 7#b77;,d71 income %all be det]m9$ 9 ! mann] describ$ "u section #afab = purposes ( ! supplem5tal security income program1 except t support & ma9t5ance furni%$ 9 k9d %all n be c\nt$ z income2 & 7,b7 ! t]m pov]ty l9e has ! mean+ giv5 su* t]m 9 section #fgc7b7 ( ! ,community ,s]vices ,block ,grant ,act 7#db ,u4,s4,c4 #iijb7b771 includ+ any revision requir$ by su* section4 7c7 ,b5efici>y protections 7#a7 ,9 g5]al ,9 ! case 9 :i* ! paym5t = ,m$ic>e co/ assi/ance = a ,m$ic>e ,co/ ,assi/ance ,program eligible individual ) respect to an item or s]vice is r$uc$ or elim9at$ ! individual %all n h any legal liability to make paym5t to a provid] ( s]vices or suppli] or to an organization describ$ 9 section #aijc7m77#a77;,a7 = ! s]vice1 & any lawful sanction t may be impos$ ^u a provid] ( s]vices or suppli] or su* an organization = excess *>ges "u ?is title or title ,,xix %all apply to ! imposition ( any *>ge impos$ ^u ! individual 9 su* case4 7#b7 ,cl>ification ,?is p>agraph %all n be con/ru$ z prev5t+ paym5t ( any m$ic>e co/ assi/ance by a m$ic>e supplem5tal policy or an employ] retiree heal? plan on behalf ( an individual4 7d7 ,adm9i/ration 7#a7 ,9 g5]al ,! ,secret>y %all e/abli% proc$ures = ! adm9i/ration ( ! program "u ?is section4 7#b7 ,fund+ ,= purposes ( c>ry+ out ?is section1 ! ,secret>y %all make paym5ts f ! ,f$]al ,hospital ,insurance ,tru/ ,fund "u section #ahag & ! ,f$]al ,supplem5t>y ,m$ical ,insurance ,tru/ ,fund "u section #ahda1 9 su* proportion z ! ,secret>y det]m9es appropriate1 ( su* am\nts z ! ,secret>y det]m9es necess>y to provide ,m$ic>e co/ assi/ance "u ?is section4 7e7 ,ref]5ces to m$ic>e co/-,%>+ ,effective beg9n+ on ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 any ref]5ce to m$ic>e co/-%>+ describ$ 9 section #aije7p7 %all be deem$ a ref]5ce to ,m$ic>e co/ assi/ance "u ?is section4 7f7 ,outrea* ef=ts ,= provisions relat+ to outrea* ef=ts to increase aw>5ess ( ! availability ( ,m$ic>e co/ assi/ance1 see section #aadd4 4 7b7 ,special enrollm5t p]iod 7#a7 ,no premium p5alty ,section #ahci7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acier7b77 is am5d$1 9 ! la/ s5t5ce1 by ins]t+ ! foll[+ be=e ! p]iod3 or1 effective beg9n+ on ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 = individuals :o are ,m$ic>e ,co/ ,assi/ance ,program eligible individuals 7z def9$ 9 section #ahii;,c7b77#a7744 7#b7 ,special enrollm5t p]iod ,section #ahcg ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciep7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7o7 ,special enrollm5t p]iod = ,m$ic>e ,co/ ,assi/ance ,program eligible individual 7#a7 ,9 g5]al ,effective beg9n+ on ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 ! ,secret>y %all e/abli% special enrollm5t p]iods = ,m$ic>e ,co/ ,assi/ance ,program eligible individuals 7z def9$ 9 section #ahii;,c7b77#a774 7#b7 ,cov]age p]iod ,9 ! case ( an individual :o enrolls dur+ ! special enrollm5t p]iod provid$ "u p>agraph 7#a71 ! cov]age p]iod "u ?is "p %all-- 7,a7 beg9 on ! fir/ day ( ! fir/ mon? 9 :i* ! individual applies = a det]m9ation "u section #ahii;,c7b77#b77;,a72 & 7,b7 rema9 9 effect until su* "t z ! ,secret>y det]m9es ! individual no long] eligible z det]m9$ "u section #ahii;,c7b77#b77;,c77ii74 4 7#c7 ,con=m+ sunset ( ,/ate agreem5ts relat+ to enrollm5t ( qualifi$ m$ic>e b5efici>ies 7,a7 ,"p ,a ,section #ahah7;g7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#b7;g77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#c7 ,sunset ,?is subsection %all n apply on or aft] ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act4 4 7,b7 ,"p ,b ,section #ahdc7;h7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciev7h77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#c7 ,sunset ) respect to qualifi$ m$ic>e b5efici>ies ,?is subsection %all n apply ) respect to qualifi$ m$ic>e b5efici>ies on or aft] ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act4 4 7c7 ,public aw>5ess campaign ,section #aadd ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#ad7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7d7 ,public aw>5ess campaign 7#a7 ,9 g5]al ,! ,commission] %all conduct a public aw>5ess campaign to educate ,m$ic>e b5efici>ies on ! availability ( ,m$ic>e co/ assi/ance = l[-income individuals "u section #ahii;,c4 7#b7 ,coord9ation ,9 c>ry+ out su* public aw>5ess campaign1 ! ,commission] %all coord9ate ) ,/ate heal? insurance assi/ance programs describ$ 9 subsection 7a77#a77;,a7 ( section #aai ( ! ,m$ic>e ,improvem5ts = ,pati5ts & ,provid]s ,act ( #bjjh 7#db ,u4,s4,c4 #acie;b-#c note71 ! ,adm9i/rator ( ! ,adm9i/ration = ,community ,liv+1 & ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices4 7#c7 ,fund+ ,!re are h]eby appropriat$ to ! ,commission]1 out ( any funds 9 ! ,treasury n o!rwise appropriat$1 #aj1jjj1jjj = ea* ( fiscal ye>s #bjbf ?r\gh #bjbh1 to provide grants to ,/ate heal? insurance assi/ance programs to c>ry out outrea* & education activities "u ! public aw>5ess campaign pursuant to ?is subsection4 4 #d4 ,mov+ ,m$ic>e co/-%>+ b5efits f ,m$icaid to ,m$ic>e 7a7 ,end+ mo/ ,m$ic>e co/-,%>+ b5efits "u ,m$icaid ,section #aijb7;a77#aj7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77 is am5d$-- 7#a7 by ins]t+ = cal5d> qu>t]s beg9n+ be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 be=e = mak+ ea* place x appe>s 9 clauses 7i71 7iii71 & 7iv7 ( subp>agraph 7,e72 & 7#b7 9 ! matt] foll[+ subp>agraph 7,g7-- 7,a7 by ins]t+ furni%$ dur+ cal5d> qu>t]s beg9n+ be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act aft] 7describ$ 9 section #aije7p77#c772 7,b7 by /rik+ 7,,xv7 & ins]t+ 1 7,,xv72 7,c7 by /rik+ & 7,,xviii7 & ins]t+ 1 7,,xviii72 & 7,d7 by ins]t+ 1 & 7,,xix7 no m$ical assi/ance = m$ic>e co/-%>+1 o!r ?an m$ical assi/ance = m$ic>e co/-%>+ = qualifi$ disabl$ & work+ individuals describ$ 9 section #aije7s71 %all be made available aft] ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act be=e ! semicolon at ! end4 7b7 ,con=m+ am5dm5ts 7#a7 ,title ,,xix 7,a7 ,section #aijc7;i7 ( su* ,act 7#db ,u4,s4,c4 #acif;b7i77 is am5d$-- 7i7 9 p>agraph 7#bf71 by /rik+ 2 & & ins]t+ a semicolon2 7ii7 9 p>agraph 7#bg71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7iii7 by ins]t+ aft] p>agraph 7#bg7 ! foll[+ new p>agraph3 7#bh7 ) respect to any am\nt exp5d$ = m$ical assi/ance = m$ic>e co/-%>+ 7o!r ?an m$ical assi/ance = m$ic>e co/-%>+ = qualifi$ disabl$ & work+ individuals describ$ 9 section #aije7s77 furni%$ dur+ cal5d> qu>t]s beg9n+ on or aft] ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act4 4 7,b7 ,section #aije7;a7 ( su* ,act 7#db ,u4,s4,c4 #acif;d7a77 is am5d$1 9 ! fir/ s5t5ce1 by ins]t+ furni%$ dur+ cal5d> qu>t]s beg9n+ be=e ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act aft] m$ic>e co/-%>+4 7,c7 ,section #aicc7;g7 ( su* ,act 7#db ,u4,s4,c4 #acifu-#c7;g77 is am5d$-- 7i7 9 p>agraph 7#b77,q71 by /rik+ p>agraph 7#d71 = ea* subsequ5t ye> & ins]t+ p>agraphs 7#d7 & 7#e71 = ea* subsequ5t ye> 7prior to ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act2 & 7ii7 by add+ at ! end ! foll[+3 7#e7 ,sunset ,no individual %all be select$ to be a qualify+ individual = any cal5d> ye> or p]iod "u ?is section beg9n+ on or aft] ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 & no ,/ate allocation %all be made = any fiscal ye> or p]iod "u ?is section beg9n+ on or aft] ! date t is #f mon? aft] su* date ( enactm5t4 4 7,d7 ,section #aice7;a7 ( su* ,act 7#db ,u4,s4,c4 #acifu-#e7;a77 is am5d$-- 7i7 9 p>agraph 7#b71 by /rik+ make det]m9ations & ins]t+ prior to ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 make det]m9ations2 & 7ii7 9 p>agraph 7#c71 by ins]t+ prior to ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 be=e ! ,/ate %all4 7#b7 ,title ,,xi ,section #aadd ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#ad7 is am5d$-- 7,a7 9 subsection 7a7-- 7i7 9 p>agraph 7#a77;,a7-- 7,i7 by /rik+ sections #aijb7;a77#aj77;,e7 & #aicc & ins]t+ section #aijb7;a77#aj77;,e7 & 7prior to ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act7 section #aicc2 7,,ii7 by /rik+ = ! transitional assi/ance "u section #ahfj;,d-#ca7;f71 or & ins]t+ a comma2 & 7,,iii7 by ins]t+ 1 or = ,m$ic>e premium & co/-%>+ assi/ance "u section #ahii;,c 79 ! case ( mon?s beg9n+ on or aft] ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act7 be=e ! semicolon2 & 7ii7 by /rik+ p>agraph 7#b7 & ins]t+ ! foll[+3 7#b7 ,cont5t ( notice ,any notice furni%$ "u p>agraph 7#a7 %all /ate t eligibility = su* m$ical assi/ance1 subsidies1 or program is condition$ ^u meet+ ! applicable eligibility crit]ia4 2 7,b7 9 subsection 7b77#a77;,a7-- 7i7 by /rik+ sections #aijb7;a77#aj77;,e7 & #aicc & ins]t+ section #aijb7;a77#aj77;,e7 & 7prior to ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act7 section #aicc2 7ii7 by /rik+ = transitional assi/ance "u section #ahfj;,d-#ca7;f71 or2 & 7iii7 by ins]t+ 1 or = ,m$ic>e premium & co/-%>+ assi/ance "u section #ahii;,c be=e ! semicolon2 & 7,c7 9 subsection 7c7-- 7i7 9 p>agraph 7#a77;,b71 by ins]t+ 1 & 7beg9n+ on ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act7 provide an application = enrollm5t "u ! ,m$ic>e ,sav+s ,program be=e ! p]iod2 7ii7 9 p>agraph 7#b71 9 ! p>agraph head]1 by ins]t+ m$ic>e sav+s program application & be=e lis application2 & 7iii7 9 p>agraph 7#g71 by /rik+ means ! program ( m$ical assi/ance & all t foll[s ?r\gh ! p]iod & ins]t+ 8means-- 7,a7 prior to ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 ! program ( m$ical assi/ance = paym5t ( ! co/ ( m$ic>e co/-%>+ "u ! ,m$icaid program pursuant to sections #aijb7;a77#aj77;,e7 & #aicc2 & 7,b7 beg9n+ on ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 ! program = m$ical assi/ance = paym5t ( ! co/ ( m$ic>e co/-%>+ = qualifi$ disabl$ & work+ individuals describ$ 9 section #aije7s7 pursuant to section #aijb7;a77#aj77;,e77ii7 & m$ic>e premium & co/-%>+ assi/ance provid$ "u section #ahii;,c4 4 7c7 ,ensur+ t ,m$ic>e co/-,%>+ b5efici>ies "u ,m$icaid receive ,m$ic>e co/ assi/ance ,n lat] ?an #c mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices & ! ,commission] ( ,social ,security %all jo9tly develop & implem5t a transition plan to ensure t all individuals :o are eligible = & are receiv+ m$ical assi/ance = ! paym5t ( m$ic>e co/-%>+ "u a ,/ate ,m$icaid program pursuant to clauses 7i71 7iii71 & 7iv7 ( section #aijb7;a77#aj77;,e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,e77 z ( ! day prior to ! date t is #f mon?s aft] ! date ( ! enactm5t ( ?is ,act1 receive ,m$ic>e co/ assi/ance "u section #ahii;,c ( su* ,act1 z add$ by section #c1 z ( ! date t is #f mon?s aft] su* date ( enactm5t4 #e4 ,enhanc+ prescription drug af=dability by exp&+ access to assi/ance ) out-(-pocket co/s "u ,m$ic>e "p ,d = l[-income s5iors & individuals ) disabilities 7a7 ,exp&+ access ,section #ahfj;,d-#ad ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad7 is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 9 ! head+1 by /rik+ #aej p]c5t & ins]t+ #bjj p]c5t2 7,b7 9 p>agraph 7#a7-- 7i7 9 ! head+1 by /rik+ #ace p]c5t & ins]t+ #bjj p]c5t2 & 7ii7 9 ! matt] prec$+ subp>agraph 7,a7-- 7,i7 by /rik+ #ace p]c5t & ins]t+ #bjj p]c5t2 & 7,,ii7 by /rik+ & :o meets ! res\rces requirem5t describ$ 9 p>agraph 7#c77;,d7 or :o is cov]$ "u ?is p>agraph "u p>agraph 7#c77;,b77i7 & ins]t+ or :o is cov]$ "u ?is p>agraph "u p>agraph 7#c77;,b77v72 7,c7 by /rik+ p>agraph 7#b72 7,d7 9 p>agraph 7#c7-- 7i7 9 subp>agraph 7,a7-- 7,i7 9 clause 7i71 by add+ & at ! end2 7,,ii7 9 clause 7ii7-- 7aa7 by /rik+ #aej p]c5t & ins]t+ #bjj p]c5t2 & 7bb7 by /rik+ 2 & at ! end & ins]t+ a p]iod2 & 7,,iii7 by /rik+ clause 7iii72 7ii7 by /rik+ subp>agraphs 7,b7 & 7,c7 & ins]t+ ! foll[+3 7,b7 ,det]m9ations ,= provisions relat+ to jo9t det]m9ations ) respect to eligibility = ,m$ic>e co/ assi/ance "u section #ahii;,c & premium & co/-%>+ subsidies "u ?is section1 see section #ahii;,c7b77#b74 7,c7 ,income det]m9ations ,= purposes ( apply+ ?is section-- 7i7 9 ! case ( an individual :o is n treat$ z a ,m$ic>e co/-%>+ assi/ance eligible individual & a subsidy eligible individual "u section #ahii;,c7b77#b77;,d71 income %all be det]m9$ 9 ! mann] describ$ "u section #afab = purposes ( ! supplem5tal security income program1 except t support & ma9t5ance furni%$ 9 k9d %all n be c\nt$ z income2 & 7ii7 ! t]m pov]ty l9e has ! mean+ giv5 su* t]m 9 section #fgc7b7 ( ! ,community ,s]vices ,block ,grant ,act 7#db ,u4,s4,c4 #iijb7b771 includ+ any revision requir$ by su* section4 2 & 7iii7 by /rik+ subp>agraphs 7,d71 7,e71 & 7,g72 & 7,e7 9 p>agraph 7#d71 by /rik+ subp>agraph 7,b72 & 7#b7 9 subsection 7c77#a71 9 ! second s5t5ce1 by /rik+ subsections 7a77#a77;,d7 & 7a77#b77;,e7 & ins]t+ subsection 7a77#a77;,d74 7b7 ,treatm5t ( r$uction ( co/-,%>+ = individuals receiv+ home & community bas$ s]vices ,section #ahfj;,d-#ad7;a77#a77;,d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aad7;a77#a77;,d77 is am5d$-- 7#a7 by /rik+ :o w\ld be su* an in/itutionaliz$ individual or c\ple1 if ! full-b5efit dual eligible individual 7 n2 & 7#b7 by /rik+ or subsection 7c7 or 7d7 ( section #aiae or "u a ,/ate plan am5dm5t "u subsection 7i7 ( su* section & ins]t+ 1 section #aaae;,a1 section #aiae1 or "u a ,/ate plan am5dm5t4 7c7 ,effective date ,! am5dm5ts made by ?is section %all apply to plan ye>s beg9n+ on or aft] ! date t is #f mon?s aft] ! date ( ! enactm5t ( ?is ,act1 & apply on or aft] su* date4 #f4 ,sunset ,effective on ! date t is #e ye>s aft] ! date t is #f mon?s aft] ! date ( ! enactm5t ( ! ,improv+ ,m$ic>e ,cov]age ,act1 ?is ,act 7includ+ ! am5dm5ts made by ?is ,act7 is repeal$1 & any provision ( law am5d$ or repeal$ by ?is ,act is h]eby re/or$ or reviv$ z if ?is ,act _h n be5 enact$ into law4