,,ii #aai? ,,congress #a/ ,session ,s4 #cbfd ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,novemb] #bj1 #bjbe,mr4 ,scott ( ,florida introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to e/abli% a heal? fre$om waiv] program1 to promote bett] price report+ & outcomes1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,m ,af=dable ,c>e ,act4 #b4 ,heal? fre$om waiv] program ,"p #d ( subtitle ,d ( title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjea et seq47 is am5d$ by add+ at ! end ! foll[+3 #acce4 ,heal? fre$om waiv] program 7a7 ,9 g5]al 7#a7 ,waiv] program ,! ,secret>y %all waive all or any requirem5ts describ$ 9 p>agraph 7#d71 z det]m9$ by ! applicable ,/ate1 = plan ye>s beg9n+ on or aft] ,janu>y #a1 #bjbf1 ) respect to heal? insurance cov]age )9 any ,/ate t submits a notification "u p>agraph 7#b71 provid$ t ! ,/ate ma9ta9s an invisible high-risk insurance pool or ano!r program design$ to mitigate risk to insurance premium co/s4 7#b7 ,notification ,a ,/ate entity describ$ 9 p>agraph 7#c7 desir+ a waiv] "u ?is section = any plan ye> beg9n+ on or aft] ,janu>y #a1 #bjbf1 %all notify ! ,secret>y ( its int5t to p>ticipate 9 ! waiv] program ) respect to all or any requirem5ts describ$ 9 p>agraph 7#d74 ,su* notification %all be fil$ at su* "t1 n lat] ?an #ij days be=e ! ,/ate int5ds to beg9 p>ticipation 9 ! waiv] program1 & 9 su* mann] z ! ,secret>y may require1 & conta9 su* in=mation z ! ,secret>y may require1 includ+ ! requirem5ts "u p>agraph 7#d7 t ! ,/ate int5ds to waive & evid5ce t ! ,/ate ma9ta9s a high-risk insurance pool4 7#c7 ,/ate submission ,a notification ) respect to a ,/ate may be submitt$ by-- 7,a7 ! gov]nor ( ! ,/ate2 or 7,b7 ! legislature ( ! ,/ate1 ^u a majority vote by ! ,/ate legislature4 7#d7 ,requirem5ts ,! requirem5ts describ$ 9 ?is p>agraph ) respect to heal? insurance cov]age )9 ! ,/ate are z foll[s3 7,a7 ,"p #a ( subtitle ,d4 7,b7 ,"p #b ( subtitle ,d4 7,c7 ,section #adjb4 7,d7 ,sections #cf;,b & #ejjj;,a ( ! ,int]nal ,rev5ue ,code ( #aihf4 7#e7 ,money foll[s ! p]son 7,a7 ,9 g5]al ,) respect to a ,/ate waiv] "u p>agraph 7#a71 "u :i*1 due to ! /ructure ( ! ,/ate plan1 individuals & small employ]s 9 ! ,/ate w\ld n qualify = ! premium tax cr$its1 co/-%>+ r$uctions1 or small bus9ess cr$its "u sections #cf;,b ( ! ,int]nal ,rev5ue ,code ( #aihf or "u "p ,i ( subtitle ,e = :i* !y w\ld o!rwise be eligible1 ! ,secret>y %all provide = an alt]native means by :i* ! aggregate am\nt ( su* cr$its or r$uctions t w\ld h be5 paid on behalf ( p>ticipants 9 ! ,ex*anges e/abli%$ "u ?is title _h ! ,/ate n receiv$ su* waiv]1 %all be paid into ! ,trump ,heal? ,fre$om ,acc\nts e/abli%$ "u section #bbc7;i7 ( ! ,int]nal ,rev5ue ,code ( #aihf ( eligible resid5ts ( ! ,/ate4 7,b7 ,paym5ts to ,trump ,heal? ,fre$om ,acc\nts ,! ,secret>y %all pay into ! ,trump ,heal? ,fre$om ,acc\nt ( ea* eligible resid5t ( a ,/ate = :i* a waiv] is 9 effect = a plan ye> ! am\nt equal to ! total am\nt = :i* ! resid5t w\ld h be5 eligible 9 premium tax cr$it am\nts "u section #cf;,b ( ! ,int]nal ,rev5ue ,code ( #aihf & co/-%>+ r$uction am\nts "u section #adjb = ! ye>1 _h ! ,/ate n _h su* waiv] 9 effect4 ,9 det]m9+ ! appropriate paym5t am\nt "u ?is subp>agraph1 ! ,secret>y %all calculate premium tax cr$it am\nts & co/-%>+ r$uction am\nts bas$ on ! national av]age annual premium am\nt = a silv] ti] b5*m>k plan among ,/ates t d n h su* waiv]s 9 effect = ! applicable ye>4 ,! ,secret>y %all make paym5ts into ! ,trump ,heal? ,fre$om ,acc\nts ( eligible resid5ts on a mon?ly basis1 qu>t]ly basis1 or 9 "o lump sum at ! beg9n+ ( ! ye>1 at ! option ( ea* eligible resid5t4 7#f7 ,coord9at$ waiv] process ,! ,secret>y %all develop a process = coord9at+ & consolidat+ ! ,/ate waiv] processes applicable "u ! provisions ( ?is section1 & ! exi/+ waiv] processes applicable "u section #accb & titles ,,xviii1 ,,xix1 & ,,xxi ( ! ,social ,security ,act1 & any o!r ,f$]al law relat+ to ! provision ( heal? c>e items or s]vices4 ,su* process %all p]mit a ,/ate to submit a s+le application = a waiv] "u any or all ( su* provisions4 7#g7 ,ex*anges 7,a7 ,9 g5]al ,9 ! case ( a ,/ate 9 :i* a waiv] is 9 effect "u ?is section = a plan ye>-- 7i7 ! ,/ate may-- 7,i7 op]ate an ,ex*ange e/abli%$ z describ$ 9 section #acaa7;b72 or 7,,ii7 all[ "o or m private entities to run comm]cial plat=ms t sell heal? plans approv$ by ! ,/ate insurance commission]2 or 7ii7 if ! ,/ate does n op]ate an ,ex*ange z describ$ 9 clause 7i77,i7 or all[ = "o or m comm]cial plat=ms describ$ 9 clause 7i77,,ii71 ! ,secret>y %all op]ate a ,f$]al ,ex*ange1 z describ$ 9 section #acba7;c71 provid$ t any ,/ate laws reg>d+ ! availability ( heal? plans on1 & ! op]ation (1 su* ,ex*ange %all apply 9 lieu ( any provision "u "p #a or "p #b t su* ,/ate has waiv$4 7,b7 ,application program int]face ,! ,secret>y %all make available to any ,/ate t all[s = comm]cial plat=ms describ$ 9 subp>agraph 7,a77i77,,ii71 ! application program int]face us$ = op]at+ ,f$]al & ,/ate ,ex*anges1 = use by any private entity runn+ su* a plat=m "u ,/ate au?ority4 7#h7 ,def9itions ,9 ?is section3 7,a7 ,eligible resid5t ,! t]m eligible resid5t means1 ) respect to a ,/ate = :i* a waiv] is 9 effect "u ?is section1 a resid5t :o-- 7i7 9 ! abs5ce ( su* a waiv] 9 ! ,/ate1 w\ld be eligible = a premium tax cr$it "u section #cf;,b ( ! ,int]nal ,rev5ue ,code ( #aihf or a co/-%>+ r$uction "u section #adjb1 if ! resid5t enroll$ 9 a qualifi$ heal? plan (f]$ on ! ,ex*ange ( su* ,/ate2 & 7ii7 enrolls 9 a plan (f]$ on ! ,ex*ange describ$ 9 p>agraph 7#g7 = ! applicable plan ye>4 7,b7 ,secret>y ,t]m ,secret>y means-- 7i7 ! ,secret>y ( ,heal? & ,human ,s]vices ) respect to waiv]s relat+ to ! provisions describ$ 9 subp>agraph 7,a7 ?r\gh 7,c7 ( p>agraph 7#d72 & 7ii7 ! ,secret>y ( ! ,treasury ) respect to waiv]s relat+ to ! provisions describ$ 9 p>agraph 7#d77;,d74 7b7 ,waiv] p]iod ,ea* waiv] "u ?is section %all be 9 effect beg9n+ on ,janu>y #a ( ! plan ye> = :i* a timely notice is submitt$ by ! ,/ate "u subsection 7a77#b71 & cont9u+ until ! entity ( ! ,/ate describ$ 9 subp>agraph 7,a7 or 7,b7 ( subsection 7a77#c7 t submitt$ ! notification "u subsection 7a77#b7 submits to ! ,secret>y a notification ( int5t to discont9ue p>ticipation 9 ! waiv] program "u ?is section4 7c7 ,limitation ,! ,secret>y may n p]mit a waiv] "u ?is section ( any ,f$]al law or requirem5t ?is is n )9 ! au?ority ( ! ,secret>y4 7d7 ,availability ( plans 7#a7 ,9 g5]al ,any heal? insurance cov]age (f]$ 9 a ,/ate = :i* a waiv] "u ?is section is 9 effect1 & au?oriz$ by ! insurance commission] ( ! ,/ate1 %all be made available on1 z applicable1 ! ,f$]al or ,/ate ,ex*ange or comm]cial plat=ms describ$ 9 subsection 7a77#g71 ( all ,/ates = :i* su* a waiv] is 9 effect1 subject to ! laws ( ea* su* ,/ate4 7#b7 ,*ild-only plans ,9 any ,/ate = :i* a waiv] "u ?is section is 9 effect1 a heal? insurance issu] may (f] a plan 9 :i* ! only individuals eligible to enroll are individuals :o1 z ( ! beg9n+ ( a plan ye>1 h n yet atta9$ ! age ( #ba4 7e7 ,regulations ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ! ,m ,af=dable ,c>e ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices1 9 coord9ation ) ! ,secret>y ( ! ,treasury1 %all promulgate regulations to c>ry out ?is section4 7f7 ,rule ( con/ruction reg>d+ consum] protections1 includ+ ! pre-,exi/+ condition protection ,no?+ 9 ?is section %all be con/ru$ to all[ a ,/ate to waive ! requirem5ts ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act1 includ+ sections #bgja1 #bgjb1 #bgjc1 #bgjd1 #bgje1 #bgjh1 #bgaa1 #bgab1 & #bgah ( su* ,act4 4 #c4 ,trump ,heal? ,fre$om ,acc\nts 7a7 ,9 g5]al ,section #bbc ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ by add+ at ! end ! foll[+ new subsection3 7i7 ,trump ,heal? ,fre$om ,acc\nts ,= purposes ( ?is section-- 7#a7 ,9 g5]al ,9 ! case ( a ,trump ,heal? ,fre$om ,acc\nt1 ?is section %all be appli$ z provid$ 9 p>agraphs 7#c7 ?r\gh 7#h74 7#b7 ,trump ,heal? ,fre$om ,acc\nt ,! t]m ,trump ,heal? ,fre$om ,acc\nt means a heal? sav+s acc\nt 7det]m9$ z provid$ 9 ?is subsection7 e/abli%$ by or on behalf ( an individual resid+ 9 a ,/ate = :i* a waiv] "u section #acce ( ! ,pati5t ,protection & ,af=dable ,c>e ,act is 9 effect :i* receives deposits ( am\nts transf]r$ to ! individual pursuant to section #acce7;a77#e7 ( su* ,act4 7#c7 ,eligible individual ,any individual cov]$ "u a heal? plan au?oriz$ to be made available on an ,ex*ange by section #acce7;d7 ( su* ,act %all be treat$ z an eligible individual4 7#d7 ,treatm5t ( transf]r$ contributions ,am\nts transf]r$ to a ,trump ,heal? ,fre$om ,acc\nt pursuant to section #acce7;a77#e7 ( su* ,act %all n be tak5 into acc\nt 9 det]m9+ ! d$uction all[$ by subsection 7a74 7#e7 ,heal? insurance may be pur*as$ f acc\nt ,subsection 7d77#b77;,b7 %all n apply4 7#f7 ,acc\nt mu/ be only ,,hsa ( individual 7,a7 ,9 g5]al ,an individual :o has a ,trump ,heal? ,fre$om ,acc\nt %all n be treat$ z an eligible individual ) respect to any heal? sav+s acc\nt o!r ?an su* ,trump ,heal? ,fre$om ,acc\nt4 7,b7 ,rollov] ( exi/+ acc\nt p]mitt$ ,an individual on ^: behalf a ,trump ,heal? ,fre$om ,acc\nt is e/abli%$ may roll ov] ! balance ( any o!r heal? sav+s acc\nt ( ! individual to su* ,trump ,heal? ,fre$om ,acc\nt accord+ to ! rules ( subsection 7f77#e74 7#g7 ,no rollov]s p]mitt$ ,except z provid$ 9 p>agraph 7#f77;,b71 subsection 7f77#e7 %all n apply & no am\nt %all be contribut$ f a ,trump ,heal? ,fre$om ,acc\nt to any heal? sav+s acc\nt o!r ?an a ,trump ,heal? ,fre$om ,acc\nt4 7#h7 ,re/riction on use ( am\nts ,no am\nts 9 a ,trump ,heal? ,fre$om ,acc\nt may be us$-- 7,a7 to pay premiums = a heal? plan t cov]s-- 7i7 g5d] transition proc$ures1 or 7ii7 abortion s]vices2 or 7,b7 to pay = any s]vice describ$ 9 clause 7i7 or 7ii7 ( subp>agraph 7,a74 7#i7 ,def9itions ,= purposes ( p>agraph 7#h7-- 7,a7 ,g5d] transition proc$ure 7i7 ,9 g5]al ,! t]m g5d] transition proc$ure means any hormonal or surgical int]v5tion = ! purpose ( g5d] transition1 includ+-- 7,i7 gonadotrop9-releas+ hormone 7,gn,r,h7 agoni/s or o!r pub]ty-block+ or suppress+ drugs to /op or delay normal pub]ty2 7,,ii7 te/o/]one1 e/rog51 proge/]one1 or o!r &rog5s to an individual at doses t are supraphysiologic to :at w\ld normally be produc$ endog5\sly 9 a heal?y individual ( ! same age & sex2 7,,iii7 ca/ration2 7,,iv7 or*iectomy2 7,v7 scrotopla/y2 7,,vi7 implantation ( erection or te/icul> pro/heses2 7,,vii7 vasectomy2 7,,viii7 hy/]ectomy2 7,,ix7 oophorectomy2 7,x7 ov>iectomy2 7,,xi7 recon/ruction ( ! fix$ "p ( ! ure?ra ) or )\t a metoidiopla/y or a phallopla/y2 7,,xii7 metoidiopla/y2 7,,xiii7 p5ectomy2 7,,xiv7 phallopla/y2 7,,xv7 vag9opla/y2 7,,xvi7 clitoropla/y2 7,,xvii7 vag9ectomy2 7,,xviii7 vulvopla/y2 7,,xix7 r$uction ?yro*ondropla/y2 7,,xx7 *ondrol>yngopla/y2 7,,xxi7 ma/ectomy2 7,,xxii7 tubal ligation2 7,,xxiii7 /]ilization2 7,,xxiv7 any pla/ic1 cosmetic1 or ae/hetic surg]y t fem9izes or mascul9izes ! facial or o!r physiological features ( an individual2 7,,xxv7 any placem5t ( *e/ implants to create fem99e brea/s2 7,,xxvi7 any placem5t ( fat or artificial implants 9 ! gluteal region2 7,,xxvii7 augm5tation mammopla/y2 7,,xxviii7 liposuction2 7,,xxix7 lip(ill+2 7,,xxx7 voice surg]y2 7,,xxxi7 hair recon/ruction2 7,,xxxii7 pectoral implants2 & 7,,xxxiii7 ! removal ( any o!rwise heal?y or non-diseas$ body "p or tissue4 7ii7 ,exclusions ,! t]m g5d] transition proc$ure does n include ! foll[+ :5 furni%$ to an individual by a heal? c>e provid] ) ! cons5t ( su* individual or1 if applicable1 su* individual's p>5ts or legal gu>dian3 7,i7 ,s]vices to individuals born ) a m$ically v]ifiable disord] ( sex developm5t1 includ+ an individual ) ext]nal sex *>act]i/ics t are irresolvably ambigu\s1 su* z an individual born ) #df ,,xx *romosomes ) virilization1 an individual born ) #df ,,xy *romosomes ) und]virilization1 or an individual born hav+ bo? ov>ian & te/icul> tissue4 7,,ii7 ,s]vices provid$ :5 a physician has o!rwise diagnos$ a disord] ( sexual developm5t 9 :i* ! physician has det]m9$ ?r\gh g5etic or bio*emical te/+ t ! individual does n h normal sex *romosome /ructure1 sex /]oid hormone production1 or sex /]oid hormone action = a heal?y individual ( ! same sex & age4 7,,iii7 ,! treatm5t ( any infection1 injury1 disease1 or disord] t has be5 caus$ by or exac]bat$ by ! p]=mance ( g5d] transition proc$ures1 :e!r or n ! g5d] transition proc$ure 0 p]=m$ 9 accordance ) ,/ate & ,f$]al law or :e!r or n fund+ = ! g5d] transition proc$ure is p]missible "u ?is section4 7,,iv7 ,any proc$ure und]tak5 because ! individual suff]s f a physical disord]1 physical injury1 or physical illness 7b n m5tal1 behavioral1 or emotional di/ress or a m5tal1 behavioral1 or emotional disord]7 t w\ld1 z c]tifi$ by a physician1 place ! individual 9 imm95t dang] ( dea? or impairm5t ( major bodily function1 unless ! proc$ure is p]=m$4 7,v7 ,pub]ty suppression or block+ prescription drugs = ! purpose ( normaliz+ pub]ty = a m9or exp]i5c+ precoci\s pub]ty4 7,,vi7 ,male circumcision4 7,b7 ,g5d] transition ,! t]m g5d] transition means ! process 9 :i* an individual goes f id5tify+ ) or pres5t+ z 8 or h] sex to id5tify+ ) or pres5t+ a self-proclaim$ id5tity t does n correspond ) or is diff]5t f 8 or h] sex1 & may be accompani$ ) social1 legal1 or physical *anges4 7,c7 ,sex ,! t]m sex1 :5 ref]r+ to an individual's sex1 means to ref] to ei!r male or female1 z biologically det]m9$4 7,d7 ,female ,! t]m female1 :5 us$ to ref] to a natural p]son1 means an individual :o naturally has1 _h1 w h1 or w\ld h1 b = a cong5ital anomaly1 hi/orical accid5t1 or int5tional or un9t5tional disruption1 ! reproductive sy/em t at "s po9t produces1 transports1 & utilizes eggs = f]tilization4 7,e7 ,male ,! t]m male1 :5 us$ to ref] to a natural p]son1 means an individual :o naturally has1 _h1 w h1 or w\ld h1 b = a cong5ital anomaly1 hi/orical accid5t1 or int5tional or un9t5tional disruption1 ! reproductive sy/em t at "s po9t produces1 transports1 & utilizes sp]m = f]tilization4 7,f7 ,abortion s]vices 7i7 ,9 g5]al ,! t]m abortion s]vices means-- 7,i7 drugs or proc$ures us$ ) ! prim>y int5t to end ! life ( ! human be+ 9 ! womb1 7,,ii7 pre-viable deliv]y n describ$ 9 clause 7ii71 & 7,,iii7 po/-viable deliv]y ) int5tional dea? ( ! fetus4 7ii7 ,exclusions ,su* t]m does n include-- 7,i7 sep>ation ( ! "m & h] embryo or fetus to prev5t ! "m's dea? or imm$iate irrev]sible bodily h>m1 :i* _c be mitigat$ 9 any o!r way1 7,,ii7 treatm5t ( ectopic or mol> pregnancy1 7,,iii7 treatm5t ( misc>riage1 or 7,,iv7 any s]vice describ$ 9 clause 7i7 9 ! case ( a pregnancy :i* is ! result ( an act ( rape or ince/4 4 7b7 ,effective date ,! am5dm5t made by ?is section %all apply to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjbe4 #d4 ,cr$it = employee insurance exp5ses ( small employ]s 9 waiv] ,/ate 7a7 ,9 g5]al ,subsection 7g7 ( section #de,r ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ to read z foll[s3 7g7 ,cr$it = small employ]s 9 waiv] ,/ate ,= purposes ( ?is section-- 7#a7 ,9 g5]al ,9 ! case ( an eligible small employ] 7det]m9$ ) ! modifications provid$ 9 ?is subsection7 locat$ 9 a ,/ate = :i* a waiv] "u section #acce ( ! ,pati5t ,protection & ,af=dable ,c>e ,act is 9 effect1 ?is section %all be appli$ z provid$ 9 p>agraphs 7#b7 ?r\gh 7#g74 7#b7 ,heal? insurance cr$it am\nt ,subsection 7b7 %all be appli$ by sub/itut+ #ej p]c5t = #ej p]c5t 7#ce p]c5t 9 ! case ( a tax-exempt eligible small employ]74 7#c7 ,qualifi$ plans ,subsections 7b7 & 7d77#d7 %all be appli$ by treat+ any heal? plan au?oriz$ to be made available on an ,ex*ange 9 su* ,/ate by section #acce7;d7 ( su* ,act z a qualifi$ heal? plan (f]$ ?r\gh an ,ex*ange4 7#d7 ,phase\t n to apply ,subsection 7c7 %all n apply4 7#e7 ,eligible small employ] ,subsection 7d7 %all be appli$-- 7,a7 by sub/itut+ #ej = #be 9 p>agraph 7#a77;,a7 !re(1 & 7,b7 )\t reg>d to subp>agraph 7,b7 ( p>agraph 7#a7 !re(4 7#f7 ,employee ,subsection 7e77#a77;,a7 %all be appli$ )\t reg>d to clause 7i7 !re(4 7#g7 ,cr$it p]iod ,subsection 7e77#b7 %all n apply1 & ! cr$it p]iod ) respect to any su* employ] %all be ! p]iod consi/+ ( ! #a/ taxable ye> 9 :i* ! employ] 7or any pr$ecessor7 (f]s #a or m qualifi$ heal? plans to its employees1 & any subsequ5t taxable ye>4 7#h7 ,tax-exempt rules n to apply ,subsection 7f7 %all n apply4 4 7b7 ,effective date ,! am5dm5t made by ?is section %all apply to taxable ye>s beg9n+ aft] ,decemb] #ca1 #bjbe4 #e4 ,promot+ bett] price report+ & outcomes data ,n lat] ?an #ij days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices1 9 coord9ation ) ! ,secret>y ( ! ,treasury & ! ,secret>y ( ,labor1 %all update all regulations & guidance issu$ by su* secret>ies pursuant to ,executive ,ord] #achgg 7#hd ,f$4 ,reg4 #cjhdi 7,june #bd1 #bjai771 includ+ by-- 7#a7 requir+ ! disclosure ( ! actual prices ( items & s]vices1 n price e/imates2 7#b7 issu+ updat$ guidance or regulations ensur+ pric+ in=mation is /&>diz$ & easily comp>able across hospitals & heal? plans2 7#c7 issu+ guidance or propos$ regulatory action updat+ en=cem5t policies design$ to ensure compliance ) ! transp>5t report+ ( complete1 accurate1 & mean+ful data2 & 7#d7 requir+ ! public report+ ( outcomes data by provid]s4