II 

113TH CONGRESS 

1ST SESSION S. 858 

To provide for an earlier start for State health care coverage innovation 

waivers under the Patient Protection and Affordable Care Act, and 

for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 6, 2013 

Mr. SANDERS (for himself and Mr. LEAHY) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To provide for an earlier start for State health care coverage 

innovation waivers under the Patient Protection and Affordable Care Act, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘State Leadership in 

5 Health Care Act’’. 


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1 SEC. 2. EARLIER START FOR STATE HEALTH CARE COV2 ERAGE INNOVATION WAIVERS. 

3 (a) IN GENERAL.—Section 1332 of the Patient Pro4 tection and Affordable Care Act (42 U.S.C. 18052) is 

5 amended— 

6 (1) in subsection (a)(1), by striking ‘‘January 

7 1, 2017’’ and inserting ‘‘January 1, 2015’’; and 

8 (2) by amending subsection (e) to read as fol9 lows: 

10 ‘‘(e) TERM OF WAIVER.— 

11 ‘‘(1) IN GENERAL.—No waiver under this sec12 tion may extend over a period of more than 5 years 

13 unless the State requests continuation of such waiv14 er and such request is granted by the Secretary 

15 under paragraph (2). 

16 ‘‘(2) APPROVAL OF REQUEST.— 

17 ‘‘(A) IN GENERAL.—A request under para18 graph (1) shall be deemed granted unless the 

19 Secretary, not later than 90 days after the date 

20 of submission to the Secretary of such request, 

21 either denies such request in writing or informs 

22 the State in writing with respect to any addi23 tional information that is needed in order to 

24 make a final determination with respect to the 

25 request. 


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1 ‘‘(B) DENIAL OF REQUEST.—The Sec2 retary may deny such a request only if the Sec3 retary— 

4 ‘‘(i) determines that the State plan 

5 under the waiver to be continued did not 

6 meet the requirements under subsection 

7 (b); 

8 ‘‘(ii) notifies the State in writing of 

9 the requirements under subsection (b) that 

10 the State plan did not meet and provides 

11 to the State the information used by the 

12 Secretary in making that determination; 

13 and 

14 ‘‘(iii) provides the State with an op15 portunity to appeal such determination and 

16 provide information as to how such re17 quirements were met. 

18 ‘‘(C) RECONSIDERATION OF REQUEST.—In 

19 the case of an appeal described in subparagraph 

20 (B)(iii), the Secretary shall consider any infor21 mation provided under such clause and recon22 sider the determination made under subpara23 graph (B)(i), and shall issue a written decision 

24 on such appeal not later than 60 days after the 

25 date on which the Secretary receives notice of 


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1 such appeal. The Secretary shall grant the re2 quest if the Secretary determines upon recon3 sideration that the State plan meets such re4 quirements.’’. 

Æ 


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