I 

115TH CONGRESS 

1ST SESSION H. R. 208 

To waive the essential health benefits requirements for certain States. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 3, 2017 

Mr. YOUNG of Alaska introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To waive the essential health benefits requirements for 

certain States. 

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 ‘‘Ensuring Health Care 

5 Opportunities Act’’. 

6 SEC. 2. WAIVER OF ESSENTIAL HEALTH BENEFITS RE7 QUIREMENTS. 

8 (a) IN GENERAL.—In the case of a State in which 

9 the applicable State authority (as defined in section 

10 2791(d)(1) of the Public Health Service Act (42 U.S.C. 

11 300gg–91(d)(1))) certifies to the Secretary of Health and 


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1 Human Services that, with respect to at least one county 

2 (or, in the case of a State that does not have counties, 

3 equivalent municipality), only one health insurance issuer 

4 offers coverage in the individual market for a plan year, 

5 the following shall not apply to health plans in such State 

6 for such plan year: 

7 (1) The requirement under section 1301(a)(1) 

8 of the Patient Protection and Affordable Care Act 

9 (42 U.S.C. 18021(a)(1)) that, to be a qualified 

10 health plan eligible to be offered through an Ex11 change in the State, such plan provide the essential 

12 health benefits package described in section 1302(a) 

13 of such Act (42 U.S.C. 18022(a)). 

14 (2) The requirement under section 2707(a) of 

15 the Public Health Service Act (42 U.S.C. 300gg– 

16 6(a)) that health insurance coverage offered in the 

17 individual or small group market in the State in18 cludes the essential health benefits package required 

19 under section 1302(a) of the Patient Protection and 

20 Affordable Care Act (42 U.S.C. 18022(a)). 

21 (b) STATE CERTIFICATION.—To be eligible for a 

22 waiver under subsection (a), a State shall make the certifi23 cation described in subsection (a) not later than— 

24 (1) 90 days after the date of enactment of this 

25 Act, in the case of a State in which, on the date of 


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1 enactment of this Act, at least one county in the 

2 State (or, in the case of a State that does not have 

3 counties, equivalent municipality), only one health 

4 insurance issuer offers coverage in the individual 

5 market for the plan year in effect on such date of 

6 enactment; and 

7 (2) 90 days after the applicable State authority 

8 (as defined in section 2791(d)(1) of the Public 

9 Health Service Act (42 U.S.C. 300gg–91(d)(1))) 

10 first discovers, or reasonably should discover, that, 

11 in at least one county in the State (or, in the case 

12 of a State that does not have counties, equivalent 

13 municipality), only one health insurance issuer offers 

14 in the current plan year, or will offer in a future 

15 plan year, coverage in the individual market for the 

16 current plan year or a future plan year, as applica17 ble, in the case of a State not described in para18 graph (1). 

19 (c) TERM OF WAIVER.—A waiver under this section 

20 may extend over a period of not more than 5 years, pro21 vided that the State continues to meet the criteria for eli22 gibility for the waiver under subsection (a). A State that 

23 continues to meet such criteria for more than 5 years may 

24 recertify under subsection (a) every 5 years. 


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1 (d) PLANS OFFERING ESSENTIAL HEALTH BENE2 FITS.—Nothing in this Act prevents a health insurance 

3 issuer from offering in a State to which a waiver under 

4 subsection (a) applies health insurance coverage that in5 cludes the essential health benefits package described in 

6 section 1302(a) of the Patient Protection and Affordable 

7 Care Act (42 U.S.C. 18022(a)). 

Æ 


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