I 
112TH CONGRESS 
1ST SESSION 
H. R. 984 
To amend title I of the Patient Protection and Affordable Care Act to 
provide for a process for waiver of requirements of that title where 
the requirement is asserted to otherwise result in a significant decrease 
in access to coverage or significant increase in premiums or other costs. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 9, 2011 
Mr. ROGERS of Michigan (for himself, Mr. BOREN, Mr. FLEMING, Mr. 
ROSKAM, Mr. TIBERI, Mrs. BACHMANN, Mr. FLORES, Mr. HARRIS, Mr. 
BURGESS, Mrs. MCMORRIS
RODGERS, Mrs. BLACKBURN, and Mr. 
BENISHEK) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means and Education and the Workforce, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee con-
cerned 
A BILL 
To amend title I of the Patient Protection and Affordable 
Care Act to provide for a process for waiver of require-
ments of that title where the requirement is asserted 
to otherwise result in a significant decrease in access 
to coverage or significant increase in premiums or other 
costs. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Health Care Waiver 
Fairness Act of 2011’’. 
SEC. 2. PPACA WAIVER PROCESS. 
(a) IN GENERAL.—Title I of the Patient Protection 
and Affordable Care Act (Public Law 111–148) is amend-
ed by adding at the end the following new subtitle: 
‘‘Subtitle G—Waiver Process 
‘‘SEC. 1601. ESTABLISHMENT OF WAIVER PROCESS. 
‘‘(a) IN GENERAL.—The applicable authorities (as 
defined in subsection (c)) shall collectively establish a 
process (in this section referred to as the ‘waiver process’) 
under which the administrator of a health plan, an em-
ployer, an individual, or other entity may seek to waive 
the application of a requirement under this title with re-
spect to such plan, employer, individual, or entity. Among 
the requirements under this title, such process shall apply 
to the following: 
‘‘(1) Section 5000A of the Internal Revenue 
Code of 1986 (relating to requirement to maintain 
minimum essential coverage), as inserted by section 
1501(b). 
‘‘(2) Section 6055 of the Internal Revenue Code 
of 1986 (relating to reporting of health insurance 
coverage), as inserted by section 1502(a). 
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‘‘(3) Section 18A of the Fair Labor Standards 
Act of 1938 (42 U.S.C. 218a, relating to automatic 
enrollment for employees of large employers), as in-
serted by section 1511. 
‘‘(4) Section 18B of the Fair Labor Standards 
Act of 1938 (42 U.S.C. 218b, relating to notice to 
employees), as inserted by section 1512. 
‘‘(5) Section 4980H of the Internal Revenue 
Code of 1986 (relating to shared responsibility for 
employers regarding health coverage), as inserted by 
section 1513(a). 
‘‘(6) Section 6056 of the Internal Revenue Code 
of 1986 (relating to certain employers required to 
report on health insurance coverage), as inserted by 
section 1514(a). 
‘‘(7) Section 10108 (relating to free choice 
vouchers). 
‘‘(8) Regulations regarding the treatment of 
group health plans or health insurance coverage as 
a grandfathered health plan (as defined in section 
1251(e)). 
‘‘(9) Section 2718(b) of the Public Health Serv-
ice Act (relating to medical loss ratios), as inserted 
by section 1001. 
‘‘(b) WAIVER PROCESS.— 
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‘‘(1) IN GENERAL.—The applicable authorities 
shall establish the waiver process consistent with the 
following: 
‘‘(A) NOTICE AND GUIDANCE.—Public no-
tice and guidance shall be provided regarding 
the process for submission of waiver requests. 
‘‘(B) STANDARD.—A waiver request with 
respect to the application of a requirement to a 
plan, employer, individual, or entity shall be ac-
companied by a statement that— 
‘‘(i) identifies the specific requirement 
(or requirements) to be waived; and 
‘‘(ii) describes how the imposition of 
each specific requirement for which a waiv-
er is requested on the plan, employer, indi-
vidual, or entity would result in a signifi-
cant decrease in access to coverage or a 
significant increase in premiums or other 
costs for such plan, employer, individual, 
or entity. 
‘‘(C) DEEMED
APPROVAL.—A waiver re-
quest filed that is accompanied by such a state-
ment shall be deemed to be approved. 
‘‘(D) PUBLICATION OF DATA.—The appli-
cable authorities shall regularly publish data re-
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garding the waiver requests received for the dif-
ferent requirements. 
‘‘(2) TREATMENT OF APPROVED WAIVERS.—In 
the case of approval under the waiver process of a 
waiver request with respect to a requirement of this 
title and an entity, notwithstanding any other provi-
sion of law, such requirement shall not apply to such 
entity on and after the date of approval of the re-
quest. 
‘‘(3) RELATION TO OTHER EXEMPTIONS AND 
EXCEPTIONS.—Nothing in this section shall be con-
strued as superceding other provisions of this title 
insofar as they provide for exceptions, exemptions, 
or other special treatment with respect to require-
ments under this title. 
‘‘(c) APPLICABLE AUTHORITY.—In this section, the 
term ‘applicable authority’ means— 
‘‘(1) except as otherwise provided in this sub-
section, the Secretary of Health and Human Serv-
ices; 
‘‘(2) the Secretary of Labor with respect to the 
provisions of this title, including amendments made 
by this title, that are administered by such Sec-
retary; and 
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‘‘(3) the Secretary of the Treasury with respect 
to the provisions of this title, including amendments 
made by this title, that are administered by such 
Secretary, including sections of the Internal Revenue 
Code of 1986 specified in subsection (a). 
‘‘(d) REFERENCES TO REQUIREMENTS UNDER THIS 
TITLE.—In this section, a reference to a requirement 
under this title include such a requirement under an 
amendment made by this title, including as amended by 
title X of this Act or by the provisions of the Health Care 
and Education Reconciliation Act of 2010 (Public Law 
111–152). 
‘‘(e) PUBLIC
AWARENESS
CAMPAIGN.—Of the 
amounts available in the Prevention and Public Health 
Fund established under section 4002, notwithstanding any 
other provision of law, $50,000,000 shall be available to 
and expended by the Secretary of Health and Human 
Services to conduct, in coordination with other applicable 
authorities, a public awareness campaign of the waiver 
process. Amounts made available under this subsection 
shall remain available until expended.’’. 
(b) CLERICAL AMENDMENT.—The table of contents 
of such Act is amended by adding at the end of the items 
relating to title I the following: 
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