‘‘(b) UNIVERSAL PHASE (PHASE II) PLAN RE-
QUIRED.— 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), not later than January 1, 2008, a State 
shall submit to the Secretary a plan that sets forth 
how the State intends to use the funds provided 
under this part to ensure universal, affordable, and 
comprehensive health insurance coverage to eligible 
residents of the State consistent with the provisions 
of this part. 
‘‘(2) STATES WITH PHASE I PLANS.— 
‘‘(A) IN GENERAL.—Not later than Janu-
ary 1, 2008, a State with a phase I State plan 
shall submit an addendum to such plan that 
provides assurances to the Secretary that such 
plan conforms to the requirements of this part. 
‘‘(B) CONVERSION TO UNIVERSAL PHASE 
(PHASE II) PLAN.—If an addendum to an ex-
pansion phase (phase I) plan is approved by the 
Secretary— 
‘‘(i) the plan shall be automatically 
converted to a universal phase (phase II) 
plan; and
‘‘(ii) section 2214 and any provision 
of part A that is inconsistent with this 
part shall not apply to the plan. 
‘‘(3) FAILURE
TO
SUBMIT
PLAN
OR
ADDEN-
DUM.—If a State fails to submit a plan as required 
in paragraph (1) (or an addendum as required in 
paragraph (2)), or fails to have such plan or adden-
dum approved by the Secretary, such State shall be 
in violation of this part; and any residents of such 
a State may bring a cause of action against the 
State in Federal district court to require the State 
to comply with the provisions of this part. 
‘‘SEC. 2212. PLAN REQUIREMENTS. 
‘‘(a) IN GENERAL.—A universal phase (phase II) 
plan shall include a description, consistent with the re-
quirements of this part, of the following: 
‘‘(1) DETAILS
OF
THE
UNIVERSAL
PHASE 
(PHASE II) PLAN.—The activities that the State in-
tends to carry out using funds received under this 
part to ensure that all eligible residents of the State 
have access to the coverage provided under this part, 
including how the State will coordinate efforts under 
the program under this part with existing State ef-
forts to increase to 100 percent the health insurance
coverage of eligible residents of the State by Janu-
ary 1, 2010. 
‘‘(2) REQUIREMENTS
FOR
EMPLOYERS.—The 
manner in which the State will ensure that employ-
ers within the State will comply with the require-
ments of section 2214. 
‘‘(3) PART A PROVISIONS.—The following pro-
visions apply to a universal phase (phase II) plan 
under this part in the same manner as such provi-
sions apply to an expansion phase (phase I) plan 
under part A: 
‘‘(A) STATE
OUTREACH
PROGRAMS; AC-
CESS.—Section 2202(a)(4). 
‘‘(B) ASSURANCE OF COVERAGE OF ESSEN-
TIAL SERVICES.—Section 2202(a)(5). 
‘‘(C) REPRESENTATION ON BOARDS AND 
COMMISSIONS.—Section 2202(a)(6). 
‘‘(D) DISCLOSURE
OF
INFORMATION
TO 
THE PUBLIC.—Section 2202(a)(7). 
‘‘(E) CONSUMER PROTECTIONS AND WORK-
FORCE STANDARDS.—Section 2202(a)(8). 
‘‘(F) 
PUBLIC
REVIEW.—Section 
2202(a)(9).
‘‘(G) SERVICES
IN
RURAL
AND
UNDER-
SERVED AREAS; CULTURAL COMPETENCY.—Sec-
tion 2202(a)(10). 
‘‘(H) 
PURCHASING
POOLS.—Section 
2202(a)(11). 
‘‘(I) LIMITATION ON ADMINISTRATIVE EX-
PENDITURES.—Section 2202(a)(12). 
‘‘(J) 
SELF-EMPLOYED
AND
MULTI-
EMPLOYED.—Section 2202(a)(13). 
‘‘(K) 
MEDICAID
WRAPAROUND
COV-
ERAGE.—Section 2202(a)(14). 
‘‘(4) OTHER MATTERS.—Any other matter de-
termined appropriate by the Secretary. 
‘‘(b) PERMISSIBLE ACTIVITIES.—A State may use 
amounts provided under this part for any activities con-
sistent with this part that are appropriate to enroll indi-
viduals in health plans to ensure that all eligible residents 
of the State are provided coverage under this part, includ-
ing through the use of direct payments to health plans 
or providers of services. 
‘‘(c) COST CONTAINMENT; COMPETITIVE BIDDING.— 
Notwithstanding subsection (b), State purchasing pools 
shall solicit bids from health plans at least annually. 
‘‘(d) PROCESS
FOR SUBMISSION, APPROVAL, AND 
AMENDMENT OF UNIVERSAL PHASE (PHASE II) PLAN.—