I 
112TH CONGRESS 
1ST SESSION H. R. 3072 
To amend the Patient Protection and Affordable Care Act to provide State 
flexibility for the offering of health benefits through alternative health 
arrangements. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 29, 2011 
Mr. HALL introduced the following bill; which was referred to the Committee 
on Energy and Commerce 
A BILL 
To amend the Patient Protection and Affordable Care Act 
to provide State flexibility for the offering of health 
benefits through alternative health arrangements. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘State Authorized Alter-
native Health Arrangement Act of 2011’’. 
SEC. 2. ALTERNATIVE HEALTH ARRANGEMENTS FOR THE 
PROVISION OF HEALTH BENEFITS. 
Section 1311(f) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 18031(f); Public Law 111–148) 
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is amended by adding at the end the following new para-
graph: 
‘‘(4) ALTERNATIVE
HEALTH
ARRANGEMENTS 
FOR THE PROVISION OF HEALTH BENEFITS.— 
‘‘(A) ESTABLISHMENT
OF
ALTERNATIVE 
HEALTH ARRANGEMENTS.— 
‘‘(i) IN GENERAL.—A State may es-
tablish one or more alternative health ar-
rangements (each referred to in this sub-
section as an ‘alternative health arrange-
ment’) that serve the beneficiaries of one 
or more qualified benefits programs (as de-
fined in subparagraph (B)(i)) if the num-
ber of participants served by each such ar-
rangement is determined by the State to 
be adequate for purposes of carrying out 
the requirements of this title. 
‘‘(ii) DESIGNATION
OF
QUALIFIED 
BENEFITS PROGRAMS TO BE OFFERED.—A 
State that establishes an alternative health 
arrangement shall designate one or more 
qualified benefits programs to be offered 
through such arrangement. 
‘‘(iii) TREATMENT AS SEPARATE EX-
CHANGE.—An alternative health arrange-
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ment shall be in addition to an Exchange 
or a subsidiary Exchange under this sec-
tion. 
‘‘(iv) CRITERIA
APPLICABLE
TO
AL-
TERNATIVE
HEALTH
ARRANGEMENT.—An 
alternative health arrangement shall be 
deemed to be an Exchange under this title, 
except that— 
‘‘(I) the requirement of section 
1311(d)(2) (relating to the offering of 
coverage) shall only apply, with re-
spect to such an arrangement, to the 
offering of qualified benefits programs 
and only to beneficiaries served by 
such programs; and 
‘‘(II) the requirements of section 
1311(e)(1) (relating to certification of 
health plans) shall be deemed to have 
been satisfied with respect to qualified 
benefits programs offered through the 
arrangement by the designation of 
such programs by the State under 
clause (ii). 
‘‘(B) QUALIFIED BENEFITS PROGRAMS.— 
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‘‘(i) DEFINITION.—In this paragraph, 
the term ‘qualified benefits program’ 
means an entity or arrangement (such as 
a program created by a group of govern-
ment agencies, instrumentalities, or polit-
ical subdivisions by interlocal agreement or 
other method authorized by State law) 
that— 
‘‘(I) is established, authorized, 
and operating pursuant to State law 
to provide or administer health cov-
erage for officials, employees, and re-
tirees (and dependents of such offi-
cials, employees, and retirees) of a 
group of employers; and 
‘‘(II) the State finds, subject to 
clause (ii), satisfies criteria under this 
title to be a qualified health plan. 
‘‘(ii) SATISFACTION OF CERTAIN RE-
QUIREMENTS.—In applying this title with 
respect to a qualified benefits program 
that is designated by a State under sub-
paragraph (A)(ii) and offered through an 
alternative health arrangement, the fol-
lowing special rules apply: 
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‘‘(I) The entity offering such cov-
erage shall be deemed to meet the re-
quirement of section 1301(a)(1)(C)(i) 
(relating to licensure as a health in-
surance issuer). 
‘‘(II) Section 1301(a)(1)(C)(iii) 
(relating to uniform premium rates) 
shall be applied separately to each dif-
ferent health benefits option offered 
under the qualified benefits program 
through the arrangement. 
‘‘(III) Section 1311(c)(1)(D) (re-
lating 
to 
accreditation) 
shall 
be 
deemed to have been satisfied by vir-
tue of the designation by the State 
under subparagraph (A)(ii). 
‘‘(IV) Section 1311(e)(1) (relat-
ing to certification of health plans) 
shall not apply insofar as it applies to 
accreditation 
under 
section 
1311(c)(1)(D). 
‘‘(V) Section 1311(e)(2) (relating 
to premium considerations) shall not 
apply insofar as it requires alternative 
health arrangements to display pre-
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mium information to the general pub-
lic or conduct an analysis of premium 
growth outside of the alternative 
health arrangement. 
‘‘(iii) TREATMENT
AS
A
HEALTH 
PLAN, QUALIFIED HEALTH PLAN, AND IN-
DIVIDUAL
INSURANCE
COVERAGE.—A 
qualified benefits program offered through 
an alternative health arrangement shall be 
treated— 
‘‘(I) subject to clause (ii), as 
meeting the definition of a health plan 
under section 1301(b) and as a quali-
fied health plan under this title; and 
‘‘(II) as a health plan offered in 
the individual market for purposes of 
section 5000A(f)(1)(C) of the Internal 
Revenue Code. 
‘‘(C) CONSTRUCTION.—Nothing in this 
paragraph shall be construed— 
‘‘(i) to authorize or require an alter-
native health arrangement to offer health 
benefits to any individual other than a ben-
eficiary covered under such arrangement; 
or 
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‘‘(ii) to authorize the offering of such 
health benefits through an Exchange.’’. 
Æ 
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