I 
114TH CONGRESS 
2D SESSION 
H. R. 6018 
To waive the essential health benefits requirements for certain States. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 13, 2016 
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. 
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 ‘‘Ensuring Health Care 
Opportunities Act’’. 
SEC. 2. WAIVER OF ESSENTIAL HEALTH BENEFITS RE-
QUIREMENTS. 
(a) IN GENERAL.—In the case of a State in which 
the applicable State authority (as defined in section 
2791(d)(1) of the Public Health Service Act (42 U.S.C. 
300gg–91(d)(1))) certifies to the Secretary of Health and 
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Human Services that, with respect to at least one county 
(or, in the case of a State that does not have counties, 
equivalent municipality), only one health insurance issuer 
offers coverage in the individual market for a plan year, 
the following shall not apply to health plans in such State 
for such plan year: 
(1) The requirement under section 1301(a)(1) 
of the Patient Protection and Affordable Care Act 
(42 U.S.C. 18021(a)(1)) that, to be a qualified 
health plan eligible to be offered through an Ex-
change in the State, such plan provide the essential 
health benefits package described in section 1302(a) 
of such Act (42 U.S.C. 18022(a)). 
(2) The requirement under section 2707(a) of 
the Public Health Service Act (42 U.S.C. 300gg– 
6(a)) that health insurance coverage offered in the 
individual or small group market in the State in-
cludes the essential health benefits package required 
under section 1302(a) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18022(a)). 
(b) STATE CERTIFICATION.—To be eligible for a 
waiver under subsection (a), a State shall make the certifi-
cation described in subsection (a) not later than— 
(1) 90 days after the date of enactment of this 
Act, in the case of a State in which, on the date of 
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enactment of this Act, at least one county in the 
State (or, in the case of a State that does not have 
counties, equivalent municipality), only one health 
insurance issuer offers coverage in the individual 
market for the plan year in effect on such date of 
enactment; and 
(2) 90 days after the applicable State authority 
(as defined in section 2791(d)(1) of the Public 
Health Service Act (42 U.S.C. 300gg–91(d)(1))) 
first discovers, or reasonably should discover, that, 
in at least one county in the State (or, in the case 
of a State that does not have counties, equivalent 
municipality), only one health insurance issuer offers 
in the current plan year, or will offer in a future 
plan year, coverage in the individual market for the 
current plan year or a future plan year, as applica-
ble, in the case of a State not described in para-
graph (1). 
(c) TERM OF WAIVER.—A waiver under this section 
may extend over a period of not more than 5 years, pro-
vided that the State continues to meet the criteria for eli-
gibility for the waiver under subsection (a). A State that 
continues to meet such criteria for more than 5 years may 
re-certify under subsection (a) every 5 years. 
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(d) PLANS OFFERING ESSENTIAL HEALTH BENE-
FITS.—Nothing in this Act prevents a health insurance 
issuer from offering in a State to which a waiver under 
subsection (a) applies health insurance coverage that in-
cludes the essential health benefits package described in 
section 1302(a) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18022(a)). 
Æ 
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