SEC. 103. ENROLLMENT. 
(a) IN GENERAL.—Each State health security pro-
gram shall provide a mechanism for the enrollment of indi-
viduals entitled or eligible for benefits under this Act. The 
mechanism shall— 
(1) include a process for the automatic enroll-
ment of individuals at the time of birth in the 
United States and at the time of immigration into 
the United States or other acquisition of lawful resi-
dent status in the United States; 
(2) provide for the enrollment, as of January 1, 
2011, of all individuals who are eligible to be en-
rolled as of such date; and 
(3) include a process for the enrollment of indi-
viduals made eligible for health care services under 
subsections (b) and (c) of section 102. 
(b) AVAILABILITY OF APPLICATIONS.—Each State 
health security program shall make applications for enroll-
ment under the program available— 
(1) at employment and payroll offices of em-
ployers located in the State; 
(2) at local offices of the Social Security Ad-
ministration; 
(3) at social services locations; 
(4) at out-reach sites (such as provider and 
practitioner locations); and 
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(5) at other locations (including post offices 
and schools) accessible to a broad cross-section of in-
dividuals eligible to enroll. 
(c) ISSUANCE OF HEALTH SECURITY CARDS.—In 
conjunction with an individual’s enrollment for benefits 
under this Act, the State health security program shall 
provide for the issuance of a health security card that shall 
be used for purposes of identification and processing of 
claims for benefits under the program. The State health 
security program may provide for issuance of such cards 
by employers for purposes of carrying out enrollment pur-
suant to subsection (a)(2). 
SEC. 104. PORTABILITY OF BENEFITS. 
(a) IN GENERAL.—To ensure continuous access to 
benefits for health care services covered under this Act, 
each State health security program— 
(1) shall not impose any minimum period of 
residence in the State, or waiting period, in excess 
of 3 months before residents of the State are enti-
tled to, or eligible for, such benefits under the pro-
gram; 
(2) shall provide continuation of payment for 
covered health care services to individuals who have 
terminated their residence in the State and estab-
lished their residence in another State, for the dura-
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tion of any waiting period imposed in the State of 
new residency for establishing entitlement to, or eli-
gibility for, such services; and 
(3) shall provide for the payment for health 
care services covered under this Act provided to indi-
viduals while temporarily absent from the State 
based on the following principles: 
(A) Payment for such health care services 
is at the rate that is approved by the State 
health security program in the State in which 
the services are provided, unless the States con-
cerned agree to apportion the cost between 
them in a different manner. 
(B) Payment for such health care services 
provided outside the United States is made on 
the basis of the amount that would have been 
paid by the State health security program for 
similar services rendered in the State, with due 
regard, in the case of hospital services, to the 
size of the hospital, standards of service, and 
other relevant factors. 
(b) 
CROSS-BORDER
ARRANGEMENTS.—A 
State 
health security program for a State may negotiate with 
such a program in an adjacent State a reciprocal arrange-
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