dents of the State, including the steps the State 
is taking to identify and enroll all uncovered 
residents of the State who are eligible to par-
ticipate in public or private health insurance 
programs. 
‘‘(2) DETAILS OF, AND TIMELINES FOR, EXPAN-
SION PHASE (PHASE I) PLAN.— 
‘‘(A) USE
OF
FUNDS; COORDINATION.— 
The activities that the State intends to carry 
out using funds received under this part, in-
cluding how the State will coordinate efforts 
under this part with existing State efforts to in-
crease the health insurance coverage of individ-
uals. 
‘‘(B) TIMELINES.—Consistent with sub-
section (c), the manner in which the State will 
reduce the base coverage gap for the year in-
volved, including a timetable with specified tar-
gets for reducing the base coverage gap by— 
‘‘(i) 50 percent within 2 years after 
the date of approval of the expansion 
phase (phase I) plan; and 
‘‘(ii) 100 percent within 4 years after 
such date.
‘‘(3) MAINTENANCE OF EFFORT.—The manner 
in which the State will ensure that— 
‘‘(A) employers within the State will con-
tinue to provide not less than the level of finan-
cial support toward the health insurance pre-
miums required for coverage of their employees 
as such employers provided as of the date of en-
actment of this title; and 
‘‘(B) the State will continue to provide not 
less than the level of State expenditures in-
curred for State-funded health programs as of 
such date. 
For purposes of this paragraph, any population or 
service that was covered under the medicaid pro-
gram under title XIX under a waiver under section 
1115 or section 1902(r)(2) shall be treated as if 
such State expenditures had been based on the en-
hanced FMAP formula used under the State chil-
dren’s health insurance program under title XXI. 
‘‘(4) STATE OUTREACH PROGRAMS; ACCESS.— 
The manner in which, and a timetable for when, the 
State will— 
‘‘(A) institute outreach programs; and
‘‘(B) ensure that all eligible residents of 
the State have access to the health insurance 
coverage provided under this part. 
‘‘(5) ASSURANCE OF COVERAGE OF ESSENTIAL 
SERVICES.—An assurance that the State program 
established under this part will comply with the re-
quirements of section 1867 (commonly referred to as 
the ‘Emergency Medical Treatment and Active 
Labor Act’). 
‘‘(6) REPRESENTATION ON BOARDS AND COM-
MISSIONS.—The manner in which the State will en-
sure that all Boards and Commissions that the State 
establishes to administer the plan will include, 
among others, representatives of providers, con-
sumers, employers, and health worker unions. 
‘‘(7) DISCLOSURE
OF
INFORMATION
TO
THE 
PUBLIC.—The manner in which the State will ensure 
that, with respect to entities and individuals that 
provide services for which reimbursement is provided 
under this part— 
‘‘(A) financial arrangements between in-
surers and providers and between providers and 
medical equipment suppliers are disclosed to the 
public; and
‘‘(B) ownership interests and health care 
worker qualifications and credentials are dis-
closed to the public. 
‘‘(8) CONSUMER
PROTECTIONS.—The manner 
in which the State will ensure compliance with sec-
tions 2221, 2222, 2223, and 2224. 
‘‘(9) PUBLIC REVIEW.—The manner in which 
the State will provide for the public review of insti-
tutional changes in services provided, markets and 
regions covered, withdrawal or movement of services, 
closures or downsizing, and other actions that affect 
the provision of health insurance under the plan. 
‘‘(10) SERVICES IN RURAL AND UNDERSERVED 
AREAS; CULTURAL
COMPETENCY.—The manner in 
which the State will ensure— 
‘‘(A) coverage in rural and underserved 
areas; and 
‘‘(B) that the needs of culturally diverse 
populations are met. 
‘‘(11) MECHANISMS
TO
MINIMIZE
ADVERSE 
RISK SELECTION.—The manner in which the State 
will encourage mechanisms to minimize adverse risk 
selection that provide choice of health plans and con-
trol costs.
‘‘(12) LIMITATION
ON
ADMINISTRATIVE
EX-
PENDITURES.—The manner in which the State will 
ensure that all qualified plans in the State expend 
at least 90 percent (or, during the first 2 years of 
the plan, 85 percent) of total income received from 
premiums on the provision of covered health care 
benefits (excluding all costs for marketing, adver-
tising, health plan administration, profits, or capital 
accumulation) to individuals. 
‘‘(13) 
SELF-EMPLOYED
AND
MULTI-
EMPLOYED.—The manner in which the State will 
address self-employed individuals and multiwage 
earner families. 
‘‘(14) REQUIREMENT TO MAINTAIN MEDICAID 
BENEFITS.—The manner in which the State will en-
sure that individuals who are eligible for medical as-
sistance under title XIX and who receive benefits 
under the expansion phase (phase I) plan shall re-
ceive any items or services that are not available 
under the expansion phase (phase I) plan but that 
are available under the State medicaid program 
under title XIX through ‘wraparound coverage’ 
under such program. 
‘‘(15) COST CONTAINMENT; RISK SELECTION.— 
What cost containment strategies the State will em-