I 
113TH CONGRESS 
1ST SESSION 
H. R. 261 
To amend the Patient Protection and Affordable Care Act to establish a 
public health insurance option. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 15, 2013 
Ms. SCHAKOWSKY (for herself, Mr. WAXMAN, Mr. PALLONE, Ms. DEGETTE, 
Mr. ENGEL, Mr. SARBANES, Ms. CHU, Mr. CLAY, Mr. COHEN, Mr. CON-
YERS, Mr. CUMMINGS, Ms. DELAURO, Mr. DEUTCH, Ms. EDWARDS, Mr. 
ELLISON, Mr. FARR, Mr. FATTAH, Mr. GRIJALVA, Ms. HAHN, Mr. HIG-
GINS, Mr. HOLT, Mr. HONDA, Mr. JOHNSON of Georgia, Ms. KAPTUR, 
Ms. LEE of California, Ms. LOFGREN, Mr. BEN RAY LUJA´N of New Mex-
ico, Ms. MCCOLLUM, Mr. MCDERMOTT, Mr. MCGOVERN, Mr. GEORGE 
MILLER of California, Ms. MOORE, Mr. NADLER, Ms. NORTON, Ms. PIN-
GREE of Maine, Mr. POLIS, Mr. RANGEL, Ms. ROYBAL-ALLARD, Mr. 
SERRANO, Ms. SHEA-PORTER, Ms. SLAUGHTER, Mr. TONKO, Ms. 
WATERS, Mr. WELCH, and Mr. YARMUTH) 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 establish a public health insurance option. 
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 ‘‘Public Option Deficit 
Reduction Act’’. 
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SEC. 2. PUBLIC HEALTH INSURANCE OPTION. 
(a) IN GENERAL.—Part 3 of subtitle D of title I of 
the Patient Protection and Affordable Care Act (Public 
Law 111–148) is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 1325. PUBLIC HEALTH INSURANCE OPTION. 
‘‘(a) ESTABLISHMENT AND ADMINISTRATION OF A 
PUBLIC HEALTH INSURANCE OPTION.— 
‘‘(1) ESTABLISHMENT.—For years beginning 
with 2014, the Secretary of Health and Human 
Services (in this subtitle referred to as the ‘Sec-
retary’) shall provide for the offering through Ex-
changes established under this title of a health bene-
fits plan (in this Act referred to as the ‘public health 
insurance option’) that ensures choice, competition, 
and stability of affordable, high-quality coverage 
throughout the United States in accordance with 
this section. In designing the option, the Secretary’s 
primary responsibility is to create a low-cost plan 
without compromising quality or access to care. 
‘‘(2) OFFERING THROUGH EXCHANGES.— 
‘‘(A) EXCLUSIVE
TO
EXCHANGES.—The 
public health insurance option shall only be 
made available through Exchanges established 
under this title. 
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‘‘(B) 
ENSURING
A
LEVEL
PLAYING 
FIELD.—Consistent with this section, the public 
health insurance option shall comply with re-
quirements that are applicable under this title 
to health benefits plans offered through such 
Exchanges, including requirements related to 
benefits, benefit levels, provider networks, no-
tices, consumer protections, and cost sharing. 
‘‘(C) PROVISION OF BENEFIT LEVELS.— 
The public health insurance option— 
‘‘(i) shall offer bronze, silver, and gold 
plans; and 
‘‘(ii) may offer platinum plans. 
‘‘(3) 
ADMINISTRATIVE
CONTRACTING.—The 
Secretary may enter into contracts for the purpose 
of performing administrative functions (including 
functions described in subsection (a)(4) of section 
1874A of the Social Security Act) with respect to 
the public health insurance option in the same man-
ner as the Secretary may enter into contracts under 
subsection (a)(1) of such section. The Secretary has 
the same authority with respect to the public health 
insurance option as the Secretary has under sub-
sections (a)(1) and (b) of section 1874A of the So-
cial Security Act with respect to title XVIII of such 
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Act. Contracts under this subsection shall not in-
volve the transfer of insurance risk to such entity. 
‘‘(4) OMBUDSMAN.—The Secretary shall estab-
lish an office of the ombudsman for the public 
health insurance option which shall have duties with 
respect to the public health insurance option similar 
to the duties of the Medicare Beneficiary Ombuds-
man under section 1808(c)(2) of the Social Security 
Act. In addition, such office shall work with States 
to ensure that information and notice is provided 
that the public health insurance option is one of the 
health plans available through an Exchange. 
‘‘(5) DATA COLLECTION.—The Secretary shall 
collect such data as may be required to establish 
premiums and payment rates for the public health 
insurance option and for other purposes under this 
section, including to improve quality and to reduce 
racial, ethnic, and other disparities in health and 
health care. 
‘‘(6) ACCESS TO FEDERAL COURTS.—The provi-
sions of Medicare (and related provisions of title II 
of the Social Security Act) relating to access of 
Medicare beneficiaries to Federal courts for the en-
forcement of rights under Medicare, including with 
respect to amounts in controversy, shall apply to the 
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