(iii) 
ROUNDING.—Any 
adjustment 
made under clause (ii) for a year shall be 
rounded to the nearest multiple of $100. 
(D) 
TANF 
RECIPIENT.—The 
term 
‘‘TANF recipient’’ means, for a month, an indi-
vidual who is receiving aid or assistance under 
any plan of the State approved under title I, X, 
XIV, or XVI, or part A or part E of title IV, 
of the Social Security Act, for the month. 
(E) SSI RECIPIENT.—The term ‘‘SSI re-
cipient’’ means, for a month, an individual— 
(i) with respect to whom supplemental 
security income benefits are being paid 
under title XVI of the Social Security Act 
for the month, 
(ii) who is receiving a supplementary 
payment under section 1616 of such Act or 
under section 212 of Public Law 93–66 for 
the month, or 
(iii) who is receiving monthly benefits 
under section 1619(a) of the Social Secu-
rity Act (whether or not pursuant to sec-
tion 1616(c)(3) of such Act) for the 
month. 
(b) AMOUNT OF PREMIUM SUBSIDY.— 
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(1) LOWEST INCOME INDIVIDUALS.— 
(A) IN GENERAL.—In the case of an indi-
vidual described in subparagraph (B), the pre-
mium subsidy under this section is the amount 
which would (without regard to this section) re-
duce the premium obligation of the individual 
(and family members) under section 201 to 
zero. 
(B) LOWEST
INCOME
INDIVIDUALS
DE-
SCRIBED.—An individual described in this sub-
paragraph is a premium subsidy eligible indi-
vidual who would still be such an individual 
under subsection (a)(2) if ‘‘200 percent’’ were 
substituted for ‘‘300 percent’’ in subparagraph 
(A) of such subsection. 
(2) OTHER INDIVIDUALS.— 
(A) IN GENERAL.—In the case of a pre-
mium subsidy eligible individual not described 
in paragraph (1), the premium subsidy under 
this section is the product of— 
(i) the premium obligation of the indi-
vidual (and family members) under section 
201, multiplied by 
(ii) the number of percentage points 
by which the individual’s family income 
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(expressed as a percent of the applicable 
poverty level) is less than 300 percent. 
(B) TABLE.—The Secretary may provide 
for a table which establishes the values for pre-
mium subsidies under this paragraph. 
(c) GENERAL REVENUE FINANCING FOR LOW IN-
COME SUBSIDIES.—There are authorized to be appro-
priated to the Americare Trust Fund from amounts in the 
Treasury not otherwise appropriated, such sums as may 
be necessary to cover the costs of premium subsidies pro-
vided under this section. 
SEC. 203. EFFECTIVE DATE. 
The provisions of this subtitle shall apply with respect 
to periods beginning on or after January 1, 2010. 
Subtitle B—Employer 
Contributions 
SEC. 211. GENERAL OBLIGATION FOR EMPLOYERS. 
(a) GENERAL OBLIGATION.— 
(1) IN
GENERAL.—Subject to the succeeding 
provisions of this subsection, each employer shall 
make a financial contribution toward the cost of 
health insurance coverage for employees in accord-
ance with this section. 
(2) ELIMINATION
OF
LIABILITY
IN
CASE
OF 
CERTAIN GROUP HEALTH PLAN COVERAGE.— 
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(A) IN
GENERAL.—Subject to subpara-
graph (B), an employer shall not be liable for 
any contribution under this section with respect 
to any employee who is covered under a group 
health plan of the employer described in section 
2202(d) if such employer pays at least 80 per-
cent of the cost of such health plan, as deter-
mined by the Secretary of Health and Human 
Services. 
(B) SURCHARGE
PERMISSIBLE
TO
PRE-
VENT
ADVERSE
SELECTION.—The Secretary 
may impose liability for a contribution under 
this section with respect to an employee de-
scribed in subparagraph (A) in an amount (not 
to exceed the amount specified under subsection 
(b)) insofar as the Secretary determines it nec-
essary to prevent adverse selection of the indi-
viduals enrolled under this title as a result of 
the operation of such subparagraph. 
(b) AMOUNT OF CONTRIBUTION.— 
(1) FULL-TIME EMPLOYEES.—In the case of an 
employee receiving coverage under title XXII of the 
Social Security Act, the amount of the financial con-
tribution is equal to at least 80 percent of the pre-
mium determined with respect to such employee and 
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family members under section 201 (based on class of 
enrollment and without regard to subsection (b) 
thereof) or at least 80 percent of the cost of cov-
erage under such group health plan, respectively. 
(2) REDUCTION FOR PART-TIME EMPLOYEES.— 
In the case of a part-time employee, the employer 
contribution requirements of paragraph (1) shall be 
treated as satisfied if the employer contribution with 
respect to such employee is not less than the part- 
time employment ratio of the contribution required 
under paragraph (1). 
(3) RULES RELATED TO PART-TIME EMPLOY-
MENT.—For purposes of this subsection— 
(A) PART-TIME
EMPLOYEE.—The term 
‘‘part-time employee’’ means, with respect to 
any month, an employee who works on average 
fewer than 40 hours per week. 
(B) PART-TIME
EMPLOYMENT
RATIO.— 
The term ‘‘part-time employment ratio’’ means, 
with respect to a part-time employee of an em-
ployer in a month, a fraction— 
(i) the numerator of which is the 
number of hours in the employee’s normal 
work week, and 
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(ii) the denominator of which is 40 
hours. 
(C) SPECIAL
RULES.—Under rules pre-
scribed by the Secretary of Health and Human 
Services, in consultation with the Secretary of 
the Treasury, in the case of an employee for an 
employer whose defined work week for full-time 
employees is less than 40 hours, any reference 
in this subsection to 40 hours is deemed a ref-
erence to the number of hours in the work week 
so defined. 
(D) CONVERSION TO HOURS OF EMPLOY-
MENT.—The Secretary of Health and Human 
Services, in consultation with the Secretary of 
the Treasury, shall establish rules for the con-
version of compensation to hours of employ-
ment, for purposes of this subsection in the 
case of employees that receive compensation on 
a salaried basis, or on the basis of a commis-
sion, or other contingent or bonus basis, rather 
than based on an hourly wage. 
(c) TIMING AND MANNER.— 
(1) IN GENERAL.—Each employer that is re-
quired to make a financial contribution with respect 
to an employee under this section (other than with 
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respect to coverage under a group health plan) or a 
surcharge under subsection (a)(2)(B) shall pay such 
contribution or surcharge in a form and manner, 
specified by the Secretary of the Treasury, based 
upon the form and manner in which employer excise 
taxes are required to be paid under section 3111 of 
the Internal Revenue Code of 1986. 
(2) NON-ENROLLING EMPLOYERS.—In the case 
of an employee who is covered under the class of en-
rollment of a family member, the Secretary of the 
Treasury shall provide that the financial contribu-
tion of the employer with respect to such employee 
is paid directly or indirectly to the employer of such 
family member. 
SEC. 212. EFFECTIVE DATE. 
(a) IN GENERAL.—Subject to subsection (b), the pro-
visions of this subtitle shall apply with respect to periods 
beginning on or after January 1, 2010. 
(b) ADDITIONAL PERIOD FOR SMALL EMPLOYERS.— 
The provisions of this subtitle shall not apply with respect 
to an employer that has fewer than 100 employees (as de-
termined by the Secretary of the Treasury in consultation 
with the Secretary of Health and Human Services) for pe-
riods beginning before January 1, 2013. 
Æ 
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