I 
112TH CONGRESS 
1ST SESSION 
H. R. 767 
To permit individuals to choose to opt out of the requirement to maintain 
health insurance minimum essential coverage if such individuals also 
opt out of specified insurance reform protections. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 17, 2011 
Mr. DEFAZIO introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means and the Judiciary, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To permit individuals to choose to opt out of the requirement 
to maintain health insurance minimum essential coverage 
if such individuals also opt out of specified insurance 
reform protections. 
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 ‘‘Personal Responsibility 
in Health Care Insurance Act’’. 
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SEC. 2. OPT OUT OF REQUIREMENT FOR INDIVIDUALS TO 
MAINTAIN HEALTH INSURANCE MINIMUM ES-
SENTIAL COVERAGE AND CERTAIN HEALTH 
INSURANCE PROTECTIONS. 
(a) ABILITY TO OPT OUT OF MINIMUM ESSENTIAL 
COVERAGE REQUIREMENT.— 
(1) IRC.—Section 5000A(d) of the Internal 
Revenue Code of 1986 is amended— 
(A) by striking ‘‘or (4)’’ and inserting 
‘‘(4), or (5)’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(5) INDIVIDUALS WHO HAVE CHOSEN TO OPT 
OUT.—Such term shall not include any individual, or 
a dependent of such individual, for any month dur-
ing a taxable year if such individual, or dependent, 
has 
in 
effect 
an 
exemption 
under 
section 
1311(d)(4)(H) of the Patient Protection and Afford-
able Care Act which certifies that there is in effect 
for such month, with respect to such individual, or 
such dependent, an affidavit of personal responsi-
bility described in section 1411(j) of such Act.’’. 
(2) PPACA.—Section 1411 of the Patient Pro-
tection and Affordable Care Act is amended by add-
ing at the end the following new subsection: 
‘‘(j) EXCLUSION BASED ON OPT OUT SELECTION.— 
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‘‘(1) IN
GENERAL.—For purposes of section 
5000A(d)(5) of the Internal Revenue Code of 1986, 
section 1311, and this section, an affidavit of per-
sonal responsibility described in this subsection, with 
respect to an individual or any dependent of such in-
dividual, is a statement, that indicates each of the 
following: 
‘‘(A) Such individual chooses for such indi-
vidual or such dependent, respectively, to opt 
out of the application of subsections (a) and 
(b)(1) of section 5000A of the Internal Revenue 
Code of 1986 for the period described in para-
graph (2). 
‘‘(B) Such individual acknowledges that 
such choice results in such individual or de-
pendent, respectively, waiving each of the fol-
lowing during such period: 
‘‘(i) Eligibility to enroll in a qualified 
health plan through an Exchange estab-
lished pursuant to section 1311. 
‘‘(ii) The application of section 2704 
of the Public Health Service Act (relating 
to prohibition of preexisting condition ex-
clusions or other discrimination based on 
health status), including as applied under 
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section 1255(2) of the Patient Protection 
and Affordable Care Act (relating to indi-
viduals who are under 19 years of age). 
‘‘(C) Such individual acknowledges that 
any health care related debts assumed by the 
individual or dependent, respectively, while the 
individual or dependent, respectively, has in ef-
fect such affidavit, will not be discharged under 
chapter 7 of title 11 of the United States Code. 
‘‘(2) OPT OUT SELECTION PERIOD.— 
‘‘(A) IN GENERAL.—An affidavit of per-
sonal responsibility described in paragraph (1), 
with respect to an individual or, if applicable, a 
dependent of such individual, shall be in effect 
for each month during the 3-year period begin-
ning with the first month after the applicable 
certification under section 1311(d)(4)(H) has 
been made. 
‘‘(B) RENEWABILITY.—An individual may 
file an affidavit of personal responsibility, with 
respect to the individual or any dependent of 
the individual, under this subsection, and be 
certified under section 1311(d)(4)(H) with re-
spect to such affidavit, for more than one pe-
riod described in subparagraph (A). 
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‘‘(3) ELIGIBILITY.— 
‘‘(A) IN GENERAL.—An individual may file 
an affidavit of personal responsibility under this 
section, with respect to such individual, only if, 
as of the date of submission of such affidavit, 
the individual— 
‘‘(i) is not eligible for any exemption 
described in such subsection other than by 
application of this subsection; and 
‘‘(ii) is not enrolled in any program 
described in section 5000A(f) of the Inter-
nal Revenue Code of 1986. 
‘‘(B) TREATMENT OF DEPENDENTS.—An 
individual may specify a dependent of such indi-
vidual within the affidavit of personal responsi-
bility of such individual (or may file a separate 
affidavit of personal responsibility on behalf of 
such a dependent) for purposes of this sub-
section, but only if such dependent meets the 
criteria specified in clauses (i) and (ii) of sub-
paragraph (A).’’. 
(3) CONFORMING AMENDMENTS.— 
(A) Section 1311(d)(4) of the Patient Pro-
tection and Affordable Care Act is amended— 
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(i) in subparagraph (H)(ii), by insert-
ing before the period at the end the fol-
lowing: ‘‘, including with respect to an affi-
davit of personal responsibility described in 
section 1411(j)’’; 
(ii) in subparagraph (J), by striking 
at the end ‘‘and’’; 
(iii) in subparagraph (K), by striking 
the period and inserting ‘‘; and’’; and 
(iv) by adding at the end the following 
new subparagraph: 
‘‘(L) in the case of an individual (or de-
pendent of an individual) with respect to whom 
there is filed an affidavit of personal responsi-
bility described in section 1411(j) and who is el-
igible for any program described in section 
5000A(f)(1)(A) of the Internal Revenue Code of 
1986, provide notification to such individual of 
such eligibility, including information necessary 
for the individual (or dependent) to enroll in 
such program.’’. 
(B) Section 1411(b)(5) of such Act is 
amended by adding at the end the following 
new subparagraph: 
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‘‘(C) In the case of an individual (or de-
pendent of such individual) seeking exemption 
based on the individual (or dependent) having 
in effect an affidavit of personal responsibility 
described in subsection (j), such information as 
the Secretary, in consultation with the Sec-
retary of the Treasury, shall prescribe, which 
shall include sufficient information to verify the 
individual (or dependent) meets the criteria 
specified in clauses (i) and (ii) of subsection 
(j)(3)(A).’’. 
(b) INDIVIDUALS OPTING OUT OF MINIMUM ESSEN-
TIAL COVERAGE REQUIREMENT EXCLUDED FROM CER-
TAIN HEALTH-RELATED PROGRAMS.— 
(1) ELIGIBILITY
TO
PARTICIPATE
IN
EX-
CHANGES.—Section 1312(f)(1)(A) of the Patient 
Protection and Affordable Care Act is amended— 
(A) in clause (i), by striking at the end 
‘‘and’’; 
(B) in clause (ii), by striking at the end 
the period and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
clause: 
‘‘(iii) is not an individual (or depend-
ent of such individual) who has in effect an 
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exemption under section 1311(d)(4)(H) 
which certifies that there is in effect, with 
respect to such individual (or dependent), 
an affidavit of personal responsibility de-
scribed in section 1411(j).’’. 
(2) PREEXISTING
CONDITION
EXCLUSION.— 
Section 2704 of the Public Health Service Act, as 
inserted by section 1201 of the Patient Protection 
and Affordable Care Act, is amended by inserting 
before the period at the end the following: ‘‘, except 
that this section shall not apply to an individual (or 
dependent of such individual) with respect to whom 
there is in effect an exemption under section 
1311(d)(4)(H) of the Patient Protection and Afford-
able Care Act which certifies that there is in effect, 
with respect to such individual (or dependent), an 
affidavit of personal responsibility described in sec-
tion 1411(j) of such Act’’. 
(3) HEALTH RELATED DEBTS NONDISCHARGE-
ABLE UNDER CHAPTER 7 IN CASES OF INDIVIDUALS 
WHO OPT OUT OF MINIMUM ESSENTIAL COVERAGE 
REQUIREMENT.—Notwithstanding any provision of 
title 11 of the United States Code, a discharge in a 
case under chapter 7 of such title does not discharge 
an individual (or dependent of such individual) from 
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a health care related debt if such debt was assumed 
while such individual (or dependent) has in effect an 
exemption under section 1311(d)(4)(H) of the Pa-
tient Protection and Affordable Care Act which cer-
tifies that there is in effect, with respect to such in-
dividual (or dependent), an affidavit of personal re-
sponsibility described in section 1411(j) of such Act. 
Æ 
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