fies the State submitting the application, not later 
than 60 days after the date of the submission of 
such application, that the application has been de-
nied for not being in compliance with any require-
ment of this part and of the reason for such denial. 
‘‘(3) 5-YEAR
APPLICATION
APPROVAL.—If an 
application of a State is approved for a purpose de-
scribed in section 1352 for a year, such application 
shall be treated as approved for such purpose for 
each of the subsequent 4 years. 
‘‘(4) REVOCATION
OF
APPROVAL.—The ap-
proval of an application of a State, with respect to 
a purpose described in section 1352, may be revoked 
if the State fails to use funds provided to the State 
under this section for such purpose or otherwise fails 
to comply with the requirements of this section. 
‘‘(b) DEFAULT FEDERAL SAFEGUARD.— 
‘‘(1) 2023.—For 2023, in the case of a State 
that does not submit an application under subsection 
(a) by the 90-day submission date applicable to such 
year under subsection (a)(1) and in the case of a 
State that does submit such an application by such 
date that is not approved, the Administrator, in con-
sultation with the State insurance commissioner, 
shall, from the amount calculated under paragraph 
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(4) for such year, carry out the purpose described in 
paragraph (3) in such State for such year. 
‘‘(2) 2024 
AND
SUBSEQUENT
YEARS.—For 
2024 or a subsequent year, in the case of a State 
that does not have in effect an approved application 
under this section for such year, the Administrator, 
in consultation with the State insurance commis-
sioner, shall, from the amount calculated under 
paragraph (4) for such year, carry out the purpose 
described in paragraph (3) in such State for such 
year. 
‘‘(3) SPECIFIED USE.—The amount described 
in paragraph (4), with respect to 2023 or a subse-
quent year, shall be used to carry out the purpose 
described in section 1352(a)(1) in each State de-
scribed in paragraph (1) or (2) for such year, as ap-
plicable, by providing reinsurance payments to 
health insurance issuers with respect to attachment 
range claims (as defined in section 1354(b)(2)), 
using the dollar amounts specified in subparagraph 
(B) of such section for such year) in an amount 
equal to, subject to paragraph (5), the percentage 
(specified for such year by the Secretary under such 
subparagraph) of the amount of such claims. 
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‘‘(4) AMOUNT
DESCRIBED.—The amount de-
scribed in this paragraph, with respect to 2023 or 
a subsequent year, is the amount equal to the total 
sum of amounts that the Secretary would otherwise 
estimate under section 1354(b)(2)(A)(i) for such 
year for each State described in paragraph (1) or 
(2) for such year, as applicable, if each such State 
were not so described for such year. 
‘‘(5) ADJUSTMENT.—For purposes of this sub-
section, the Secretary may apply a percentage under 
paragraph (3) with respect to a year that is less 
than the percentage otherwise specified in section 
1354(b)(2)(B) for such year, if the cost of paying 
the total eligible attachment range claims for States 
described in this subsection for such year at such 
percentage otherwise specified would exceed the 
amount calculated under paragraph (4) for such 
year. 
‘‘SEC. 1354. ALLOCATIONS. 
‘‘(a) APPROPRIATION.—For the purpose of providing 
allocations for States under subsection (b) and payments 
under section 1353(b) there is appropriated, out of any 
money in the Treasury not otherwise appropriated, 
$10,000,000,000 for 2023 and each subsequent year. 
‘‘(b) ALLOCATIONS.— 
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‘‘(1) PAYMENT.— 
‘‘(A) IN GENERAL.—From amounts appro-
priated under subsection (a) for a year, the 
Secretary shall, with respect to a State not de-
scribed in section 1353(b) for such year and 
not later than the date specified under subpara-
graph (B) for such year, allocate for such State 
the amount determined for such State and year 
under paragraph (2). 
‘‘(B) SPECIFIED DATE.—For purposes of 
subparagraph (A), the date specified in this 
subparagraph is— 
‘‘(i) for 2023, the date that is 45 days 
after the date of the enactment of this 
part; and 
‘‘(ii) for 2024 or a subsequent year, 
January 1 of the respective year. 
‘‘(C) 
NOTIFICATIONS
OF
ALLOCATION 
AMOUNTS.—For 2024 and each subsequent 
year, the Secretary shall notify each State of 
the amount determined for such State under 
paragraph (2) for such year by not later than 
January 1 of the previous year. 
‘‘(2) 
ALLOCATION
AMOUNT
DETERMINA-
TIONS.— 
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‘‘(A) IN GENERAL.—For purposes of para-
graph (1), the amount determined under this 
paragraph for a year for a State described in 
paragraph (1)(A) for such year is the amount 
equal to— 
‘‘(i) the amount that the Secretary es-
timates would be expended under this part 
for such year on attachment range claims 
of individuals residing in such State if such 
State used such funds only for the purpose 
described in paragraph (1) of section 
1352(a) at the dollar amounts and per-
centage specified under subparagraph (B) 
for such year; minus 
‘‘(ii) the amount, if any, by which the 
Secretary determines— 
‘‘(I) the estimated amount of 
premium tax credits under section 
36B of the Internal Revenue Code of 
1986 that would be attributable to in-
dividuals residing in such State for 
such year without application of this 
part; exceeds 
‘‘(II) the estimated amount of 
premium tax credits under section 
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36B of the Internal Revenue Code of 
1986 that would be attributable to in-
dividuals residing in such State for 
such year if such State were a State 
described in section 1353(b) for such 
year. 
For purposes of the previous sentence and sec-
tion 1353(b)(3), the term ‘attachment range 
claims’ means, with respect to an individual, the 
claims for such individual that exceed a dollar 
amount specified by the Secretary for a year, 
but do not exceed a ceiling dollar amount speci-
fied by the Secretary for such year, under sub-
paragraph (B). 
‘‘(B) SPECIFICATIONS.—For purposes of 
subparagraph (A) and section 1353(b)(3), the 
Secretary shall determine the dollar amounts 
and the percentage to be specified under this 
subparagraph for a year in a manner to ensure 
that the total amount of expenditures under 
this part for such year is estimated to equal the 
total amount appropriated for such year under 
subsection (a) if such expenditures were used 
solely for the purpose described in paragraph 
(1) of section 1352(a) for attachment range 
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claims at the dollar amounts and percentage so 
specified for such year. 
‘‘(3) AVAILABILITY.—Funds allocated to a 
State under this subsection for a year shall remain 
available through the end of the subsequent year.’’. 
(b) BASIC HEALTH PROGRAM FUNDING ADJUST-
MENTS.—Section 1331 of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 18051) is amended— 
(1) in subsection (a), by adding at the end the 
following new paragraph: 
‘‘(3) PROVISION OF INFORMATION ON QUALI-
FIED HEALTH PLAN PREMIUMS.— 
‘‘(A) IN
GENERAL.—The program de-
scribed in paragraph (1) shall provide that a 
State may not establish a basic health program 
unless such State furnishes to the Secretary, 
with respect to each qualified health plan of-
fered in such State during a year that receives 
any reinsurance payment from funds made 
available under part 6 for such year, the ad-
justed premium amount (as defined in subpara-
graph (B)) for each such plan and year. 
‘‘(B) ADJUSTED
PREMIUM
AMOUNT
DE-
FINED.—For purposes of subparagraph (A), the 
term ‘adjusted premium amount’ means, with 
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