‘‘(i) regulations (including regulations 
required under subsection (a)(4)(B)), rul-
ings, and interpretations issued by such 
Secretaries and the Director relating to the 
same matter over which two or more such 
Secretaries or Director have responsibility 
under this section are administered so as 
to have the same effect at all times; and 
‘‘(ii) coordination of policies relating 
to the granting, implementation, and con-
tinuation of waivers through such Secre-
taries and Director in order to have a co-
ordinated strategy that avoids duplication 
of effort by the States or Secretaries and 
Director and ensures clarity about waiver 
application status and approval. 
‘‘(2) SINGLE APPLICATION.—The process under 
paragraph (1)(A) shall permit a State to submit a 
single application for a waiver under all of the provi-
sions of this section and the provisions of law listed 
under clauses (i) and (ii) of such paragraph. 
‘‘(3) SUBMISSION
OF
CONFORMING
AMEND-
MENTS.—The Secretary of Health and Human Serv-
ices, in coordination with the other Secretaries (in-
cluding the Director of the Office of Personnel Man-
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agement), shall submit to Congress such rec-
ommendations for such technical and conforming 
amendments to law as may be appropriate to assist 
in the implementation of this section. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) HEALTH BENEFITS COVERAGE.—The term 
‘health benefits coverage’— 
‘‘(A) means— 
‘‘(i) health insurance coverage, as 
such term is defined in section 2791(b) of 
the Public Health Service Act (42 U.S.C. 
300gg–91(b)); and 
‘‘(ii) coverage under a group health 
plan, as such term is defined in section 
2791(a) of the Public Health Service Act 
(42 U.S.C. 300gg–91(a)); and 
‘‘(B) includes any medical coverage or 
health benefits provided under any specified 
Federal health program described in subpara-
graphs (A) through (E) of paragraph (4). 
‘‘(2) RESIDENT.—With respect to a State, the 
term ‘resident’ means an individual who is a citizen 
or national of the United States or an alien lawfully 
residing in the State, and whose primary residence 
(as defined by the State) is located in the State. 
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‘‘(3) 
SECRETARY.—The 
term 
‘Secretary’ 
means— 
‘‘(A) the Secretary of Health and Human 
Services with respect to waivers relating to the 
provisions described in subparagraphs (A), (B), 
and (D) through (G) of paragraph (2) of sub-
section (a); 
‘‘(B) the Secretary of the Treasury with 
respect to waivers relating to the provisions de-
scribed in subparagraph (C) of such paragraph; 
‘‘(C) the Director of the Office of Per-
sonnel Management with respect to waivers re-
lating to the provisions described in subpara-
graph (H) of such paragraph; 
‘‘(D) the Secretary of Defense with respect 
to waivers relating to the provisions described 
in subparagraph (I) of such paragraph; and 
‘‘(E) the Secretary of Labor with respect 
to waivers relating to the provisions described 
in subparagraph (J) of such paragraph. 
‘‘(4) SPECIFIED FEDERAL HEALTH PROGRAM.— 
The term ‘specified Federal health program’ means 
all of the following programs: 
‘‘(A) The Medicare program under title 
XVIII of the Social Security Act. 
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‘‘(B) The Medicaid program under title 
XIX of the Social Security Act. 
‘‘(C) The Children’s Health Insurance Pro-
gram under title XXI of the Social Security 
Act. 
‘‘(D) The Federal Employees Health Bene-
fits Plan under chapter 89 of title 5 of the 
United States Code. 
‘‘(E) Medical coverage under chapter 55 of 
title 10, United States Code, including coverage 
under the TRICARE program. 
‘‘(F) An Exchange established under this 
subtitle. 
‘‘(G) Subsidies under section 1402. 
‘‘(H) Tax credits under sections 36B and 
45R of the Internal Revenue Code of 1986.’’. 
(b) CLERICAL AMENDMENT.—The table of contents 
in section 1(b) of such Act is amended by inserting after 
the item relating to section 1332 the following new item: 
‘‘Sec. 1332A. Waiver for State universal health care.’’. 
Æ 
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