I 
112TH CONGRESS 
2D SESSION 
H. R. 6234 
To amend the Patient Protection and Affordable Care Act to provide for 
savings to the Federal Government by permitting pass-through funding 
for State authorized public entity health benefits pools. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 31, 2012 
Mr. HALL (for himself and Mr. THORNBERRY) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend the Patient Protection and Affordable Care Act 
to provide for savings to the Federal Government by 
permitting pass-through funding for State authorized 
public entity health benefits pools. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SAVINGS FROM STATE AUTHORIZED PUBLIC 
ENTITY HEALTH BENEFITS POOLS. 
The Patient Protection and Affordable Care Act 
(Public Law 111–148) is amended by inserting after sec-
tion 1332 (42 U.S.C. 18052) the following new section 
VerDate Mar 15 2010 
01:02 Aug 03, 2012
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H6234.IH
H6234
smartinez on DSK6TPTVN1PROD with BILLS
(and inserting a corresponding item in the table of con-
tents of the Act): 
‘‘SEC. 1332A. SAVINGS FROM STATE AUTHORIZED PUBLIC 
ENTITY BENEFITS POOLS. 
‘‘(a) APPLICATION.— 
‘‘(1) IN GENERAL.—A State authorized public 
entity health benefits pool (in this section referred to 
as a ‘pool’) may apply to the Secretary for a pass 
through of funding described in subsection (b) with 
respect to health care benefits provided through that 
pool for coverage years beginning on or after Janu-
ary 1, 2014. 
‘‘(2) APPROVAL
OF
APPLICATION.—The Sec-
retary shall approve such an application of a pool if 
the Secretary determines that the pool— 
‘‘(A) will provide coverage that is at least 
as comprehensive as the coverage defined in 
section 1302(b); 
‘‘(B) will provide coverage and cost sharing 
protections 
against 
excessive 
out-of-pocket 
spending that are at least as affordable as the 
provisions of this title would provide; and 
‘‘(C) will result in cost savings to the Fed-
eral Government because, due to the cost of 
providing health care benefits to individuals 
VerDate Mar 15 2010 
01:02 Aug 03, 2012
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H6234.IH
H6234
smartinez on DSK6TPTVN1PROD with BILLS
through the pool being less than the cost of 
providing health care benefits to such individ-
uals had they become participants in a qualified 
health plan offered through an Exchange, the 
payment amount under subsection (b) will be 
less than the total of premium tax credits, cost- 
sharing reductions, or small business credits 
that would otherwise be required if individuals 
and small employers in the pool were instead 
participants in an Exchange. 
‘‘(3) CONSIDERATION.—Not later than March 
1, 2013, the Secretary shall promulgate regulations 
relating to pass through of funding under this sec-
tion. The Secretary shall begin accepting applica-
tions under this section no later than July 1, 2013. 
‘‘(4) ADDITIONAL
CONSEQUENCES
OF
AP-
PROVAL.—An individual receiving health care bene-
fits through such a pool for which such an applica-
tion is approved under this section shall be treated, 
for purposes of section 5000A of the Internal Rev-
enue Code of 1986, as being covered under min-
imum essential coverage described in subsection 
(f)(1)(E) of such section. 
‘‘(b) PASS THROUGH OF FUNDING.— 
VerDate Mar 15 2010 
01:02 Aug 03, 2012
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H6234.IH
H6234
smartinez on DSK6TPTVN1PROD with BILLS
‘‘(1) IN GENERAL.—With respect to a pool ap-
plication under subsection (a)(1), under which indi-
viduals and small employers in the pool would not 
qualify for the premium tax credits, cost-sharing re-
ductions, or small business credits under sections 
36B or 45R of the Internal Revenue Code of 1986 
for which they would otherwise be eligible if they 
had entered an Exchange, the Secretary shall pro-
vide for an alternative means by which an aggregate 
amount determined under paragraph (2) shall be 
paid to the pool for purposes of implementing the 
application. 
‘‘(2) PAYMENT DETERMINATION.—The amount 
to be paid under paragraph (1) shall be deter-
mined— 
‘‘(A) based on the sum of premium tax 
credits, cost-sharing reductions, and small busi-
ness credits under sections 36B or 45R of the 
Internal Revenue Code of 1986 that would have 
been provided with respect to individuals in the 
pool had the health care benefits provided by 
the pool been a qualified health plan offered in 
an Exchange, but taking into account the lower 
cost of providing health care benefits to individ-
uals through the pool; and 
VerDate Mar 15 2010 
01:02 Aug 03, 2012
Jkt 019200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H6234.IH
H6234
smartinez on DSK6TPTVN1PROD with BILLS