226 
(C) the State will not discriminate among 
participants on the basis of any health status- 
related factor (as defined in section 2791(d)(9) 
of the Public Health Service Act), except to the 
extent a State wishes to focus on populations 
that otherwise would not obtain health insur-
ance because of such factors; and 
(D) the State will provide for such evalua-
tion, in coordination with the evaluation re-
quired under subsection (d), as the Secretary 
may specify. 
(2) APPLICATION.—The Secretary shall not 
provide a demonstration grant under the program to 
a State unless— 
(A) the State submits to the Secretary 
such an application, in such a form and man-
ner, as the Secretary specifies; 
(B) the application includes information 
regarding how the demonstration grant will ad-
dress issues such as governance, targeted popu-
lation, expected cost, and the continuation after 
the completion of the demonstration grant pe-
riod; and
227 
(C) the Secretary determines that the dem-
onstration grant will be used consistent with 
this section. 
(3) FOCUS.—A demonstration grant proposal 
under section need not cover all uninsured individ-
uals in a State or all health care benefits with re-
spect to such individuals. 
(d) EVALUATION.—The Secretary shall enter into a 
contract with an appropriate entity outside the Depart-
ment of Health and Human Services to conduct an overall 
evaluation of the program at the end of the program pe-
riod. Such evaluation shall include an analysis of improve-
ments in access, costs, quality of care, or choice of cov-
erage, under different demonstration grants. 
(e) OPTION TO PROVIDE FOR INITIAL PLANNING 
GRANTS.—Notwithstanding the previous provisions of this 
section, under the program the Secretary may provide for 
a portion of the amounts appropriated under subsection 
(f) (not to exceed $5,000,000) to be made available to any 
State for initial planning grants to permit States to de-
velop demonstration grant proposals under the previous 
provisions of this section. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated $100,000,000 for each 
fiscal year to carry out this section. Amounts appropriated
228 
under this subsection shall remain available until ex-
pended. 
(g) STATE DEFINED.—For purposes of this section, 
the term ‘‘State’’ has the meaning given such term for 
purposes of title XIX of the Social Security Act. 
TITLE 
VI—EFFECTIVE 
DATES; 
COORDINATION 
IN 
IMPLE-
MENTATION 
SEC. 601. EFFECTIVE DATES. 
(a) GROUP HEALTH COVERAGE.— 
(1) IN
GENERAL.—Subject to paragraph (2) 
and subsection (d), the amendments made by sec-
tions 201(a), 401, 501, and 502 (and title I insofar 
as it relates to such sections) shall apply with re-
spect to group health plans, and health insurance 
coverage offered in connection with group health 
plans, for plan years beginning on or after October 
1, 2006 (in this section referred to as the ‘‘general 
effective date’’). 
(2) TREATMENT OF COLLECTIVE BARGAINING 
AGREEMENTS.—In the case of a group health plan 
maintained pursuant to one or more collective bar-
gaining agreements between employee representa-
tives and one or more employers ratified before the 
date of the enactment of this Act, the amendments