promotes health or nutrition within the community 
in which the individual resides— 
‘‘(A) by serving as a liaison between com-
munities and health care agencies; 
‘‘(B) by providing guidance and social as-
sistance to community residents; 
‘‘(C) by enhancing community residents’ 
ability to effectively communicate with health 
care providers; 
‘‘(D) by providing culturally and linguis-
tically appropriate health or nutrition edu-
cation; 
‘‘(E) by advocating for individual and com-
munity health or nutrition needs; and 
‘‘(F) by providing referral and followup 
services. 
‘‘(f) APPROPRIATION.— 
‘‘(1) IN GENERAL.—There is appropriated, out 
of any money in the Treasury not otherwise appro-
priated, for the purpose of awarding grants under 
this section $100,000,000 for each of fiscal years 
2008 through 2012. 
‘‘(2) GRANTS IN ADDITION TO OTHER AMOUNTS 
PAID.—Amounts appropriated and paid under the 
authority of this section shall be in addition to 
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amounts appropriated under section 2104 and paid 
to States in accordance with section 2105, including 
with respect to expenditures for outreach activities 
in accordance with subsections (a)(1)(D)(iii) and 
(c)(2)(C) of that section. 
‘‘(g) NATIONAL ENROLLMENT CAMPAIGN.—From 
the amounts made available under subsection (a)(2) for 
a fiscal year, the Secretary shall develop and implement 
a national enrollment campaign to improve the enrollment 
of underserved child populations in the programs estab-
lished under this title and title XIX. Such campaign may 
include— 
‘‘(1) the establishment of partnerships with the 
Secretary of Education and the Secretary of Agri-
culture to develop national campaigns to link the eli-
gibility and enrollment systems for the assistance 
programs each Secretary administers that often 
serve the same children; 
‘‘(2) the integration of information about the 
programs established under this title and title XIX 
in public health awareness campaigns administered 
by the Secretary; 
‘‘(3) increased financial and technical support 
for enrollment hotlines maintained by the Secretary 
to ensure that all States participate in such hotlines; 
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‘‘(4) the establishment of joint public awareness 
outreach initiatives with the Secretary of Education 
and the Secretary of Labor regarding the impor-
tance of health insurance to building strong commu-
nities and the economy; 
‘‘(5) the development of special outreach mate-
rials for Native Americans or for individuals with 
limited English proficiency; and 
‘‘(6) such other outreach initiatives as the Sec-
retary determines would increase public awareness of 
the programs under this title and title XIX.’’. 
(b) NONAPPLICATION OF ADMINISTRATIVE EXPENDI-
TURES CAP.—Section 2105(c)(2) of the Social Security 
Act (42 U.S.C. 1397ee(c)(2)) is amended by adding at the 
end the following: 
‘‘(C) NONAPPLICATION TO EXPENDITURES 
FOR OUTREACH AND ENROLLMENT.—The limi-
tation under subparagraph (A) shall not apply 
with respect to expenditures for outreach activi-
ties under section 2102(c)(1), or for enrollment 
activities, for children eligible for child health 
assistance under the State child health plan or 
medical assistance under the State plan under 
title XIX.’’. 
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TITLE II—CHILD HEALTH INSUR-
ANCE COVERAGE THROUGH 
TAX FAIRNESS 
SEC. 201. EXPANSION OF CHILD HEALTH CARE INSURANCE 
COVERAGE THROUGH TAX FAIRNESS. 
(a) IN GENERAL.—Subpart C of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
1986 (relating to refundable credits) is amended by redes-
ignating section 36 as section 37 and by inserting after 
section 35 the following new section: 
‘‘SEC. 36. CHILD HEALTH INSURANCE COSTS. 
‘‘(a) IN GENERAL.—In the case of an eligible tax-
payer, there shall be allowed as a credit against the tax 
imposed by this subtitle an amount equal to the amount 
paid by the taxpayer during the taxable year for qualified 
health insurance for any dependent child of such taxpayer. 
‘‘(b) LIMITATIONS.— 
‘‘(1) IN GENERAL.—The amount allowed as a 
credit under subsection (a) to an eligible taxpayer 
for the taxable year shall not exceed the sum of the 
monthly limitations for coverage months during such 
taxable year for the individual referred to in sub-
section (a) for whom such taxpayer paid during the 
taxable year any amount for coverage under quali-
fied health insurance. 
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‘‘(2) MONTHLY LIMITATION.—The monthly lim-
itation for an individual for each coverage month of 
such individual during the taxable year is the 
amount equal to 1⁄12th of $1,400. 
‘‘(3) COVERAGE MONTH.—For purposes of this 
subsection— 
‘‘(A) IN
GENERAL.—The term ‘coverage 
month’ means, with respect to an individual, 
any month if— 
‘‘(i) as of the first day of such month 
such individual is covered by qualified 
health insurance, and 
‘‘(ii) the premium for coverage under 
such insurance for such month is paid by 
an eligible taxpayer. 
‘‘(B) MEDICARE
AND
MEDICAID.—Such 
term shall not include any month with respect 
to an individual if, as of the first day of such 
month, such individual— 
‘‘(i) is entitled to any benefits under 
title XVIII of the Social Security Act, or 
‘‘(ii) is a participant in the program 
under title XIX or XXI of such Act. 
‘‘(C) CERTAIN
OTHER
COVERAGE.—Such 
term shall not include any month during a tax-
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able year with respect to an individual if, at any 
time during such year, any benefit is provided 
to such individual under chapter 89 of title 5, 
United States Code. 
‘‘(D) INSUFFICIENT PRESENCE IN UNITED 
STATES.—Such term shall not include any 
month during a taxable year with respect to an 
individual if such individual is present in the 
United States on fewer than 183 days during 
such year (determined in accordance with sec-
tion 7701(b)(7)). 
‘‘(4) INDEXING.—For each taxable year begin-
ning after December 31, 2008, the dollar amount in 
paragraph (2) (as adjusted for the preceding taxable 
year by reason of this paragraph) shall be increased 
or decreased by the percentage change in the aver-
age cost of private health insurance for family cov-
erage for such taxable year as compared to such pre-
ceding taxable year as computed by the Office of the 
Actuary of the Centers for Medicare and Medicaid 
Services, rounded to the nearest whole dollar 
amount. 
‘‘(c) QUALIFIED HEALTH INSURANCE.—For pur-
poses of this section— 
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‘‘(1) IN GENERAL.—The term ‘qualified health 
insurance’ means insurance which constitutes med-
ical care as defined in section 213(d) without regard 
to— 
‘‘(A) paragraph (1)(C) thereof, and 
‘‘(B) so much of paragraph (1)(D) thereof 
as relates to qualified long-term care insurance 
contracts. 
‘‘(2) EXCLUSION
OF
CERTAIN
OTHER
CON-
TRACTS.—Such term shall not include insurance if a 
substantial portion of its benefits are excepted bene-
fits (as defined in section 9832(c)). 
‘‘(d) ELIGIBLE TAXPAYER; DEPENDENT; CHILD.— 
For purposes of this section— 
‘‘(1) ELIGIBLE TAXPAYER.—The term ‘eligible 
taxpayer’ means any taxpayer whose income exceeds 
200 percent but not 300 percent of the poverty level 
applicable to a family of the size involved, as deter-
mined in accordance with criteria established by the 
Director of the Office of Management and Budget. 
‘‘(2) DEPENDENT.—The term ‘dependent’ has 
the meaning given such term by section 152. An in-
dividual to whom section 152(e) applies shall be 
treated as a dependent of the custodial parent for a 
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coverage month unless the custodial and noncusto-
dial parent provide otherwise. 
‘‘(3) CHILD.—The term ‘child’ means a quali-
fying child (as defined in section 152(c). 
‘‘(e) SPECIAL RULES.— 
‘‘(1) COORDINATION
WITH
MEDICAL
DEDUC-
TION, ETC.—Any amount paid by an eligible tax-
payer for insurance to which subsection (a) applies 
shall not be taken into account in computing the 
amount allowable to such taxpayer as a credit under 
section 35, as a deduction under section 213(a) or 
162(l), or as an exclusion from gross income under 
section 106 or 125. 
‘‘(2) DENIAL OF CREDIT TO DEPENDENTS.—No 
credit shall be allowed under this section to any indi-
vidual with respect to whom a deduction under sec-
tion 151 is allowable to another taxpayer for a tax-
able year beginning in the calendar year in which 
such individual’s taxable year begins. 
‘‘(3) MARRIED COUPLES MUST FILE JOINT RE-
TURN.— 
‘‘(A) IN GENERAL.—If an eligible taxpayer 
is married at the close of the taxable year, the 
credit shall be allowed under subsection (a) only 
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if the taxpayer and his spouse file a joint return 
for the taxable year. 
‘‘(B) MARITAL STATUS; CERTAIN MARRIED 
INDIVIDUALS LIVING APART.—Rules similar to 
the rules of paragraphs (3) and (4) of section 
21(e) shall apply for purposes of this para-
graph. 
‘‘(4) VERIFICATION
OF
COVERAGE, ETC.—No 
credit shall be allowed under this section with re-
spect to any individual unless such individual’s cov-
erage (and such related information as the Secretary 
may require) is verified in such manner as the Sec-
retary may prescribe. 
‘‘(5) INSURANCE WHICH COVERS OTHER INDI-
VIDUALS; TREATMENT OF PAYMENTS.—Rules similar 
to the rules of paragraphs (7) and (8) of section 
35(g) shall apply for purposes of this section. 
‘‘(6) ELECTION NOT TO CLAIM CREDIT.—This 
section shall not apply to an eligible taxpayer for 
any taxable year if such taxpayer elects to have this 
section not apply for such taxable year. 
‘‘(f) COORDINATION WITH ADVANCE PAYMENTS.— 
With respect to any taxable year, the amount which would 
(but for this subsection) be allowed as a credit to an eligi-
ble taxpayer under subsection (a) shall be reduced (but 
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not below zero) by the aggregate amount paid on behalf 
of such taxpayer under section 7527A for months begin-
ning in such taxable year.’’. 
(b) INFORMATION REPORTING.— 
(1) IN GENERAL.—Subpart B of part III of 
subchapter A of chapter 61 of the Internal Revenue 
Code of 1986 (relating to information concerning 
transactions with other persons) is amended by in-
serting after section 6050V the following new sec-
tion: 
‘‘SEC. 6050W. RETURNS RELATING TO PAYMENTS FOR 
QUALIFIED HEALTH INSURANCE. 
‘‘(a) IN GENERAL.—Any person who, in connection 
with a trade or business conducted by such person, re-
ceives payments during any calendar year from any indi-
vidual for coverage of such individual or any other indi-
vidual under qualified health insurance (as defined in sec-
tion 36(c)), shall make the return described in subsection 
(b) (at such time as the Secretary may by regulations pre-
scribe) with respect to each individual from whom such 
payments were received. 
‘‘(b) FORM AND MANNER OF RETURNS.—A return 
is described in this subsection if such return— 
‘‘(1) is in such form as the Secretary may pre-
scribe, and 
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‘‘(2) contains— 
‘‘(A) the name, address, and TIN of the 
individual from whom payments described in 
subsection (a) were received, 
‘‘(B) the name, address, and TIN of each 
individual who was provided by such person 
with coverage under qualified health insurance 
(as so defined) by reason of such payments and 
the period of such coverage, and 
‘‘(C) such other information as the Sec-
retary may reasonably prescribe. 
‘‘(c) STATEMENTS TO BE FURNISHED TO INDIVID-
UALS WITH RESPECT TO WHOM INFORMATION IS RE-
QUIRED.—Every person required to make a return under 
subsection (a) shall furnish to each individual whose name 
is required under subsection (b)(2)(A) to be set forth in 
such return a written statement showing— 
‘‘(1) the name and address of the person re-
quired to make such return and the phone number 
of the information contact for such person, 
‘‘(2) the aggregate amount of payments de-
scribed in subsection (a) received by the person re-
quired to make such return from the individual to 
whom the statement is required to be furnished, and 
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‘‘(3) the information required under subsection 
(b)(2)(B) with respect to such payments. 
The written statement required under the preceding sen-
tence shall be furnished on or before January 31 of the 
year following the calendar year for which the return 
under subsection (a) is required to be made. 
‘‘(d) RETURNS WHICH WOULD BE REQUIRED TO BE 
MADE BY 2 OR MORE PERSONS.—Except to the extent 
provided in regulations prescribed by the Secretary, in the 
case of any amount received by any person on behalf of 
another person, only the person first receiving such 
amount shall be required to make the return under sub-
section (a).’’. 
(2) ASSESSABLE PENALTIES.— 
(A) 
Subparagraph 
(B) 
of 
section 
6724(d)(1) of such Code (relating to defini-
tions) is amended by redesignating clauses (xv) 
through (xx) as clauses (xvi) through (xxi), re-
spectively, and by inserting after clause (xi) the 
following new clause: 
‘‘(xv) section 6050W (relating to re-
turns relating to payments for qualified 
health insurance),’’. 
(B) Paragraph (2) of section 6724(d) of 
such Code is amended by striking the period at 
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the end of subparagraph (CC) and inserting ‘‘, 
or’’ and by adding at the end the following new 
subparagraph: 
‘‘(DD) section 6050W(c) (relating to re-
turns relating to payments for qualified health 
insurance).’’. 
(3) CLERICAL AMENDMENT.—The table of sec-
tions for subpart B of part III of subchapter A of 
chapter 61 of such Code is amended by inserting 
after the item relating to section 6050V the fol-
lowing new item: 
‘‘Sec. 6050W. Returns relating to payments for qualified health insurance.’’. 
(c) ADVANCE
PAYMENT
OF
CREDIT
FOR
PUR-
CHASERS OF QUALIFIED HEALTH INSURANCE.— 
(1) IN GENERAL.—Chapter 77 of the Internal 
Revenue Code of 1986 (relating to miscellaneous 
provisions) is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 7529. ADVANCE PAYMENT OF HEALTH INSURANCE 
CREDIT FOR PURCHASERS OF QUALIFIED 
HEALTH INSURANCE. 
‘‘(a) GENERAL RULE.—In the case of an eligible indi-
vidual, the Secretary shall make payments to the provider 
of such individual’s qualified health insurance equal to 
such individual’s qualified health insurance credit advance 
amount with respect to such provider. 
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‘‘(b) ELIGIBLE INDIVIDUAL.—For purposes of this 
section, the term ‘eligible individual’ means any indi-
vidual— 
‘‘(1) who purchases qualified health insurance 
(as defined in section 36(c)), and 
‘‘(2) for whom a qualified health insurance 
credit eligibility certificate is in effect. 
‘‘(c) QUALIFIED HEALTH INSURANCE CREDIT ELIGI-
BILITY CERTIFICATE.—For purposes of this section, a 
qualified health insurance credit eligibility certificate is a 
statement furnished by an individual to the Secretary 
which— 
‘‘(1) certifies that the individual will be eligible 
to receive the credit provided by section 36 for the 
taxable year, 
‘‘(2) estimates the amount of such credit for 
such taxable year, and 
‘‘(3) provides such other information as the 
Secretary may require for purposes of this section. 
‘‘(d) QUALIFIED HEALTH INSURANCE CREDIT AD-
VANCE AMOUNT.—For purposes of this section, the term 
‘qualified health insurance credit advance amount’ means, 
with respect to any provider of qualified health insurance, 
the Secretary’s estimate of the amount of credit allowable 
under section 36 to the individual for the taxable year 
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which is attributable to the insurance provided to the indi-
vidual by such provider. 
‘‘(e) REGULATIONS.—The Secretary shall prescribe 
such regulations as may be necessary to carry out the pur-
poses of this section.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions for chapter 77 of such Code is amended by 
adding at the end the following new item: 
‘‘Sec. 7529. Advance payment of health insurance credit for purchasers of 
qualified health insurance.’’. 
(d) CONFORMING AMENDMENTS.— 
(1) Paragraph (2) of section 1324(b) of title 
31, United States Code, is amended by inserting be-
fore the period ‘‘, or from section 36 of such Code’’. 
(2) The table of sections for subpart C of part 
IV of subchapter A of chapter 1 of the Internal Rev-
enue Code of 1986 is amended by striking the last 
item and inserting the following new items: 
‘‘Sec. 36. Health insurance costs. 
‘‘Sec. 37. Overpayments of tax.’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2007. 
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TITLE III—STATE HEALTH 
REFORM PROJECTS 
SEC. 301. STATE HEALTH REFORM PROJECTS. 
(a) PURPOSES; ESTABLISHMENT OF STATE HEALTH 
CARE EXPANSION AND IMPROVEMENT PROGRAM.— 
(1) PURPOSES.—The purposes of the programs 
approved under this section shall include, but not be 
limited to— 
(A) achieving the goals of increased health 
coverage and access; and 
(B) testing alternative reforms, such as 
building on the public or private health systems, 
or creating new systems, to achieve the objec-
tives of this Act. 
(2) INTENT OF CONGRESS.—It is the intent of 
Congress that— 
(A) the programs approved under this sec-
tion each comprise significant coverage expan-
sions; 
(B) taken as a whole, such programs 
should be diverse and balanced in their ap-
proaches to covering the uninsured; and 
(C) each such program should be rigor-
ously and objectively evaluated, so that the 
State programs developed pursuant to this sec-
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tion may guide the development of future State 
and national policy. 
(b) APPLICATIONS BY STATES AND LOCAL GOVERN-
MENTS.— 
(1) ENTITIES THAT MAY APPLY.— 
(A) IN GENERAL.—A State may apply for 
a State health care expansion and improvement 
program for the entire State (or for regions of 
the State) under paragraph (2). 
(B) REGIONAL AND SUB-STATE GROUPS.— 
A regional entity consisting of more than one 
State or one or more local governments within 
a State may apply for a multi-State or a sub- 
state health care expansion and improvement 
program for the region or area involved. 
(C) DEFINITION.—In this section, the 
term ‘‘State’’ means the 50 States, the District 
of Columbia, and the Commonwealth of Puerto 
Rico. Such term shall include a regional entity 
described in subparagraph (B). 
(2) SUBMISSION OF APPLICATION.—In accord-
ance with this section, each State or regional entity 
desiring to implement a State health care expansion 
and improvement program may submit an applica-
tion to the State Health Coverage Innovation Com-
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mission under subsection (c) (referred to in this sec-
tion as the ‘‘Commission’’) for approval. 
(3) LOCAL
GOVERNMENT
APPLICATIONS.— 
Where a State fails to submit an application under 
this section, a unit of local government of such 
State, or a consortium of such units of local govern-
ments, may submit an application directly to the 
Commission for programs or projects under this sub-
section. Such an application shall be subject to the 
requirements of this section. 
(c) STATE HEALTH COVERAGE INNOVATION COM-
MISSION.— 
(1) IN
GENERAL.—Within 90 days after the 
date of the enactment of this Act, the Secretary of 
Health and Human Services (in this section referred 
to as the ‘‘Secretary’’) shall establish a State Health 
Coverage Innovation Commission that— 
(A) shall be comprised of— 
(i) the Secretary; 
(ii) four State governors to be ap-
pointed by the National Governors Associa-
tion on a bipartisan basis; 
(iii) two members of a State legisla-
ture to be appointed, on a joint and bipar-
tisan basis, by the National Conference of 
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State Legislators and the American Legis-
lative Exchange Council; 
(iv) two county officials to be ap-
pointed by the National Association of 
Counties on a bipartisan basis; 
(v) two mayors to be appointed, on a 
joint and bipartisan basis, by the National 
League of Cities and by the United States 
Conference of Mayors; 
(vi) two individuals to be appointed by 
the Speaker of the House of Representa-
tives; 
(vii) two individuals to be appointed 
by the minority leader of the House of 
Representatives; 
(viii) two individuals to be appointed 
by the majority leader of the Senate; and 
(ix) two individuals to be appointed by 
the minority leader of the Senate; 
(B) shall request States to submit pro-
posals, which may include a variety of reform 
options such as tax credit approaches, expan-
sions of public programs such as Medicaid and 
the State Children’s Health Insurance Pro-
gram, the creation of purchasing pooling ar-
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rangements similar to the Federal Employees 
Health Benefits Program, individual market 
purchasing options, single risk pool or single 
payer systems, health savings accounts, a com-
bination of the options described in this sub-
paragraph, or other alternatives determined ap-
propriate by the Commission, including options 
suggested by States or the public, and nothing 
in this subparagraph shall be construed to pre-
vent the Commission from approving a reform 
proposal not included in this subparagraph; 
(C) shall conduct a thorough review of the 
grant application from a State and carry on a 
dialogue with all State applicants concerning 
possible modifications and adjustments; 
(D) shall submit the recommendations and 
legislative proposal described in subsection 
(d)(4)(C); 
(E) shall be responsible for receiving infor-
mation to determine the status and progress 
achieved under program or projects granted 
under this section; 
(F) shall report to the public concerning 
progress made by States with respect to the 
performance measures and goals established 
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under this section, the periodic progress of the 
State relative to its State performance meas-
ures and goals, and the State program applica-
tion procedures, by region and State jurisdic-
tion; 
(G) shall promote information exchange 
between States and the Federal Government; 
(H) shall be responsible for making rec-
ommendations to the Secretary and the Con-
gress, using equivalency or minimum standards, 
for minimizing the negative effect of State pro-
gram on national employer groups, provider or-
ganizations, and insurers because of differing 
State requirements under the programs; and 
(I) may require States to submit additional 
information or reports concerning the status 
and progress achieved under health care expan-
sion and improvement programs granted under 
this section, as needed. 
(2) PERIOD
OF
APPOINTMENT; REPRESENTA-
TION
REQUIREMENTS; VACANCIES.—Members shall 
be appointed for a term of 5 years. In appointing 
such members under paragraph (1)(A), the des-
ignated appointing individuals shall ensure the rep-
resentation of urban and rural areas and an appro-
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priate geographic distribution of such members. Any 
vacancy in the Commission shall not affect its pow-
ers, but shall be filled in the same manner as the 
original appointment. 
(3) CHAIRPERSON, MEETINGS.— 
(A) CHAIRPERSON.—The Commission shall 
select a Chairperson from among its members. 
(B) QUORUM.—Two-thirds of the members 
of the Commission shall constitute a quorum, 
but a lesser number of members may hold hear-
ings. 
(C) MEETINGS.—Not later than 30 days 
after the date on which all members of the 
Commission have been appointed, the Commis-
sion shall hold its first meeting. The Commis-
sion shall meet at the call of the Chairperson. 
(4) POWERS OF THE COMMISSION.— 
(A) NEGOTIATIONS
WITH
STATES.—The 
Commission may conduct detailed discussions 
and negotiations with States submitting appli-
cations under this section, either individually or 
in groups, to facilitate a final set of rec-
ommendations 
for 
purposes 
of 
subsection 
(d)(4)(C). 
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(B) HEARINGS.—The Commission may 
hold such hearings, sit and act at such times 
and places, take such testimony, and receive 
such evidence as the Commission considers ad-
visable to carry out the purposes of this sub-
section. 
(C) MEETINGS.—In addition to other 
meetings the Commission may hold, the Com-
mission shall hold an annual meeting with the 
participating States under this section for the 
purpose of having States report progress to-
ward the purposes in subsection (a) and for an 
exchange of information. 
(D) INFORMATION.—The Commission may 
secure directly from any Federal department or 
agency such information as the Commission 
considers necessary to carry out the provisions 
of this subsection. Upon request of the Chair-
person of the Commission, the head of such de-
partment or agency shall furnish such informa-
tion to the Commission if the head of the de-
partment or agency involved determines it ap-
propriate. 
(E) POSTAL SERVICES.—The Commission 
may use the United States mails in the same 
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manner and under the same conditions as other 
departments and agencies of the Federal Gov-
ernment. 
(5) PERSONNEL MATTERS.— 
(A) COMPENSATION.—Each member of the 
Commission who is not an officer or employee 
of the Federal Government or of a State or 
local government shall be compensated at a rate 
equal to the daily equivalent of the annual rate 
of basic pay prescribed for level IV of the Exec-
utive Schedule under section 5315 of title 5, 
United States Code, for each day (including 
travel time) during which such member is en-
gaged in the performance of the duties of the 
Commission. All members of the Commission 
who are officers or employees of the United 
States shall serve without compensation in addi-
tion to that received for their services as offi-
cers or employees of the United States. 
(B) TRAVEL EXPENSES.—The members of 
the Commission shall be allowed travel ex-
penses, including per diem in lieu of subsist-
ence, at rates authorized for employees of agen-
cies under subchapter I of chapter 57 of title 5, 
United States Code, while away from their 
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homes or regular places of business in the per-
formance of services for the Commission. 
(C) STAFF.—The Chairperson of the Com-
mission may, without regard to the civil service 
laws and regulations, appoint and terminate an 
executive director and such other additional 
personnel as may be necessary to enable the 
Commission to perform its duties. The employ-
ment of an executive director shall be subject to 
confirmation by the Commission. 
(D) DETAIL
OF
GOVERNMENT
EMPLOY-
EES.—Any Federal Government employee may 
be detailed to the Commission without reim-
bursement, and such detail shall be without 
interruption or loss of civil service status or 
privilege. 
(E) 
TEMPORARY
AND
INTERMITTENT 
SERVICES.—The Chairperson of the Commis-
sion may procure temporary and intermittent 
services under section 3109(b) of title 5, United 
States Code, at rates for individuals which do 
not exceed the daily equivalent of the annual 
rate of basic pay prescribed for level V of the 
Executive Schedule under section 5316 of such 
title. 
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hsrobinson on PROD1PC76 with BILLS
(6) FUNDING.—For the purpose of carrying out 
this subsection, there are authorized to be appro-
priated $3,000,000 for fiscal year 2008 and each fis-
cal year thereafter. 
(d) REQUIREMENTS FOR PROGRAMS.— 
(1) STATE PLAN.—A State that seeks to oper-
ate a program under this section shall prepare and 
submit to the Commission, as part of the application 
under subsection (b), a State health care plan that 
shall have as its goal increased coverage, and in 
service of that goal such additional goals as improve-
ments in quality, efficiency, cost-effectiveness, and 
the appropriate use of information technology. To 
achieve such goal, the State plan shall comply with 
the following: 
(A) COVERAGE.— 
(i) IN
GENERAL.—With respect to 
coverage, the State plan shall— 
(I) provide and describe the man-
ner in which the State will ensure that 
an increased number of individuals re-
siding within the State will have ex-
panded access to health care coverage 
with a specific 5-year target for reduc-
tion in the number or proportion of 
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hsrobinson on PROD1PC76 with BILLS
uninsured individuals through either 
private or public program expansion, 
or both, in accordance with or in addi-
tion to the options established by the 
Commission; 
(II) describe the number and per-
centage of current uninsured individ-
uals who will achieve coverage under a 
State health program; 
(III) describe the coverage that 
will be provided to beneficiaries under 
a State health program; 
(IV) identify Federal, State, or 
local and private programs that cur-
rently provide health care services in 
the State and describe how such pro-
grams could be coordinated with a 
State health program, to the extent 
practicable; and 
(V) provide for improvements in 
the availability of appropriate health 
care coverage that will increase access 
to care in urban, suburban, rural, and 
frontier areas of the State with medi-
cally 
underserved 
populations 
or 
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where there may be an inadequate 
supply of health care providers. 
(ii) COVERAGE
OPTIONS.—The cov-
erage under the State plan may be— 
(I) health insurance coverage 
that meets the aggregate actuarial 
value 
requirement 
of 
section 
2103(a)(2)(B) of the Social Security 
Act (42 U.S.C. 1397cc(a)(2)(B)); 
(II) a combination of health in-
surance coverage and a consumer-di-
rected health care spending account, if 
the actuarial value of such coverage 
plus the amount of annual deposits 
into such account from sources other 
than the beneficiary is not less than 
the actuarial value amount described 
in subclause (I); or 
(III) health care access not less 
on 
average 
than 
that 
provided 
through coverage described in sub-
clause (I). 
(iii) CONSTRUCTION.—Nothing in this 
clause shall be construed to limit in any 
way the authority of the Secretary of 
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Health and Human Services to issue waiv-
ers under section 1115 of the Social Secu-
rity Act. 
(B) QUALITY.—With respect to quality, 
the State plan may describe efforts to improve 
health care quality in the State, including an 
explanation of how such efforts would change 
(if at all) under the State plan. 
(C) COSTS.—With respect to costs, the 
State plan shall— 
(i) describe such steps as the State 
may undertake to improve the efficiency of 
health care; 
(ii) describe the public and private 
sector financing to be provided for the 
State health program; 
(iii) estimate the amount of Federal, 
State, and local expenditures, as well as, 
the costs to business and individuals under 
the State health program; and 
(iv) describe how the State plan will 
ensure the financial solvency of the State 
health program. 
(D) 
HEALTH
INFORMATION
TECH-
NOLOGY.—With respect to health information 
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technology, the State plan may describe efforts 
to improve the appropriate use of health infor-
mation technology, including an explanation of 
how such efforts would change (if at all) under 
the State plan. 
(E) EXCEPTIONS TO FEDERAL POLICIES.— 
The State plan shall describe the exceptions to 
otherwise applicable Federal statutes, regula-
tions, and policies that would apply within the 
geographic area and time period governed by 
the plan. 
(2) TECHNICAL
ASSISTANCE.—The Secretary 
shall, if requested, provide technical assistance to 
States to assist such States in developing applica-
tions and plans under this section, including tech-
nical assistance by private sector entities if deter-
mined appropriate by the Commission. 
(3) INITIAL REVIEW.—With respect to a State 
application under subsection (b), the Secretary and 
the Commission shall complete an initial review of 
such State application within 60 days of the receipt 
of such application, analyze the scope of the pro-
posal, and determine whether additional information 
is needed from the State. The Commission shall ad-
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vise the State within such period of the need to sub-
mit additional information. 
(4) FINAL DETERMINATION.— 
(A) IN
GENERAL.—In a timely manner 
consistent with subparagraph (C), the Commis-
sion shall determine whether to submit a State 
proposal to Congress for approval. 
(B) VOTING.— 
(i) IN GENERAL.—The determination 
to submit a State proposal to Congress 
under subparagraph (A) shall be approved 
by 2⁄3 of the members of the Commission 
who are present and eligible to vote and a 
majority of the entire Commission. 
(ii) ELIGIBILITY.—A member of the 
Commission shall not participate in a de-
termination under subparagraph (A) if— 
(I) in the case of a member who 
is a Governor, such determination re-
lates to the State of which the mem-
ber is the Governor; or 
(II) in the case of member not 
described in subclause (I), such deter-
mination relates to the geographic 
area of a State of which such member 
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serves as a State or local official or as 
a Member of Congress. 
(C) SUBMISSION.—Not later than 90 days 
prior to October 1 of each fiscal year, the Com-
mission may submit to Congress a list, in the 
form of a legislative proposal, of the State ap-
plications that the Commission recommends for 
approval under this section. 
(5) PROGRAM OR PROJECT PERIOD.—A State 
program or project may be approved for a period of 
5 years and may be extended for a subsequent pe-
riod of time upon approval by the Commission, 
based upon achievement of targets. 
(e) EXPEDITED CONGRESSIONAL CONSIDERATION.— 
(1) INTRODUCTION AND EXPEDITED CONSIDER-
ATION IN THE HOUSE OF REPRESENTATIVES.— 
(A) INTRODUCTION
IN
HOUSE
OF
REP-
RESENTATIVES.—The legislative proposal sub-
mitted pursuant to subsection (d)(4)(C) shall be 
in the form of a joint resolution (in this sub-
section referred to as the ‘‘resolution’’). Such 
resolution shall be introduced in the House of 
Representatives by the Speaker immediately 
upon receipt of the language and shall be re-
ferred non-sequentially to the appropriate com-
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mittee (or committees) of House of Representa-
tives. If the resolution is not introduced in ac-
cordance with the preceding sentence, the reso-
lution may be introduced by any member of the 
House of Representatives. 
(B) COMMITTEE
CONSIDERATION.—Not 
later than 15 calendar days after the introduc-
tion of the resolution described in subparagraph 
(A), each committee of House of Representa-
tives to which the resolution was referred shall 
report the resolution. The report may include, 
at the committee’s discretion, a recommenda-
tion for action by the House. If a committee 
has not reported such resolution (or an iden-
tical resolution) at the end of 15 calendar days 
after its introduction or at the end of the first 
day after there has been reported to the House 
a resolution, whichever is earlier, such com-
mittee shall be deemed to be discharged from 
further consideration of such resolution and 
such resolution shall be placed on the appro-
priate calendar of the House of Representatives. 
(C) EXPEDITED PROCEDURE IN HOUSE.— 
Not later than 5 legislative days after the date 
on which all committees have been discharged 
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from consideration of a resolution, the Speaker 
of the House of Representatives, or the Speak-
er’s designee, shall move to proceed to the con-
sideration of the resolution. It shall also be in 
order for any member of the House of Rep-
resentatives to move to proceed to the consider-
ation of the resolution at any time after the 
conclusion of such 5-day period. All points of 
order against the resolution (and against con-
sideration of the resolution) are waived. A mo-
tion to proceed to the consideration of the reso-
lution is highly privileged in the House of Rep-
resentatives and is not debatable. The motion is 
not subject to amendment, to a motion to post-
pone consideration of the resolution, or to a mo-
tion to proceed to the consideration of other 
business. A motion to reconsider the vote by 
which the motion to proceed is agreed to or not 
agreed to shall not be in order. If the motion 
to proceed is agreed to, the House of Rep-
resentatives shall immediately proceed to con-
sideration of the resolution without intervening 
motion, order, or other business, and the reso-
lution shall remain the unfinished business of 
the House of Representatives until disposed of. 
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A motion to recommit the resolution shall not 
be in order. Upon its passage in the House, the 
clerk of the House shall provide for its imme-
diate transmittal to the Senate. 
(2) EXPEDITED CONSIDERATION IN THE SEN-
ATE.— 
(A) REFERRAL
TO
COMMITTEE.—If the 
resolution is agreed to by the House of Rep-
resentatives, upon its receipt in the Senate the 
majority leader of the Senate, or the leader’s 
designee, the resolution shall be referred to the 
appropriate committee of Senate. 
(B) COMMITTEE
CONSIDERATION.—Not 
later than 15 calendar days after the referral of 
the resolution under subparagraph (A), the 
committee of the Senate to which the resolution 
was referred shall report the resolution. The re-
port may include, at the committee’s discretion, 
a recommendation for action by the Senate. If 
a committee has not reported such resolution 
(or an identical resolution) at the end of 15 cal-
endar days after its referral or at the end of the 
first day after there has been reported to the 
Senate a resolution, whichever is earlier, such 
committee shall be deemed to be discharged 
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(ii) GROUP
HEALTH
PLANS
AND 
GROUP HEALTH INSURANCE COVERAGE.— 
If the State program or project provides 
for benefits through payment for, or a con-
tract with, a group health plan or group 
health insurance coverage, the program or 
project may permit the imposition of a pre-
existing condition exclusion but only inso-
far and to the extent that such exclusion is 
permitted under the applicable provisions 
of part 7 of subtitle B of title I of the Em-
ployee Retirement Income Security Act of 
1974 and title XXVII of the Public Health 
Service Act. 
(B) COMPLIANCE WITH OTHER REQUIRE-
MENTS.—Coverage offered under the program 
or project shall comply with the requirements of 
subpart 2 of part A of title XXVII of the Public 
Health Service Act insofar as such require-
ments apply with respect to a health insurance 
issuer that offers group health insurance cov-
erage. 
(2) 
PREVENTION
OF
DUPLICATIVE
PAY-
MENTS.— 
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