shall follow the procedure described in sub-
section (c)(1). 
(c) FLOOR CONSIDERATION.— 
(1) MOTION TO PROCEED.—If a motion to dis-
charge made pursuant to subsection (b)(2)(B)(i) or 
(b)(2)(B)(ii) is adopted, then, not earlier than 5 leg-
islative days after the date on which the motion to 
discharge is adopted, a motion may be made to pro-
ceed to the bill. 
(2) FAILURE OF MOTION.—If the motion to dis-
charge made pursuant to subsection (b)(2)(B)(i) or 
(b)(2)(B)(ii) fails, such motion may be made not 
more than 2 additional times, but in no case more 
frequently than within 30 days of the previous mo-
tion. Debate on each of such motions shall be limited 
to 5 hours, equally divided. 
(3) APPLICABLE RULES.—Once the Senate is 
debating the implementing legislation the regular 
rules of the Senate shall apply. 
TITLE IV—STATE WAIVERS 
SEC. 401. STATE WAIVERS. 
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, a State may apply to the Secretary of Health 
and Human Services for waivers of such provisions of law 
as may be necessary for the State to implement policies
that make comprehensive, affordable health coverage 
available for all State residents, including access to essen-
tial benefits with limits on cost-sharing, as provided in the 
most recent report under section 301(e)(2). 
(b) REQUIREMENTS.—In order to ensure that waivers 
under this section benefit rather than harm health care 
consumers, a State shall not be eligible for a waiver under 
this section unless—
(1) the State reasonably expects to achieve a 
level of enrollment in coverage described in sub-
section (a) that is at least equal to the level of cov-
erage (taking into account the number of insured in-
dividuals, covered benefits, and premium and out-of-
pocket costs to the consumer for such coverage) that 
the State would have achieved if the State had fully 
implemented the coverage options available under ti-
tles I and II of this Act; 
(2) no individual who would have qualified for 
assistance under the State medicaid program under 
title XIX of the Social Security Act or the State 
children’s health insurance program under title XXI 
of such Act, as of either the date of the waiver re-
quest or the date of enactment of this Act, will be 
denied eligibility for such program, have a reduction 
in benefits under such program, have reduced access
to geographically and linguistically appropriate care 
or essential community providers, or be subject to 
increased premiums or cost-sharing under the waiver 
program under this section; and 
(3) the State agrees to comply with such stand-
ards or guidelines as the Secretary of Health and 
Human Services may require to ensure that the re-
quirements of paragraphs (1) and (2) are satisfied. 
(c) FEDERAL PAYMENTS.—
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall pay a State with a waiver ap-
proved under this section an amount each quarter 
equal to the sum of—
(A) the Federal payments the State and 
residents of the State (including, but not lim-
ited to, through the credit allowed under section 
36 of the Internal Revenue Code of 1986 for 
health insurance costs) would have received if 
the State had exercised the coverage options 
under titles I and II of this Act with respect to 
residents of the State who have not attained 
age 65; and 
(B) the amount of any grants authorized 
by this Act that the State would have received 
if the State had applied for such grants.
(2) ADDITIONAL
PAYMENT
FOR
MEDICARE 
BENEFICIARIES UNDER AGE 65.—
(A) IN GENERAL.—In the case of a State 
that elects to enroll an individual described in 
subparagraph (B) in coverage described in sub-
section (a), the amount described in paragraph 
(1) with respect to a quarter shall be increased 
by the amount described in subparagraph (C). 
(B) INDIVIDUAL
DESCRIBED.—An indi-
vidual is described in this subparagraph if the 
individual—
(i) has not attained age 65; 
(ii) is eligible for coverage under title 
XVIII of the Social Security Act; and 
(iii) voluntarily elects to enroll in cov-
erage described in subsection (a). 
(C) AMOUNT
DESCRIBED.—The amount 
described in this subparagraph is the amount 
equal to the amount that the Federal Govern-
ment would have incurred with respect to a 
quarter for providing coverage to an individual 
described in subparagraph (B) under title 
XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.).
(d) IMPLEMENTATION DATE.—No State may submit 
a request for a waiver under this section before October 
1, 2007.
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