I 
113TH CONGRESS 
1ST SESSION H. R. 3607 
To enable States to opt out of certain provisions of the Patient Protection 
and Affordable Care Act. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 21, 2013 
Mr. MULVANEY (for himself and Mr. GOWDY) 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 enable States to opt out of certain provisions of the 
Patient Protection and Affordable Care Act. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘State Health Care 
Choice Act’’. 
SEC. 2. PURPOSE. 
It is the purpose of this Act to protect States’ rights 
and to ensure that States have the option to continue to 
implement State laws relating to health care delivery and 
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health insurance that were in effect prior to the date of 
enactment of the Patient Protection and Affordable Care 
Act (Public Law 111–148). 
SEC. 3. PROTECTION OF STATE FLEXIBILITY TO PROVIDE 
HEALTH COVERAGE. 
(a) STATE OPT OUT OF CERTAIN PROVISIONS OF 
PPACA.— 
(1) IN GENERAL.—A State described in sub-
section (b) may elect to limit the application of any 
or all of the provisions of the Patient Protection and 
Affordable Care Act (Public Law 111–148) de-
scribed in paragraph (2) with respect to health in-
surance coverage within that State. 
(2) PROVISIONS DESCRIBED.—The provisions of 
the Patient Protection and Affordable Care Act de-
scribed in this paragraph are as follows: 
(A) Subtitles A through C of title I (and 
the amendments made by such subtitles), ex-
cept for sections 1253 and 1254. 
(B) Parts I, II, III, and V of subtitle D of 
title I (and the amendments made by such 
parts). 
(C) Part I of subtitle E of title I (and the 
amendments made by such part). 
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(D) Subtitle F of title I (and the amend-
ments made by such part). 
(E) Section 1561 (and the amendment 
made by such section). 
(F) Sections 10101 through 10107 (and 
the amendments made by such sections). 
(b) STATE DESCRIBED.— 
(1) ENACTMENT OF STATE LAW.—A State de-
scribed in this subsection is a State that enacts a 
law after the date of enactment of this Act that— 
(A) expresses the intent of the State to opt 
out of one or more of the provisions of the Pa-
tient Protection and Affordable Care Act (Pub-
lic Law 111–148) described in subsection (a); 
(B) contains a list of the provisions of such 
Act which will not apply to the State under the 
State law; and 
(C) expresses the intent of the State to 
continue to administer health coverage-related 
laws as in effect in the State on March 23, 
2010, or that provides for the implementation 
of related State laws enacted after such date. 
(2) REPEAL.—If a State repeals a law de-
scribed in paragraph (1), the provisions of the Pa-
tient Protection and Affordable Care Act listed in 
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such law shall apply with respect to such State be-
ginning on the date of such repeal. 
(c) REGULATIONS.—The Secretary of Health and 
Human Services, in consultation with the Secretary of the 
Treasury, shall promulgate regulations to provide for the 
implementation of this Act. 
Æ 
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