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operate at increased volume, and to apply stream-
lined verification and eligibility processes to other 
Federal and State programs, as appropriate. 
‘‘(6) Notification of eligibility, recertification, 
and other needed communication regarding eligi-
bility, which may include communication via email 
and cellular phones. 
‘‘(7) Other functionalities necessary to provide 
eligibles with streamlined enrollment process. 
‘‘(c) APPROVAL AND NOTIFICATION.—With respect to 
any standard or protocol developed under subsection (a) 
that has been approved by the HIT Policy Committee and 
the HIT Standards Committee, the Secretary— 
‘‘(1) shall notify States of such standards or pro-
tocols; and 
‘‘(2) may require, as a condition of receiving 
Federal funds for the health information technology 
investments, that States or other entities incorporate 
such standards and protocols into such investments. 
‘‘(d) GRANTS FOR IMPLEMENTATION OF APPROPRIATE 
ENROLLMENT HIT.— 
‘‘(1) IN GENERAL.—The Secretary shall award 
grant to eligible entities to develop new, and adapt 
existing, technology systems to implement the HIT en-
rollment standards and protocols developed under
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subsection (a) (referred to in this subsection as ‘ap-
propriate HIT technology’). 
‘‘(2) ELIGIBLE ENTITIES.—To be eligible for a 
grant under this subsection, an entity shall— 
‘‘(A) be a State, political subdivision of a 
State, or a local governmental entity; and 
‘‘(B) submit to the Secretary an application 
at such time, in such manner, and containing— 
‘‘(i) a plan to adopt and implement 
appropriate enrollment technology that in-
cludes— 
‘‘(I) proposed reduction in main-
tenance costs of technology systems; 
‘‘(II) elimination or updating of 
legacy systems; and 
‘‘(III) demonstrated collaboration 
with other entities that may receive a 
grant under this section that are lo-
cated in the same State, political sub-
division, or locality; 
‘‘(ii) an assurance that the entity will 
share such appropriate enrollment tech-
nology in accordance with paragraph (4); 
and
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‘‘(iii) such other information as the 
Secretary may require. 
‘‘(3) SHARING.— 
‘‘(A) IN GENERAL.—The Secretary shall en-
sure that appropriate enrollment HIT adopted 
under grants under this subsection is made 
available to other qualified State, qualified polit-
ical subdivisions of a State, or other appropriate 
qualified entities (as described in subparagraph 
(B)) at no cost. 
‘‘(B) QUALIFIED ENTITIES.—The Secretary 
shall determine what entities are qualified to re-
ceive enrollment HIT under subparagraph (A), 
taking into consideration the recommendations 
of the HIT Policy Committee and the HIT 
Standards Committee.’’. 
SEC. 1562. CONFORMING AMENDMENTS. 
(a) APPLICABILITY.—Section 2735 of the Public 
Health Service Act (42 U.S.C. 300gg–21), as so redesig-
nated by section 1001(4), is amended— 
(1) by striking subsection (a); 
(2) in subsection (b)— 
(A) in paragraph (1), by striking ‘‘1 
through 3’’ and inserting ‘‘1 and 2’’; and 
(B) in paragraph (2)—
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(i) in subparagraph (A), by striking 
‘‘subparagraph (D)’’ and inserting ‘‘sub-
paragraph (D) or (E)’’; 
(ii) by striking ‘‘1 through 3’’ and in-
serting ‘‘1 and 2’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(E) ELECTION
NOT
APPLICABLE.—The 
election described in subparagraph (A) shall not 
be available with respect to the provisions of sub-
part 1.’’; 
(3) in subsection (c), by striking ‘‘1 through 3 
shall not apply to any group’’ and inserting ‘‘1 and 
2 shall not apply to any individual coverage or any 
group’’; and 
(4) in subsection (d)— 
(A) in paragraph (1), by striking ‘‘1 
through 3 shall not apply to any group’’ and in-
serting ‘‘1 and 2 shall not apply to any indi-
vidual coverage or any group’’; 
(B) in paragraph (2)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘1 through 3 shall 
not apply to any group’’ and inserting ‘‘1
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and 2 shall not apply to any individual 
coverage or any group’’; and 
(ii) in subparagraph (C), by inserting 
‘‘or, with respect to individual coverage, 
under any health insurance coverage main-
tained by the same health insurance issuer’’; 
and 
(C) in paragraph (3), by striking ‘‘any 
group’’ and inserting ‘‘any individual coverage 
or any group’’. 
(b) DEFINITIONS.—Section 2791(d) of the Public 
Health Service Act (42 U.S.C. 300gg–91(d)) is amended by 
adding at the end the following: 
‘‘(20) QUALIFIED
HEALTH
PLAN.—The term 
‘qualified health plan’ has the meaning given such 
term in section 1301(a) of the Patient Protection and 
Affordable Care Act. 
‘‘(21) EXCHANGE.—The term ‘Exchange’ means 
an American Health Benefit Exchange established 
under section 1311 of the Patient Protection and Af-
fordable Care Act.’’. 
(c) TECHNICAL
AND CONFORMING AMENDMENTS.— 
Title XXVII of the Public Health Service Act (42 U.S.C. 
300gg et seq.) is amended—
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(1) in section 2704 (42 U.S.C. 300gg), as so re-
designated by section 1201(2)— 
(A) in subsection (c)— 
(i) in paragraph (2), by striking 
‘‘group health plan’’ each place that such 
term appears and inserting ‘‘group or indi-
vidual health plan’’; and 
(ii) in paragraph (3)— 
(I) by striking ‘‘group health in-
surance’’ each place that such term ap-
pears and inserting ‘‘group or indi-
vidual health insurance’’; and 
(II) in subparagraph (D), by 
striking ‘‘small or large’’ and inserting 
‘‘individual or group’’; 
(B) in subsection (d), by striking ‘‘group 
health insurance’’ each place that such term ap-
pears and inserting ‘‘group or individual health 
insurance’’; and 
(C) in subsection (e)(1)(A), by striking 
‘‘group health insurance’’ and inserting ‘‘group 
or individual health insurance’’; 
(2) by striking the second heading for subpart 2 
of part A (relating to other requirements);
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(3) in section 2725 (42 U.S.C. 300gg–4), as so 
redesignated by section 1001(2)— 
(A) in subsection (a), by striking ‘‘health 
insurance issuer offering group health insurance 
coverage’’ and inserting ‘‘health insurance issuer 
offering group or individual health insurance 
coverage’’; 
(B) in subsection (b)— 
(i) by striking ‘‘health insurance issuer 
offering group health insurance coverage in 
connection with a group health plan’’ in the 
matter preceding paragraph (1) and insert-
ing ‘‘health insurance issuer offering group 
or individual health insurance coverage’’; 
and 
(ii) in paragraph (1), by striking 
‘‘plan’’ and inserting ‘‘plan or coverage’’; 
(C) in subsection (c)— 
(i) in paragraph (2), by striking 
‘‘group health insurance coverage offered by 
a health insurance issuer’’ and inserting 
‘‘health insurance issuer offering group or 
individual health insurance coverage’’; and
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(ii) in paragraph (3), by striking 
‘‘issuer’’ and inserting ‘‘health insurance 
issuer’’; and 
(D) in subsection (e), by striking ‘‘health 
insurance issuer offering group health insurance 
coverage’’ and inserting ‘‘health insurance issuer 
offering group or individual health insurance 
coverage’’; 
(4) in section 2726 (42 U.S.C. 300gg–5), as so 
redesignated by section 1001(2)— 
(A) in subsection (a), by striking ‘‘(or 
health insurance coverage offered in connection 
with such a plan)’’ each place that such term ap-
pears and inserting ‘‘or a health insurance 
issuer offering group or individual health insur-
ance coverage’’; 
(B) in subsection (b), by striking ‘‘(or 
health insurance coverage offered in connection 
with such a plan)’’ each place that such term ap-
pears and inserting ‘‘or a health insurance 
issuer offering group or individual health insur-
ance coverage’’; and 
(C) in subsection (c)— 
(i) in paragraph (1), by striking ‘‘(and 
group health insurance coverage offered in
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connection with a group health plan)’’ and 
inserting ‘‘and a health insurance issuer of-
fering group or individual health insurance 
coverage’’; 
(ii) in paragraph (2), by striking ‘‘(or 
health insurance coverage offered in connec-
tion with such a plan)’’ each place that 
such term appears and inserting ‘‘or a 
health insurance issuer offering group or in-
dividual health insurance coverage’’; 
(5) in section 2727 (42 U.S.C. 300gg–6), as so 
redesignated by section 1001(2), by striking ‘‘health 
insurance issuers providing health insurance coverage 
in connection with group health plans’’ and inserting 
‘‘and health insurance issuers offering group or indi-
vidual health insurance coverage’’; 
(6) in section 2728 (42 U.S.C. 300gg–7), as so 
redesignated by section 1001(2)— 
(A) in subsection (a), by striking ‘‘health 
insurance coverage offered in connection with 
such plan’’ and inserting ‘‘individual health in-
surance coverage’’; 
(B) in subsection (b)— 
(i) in paragraph (1), by striking ‘‘or a 
health insurance issuer that provides health
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insurance coverage in connection with a 
group health plan’’ and inserting ‘‘or a 
health insurance issuer that offers group or 
individual health insurance coverage’’; 
(ii) in paragraph (2), by striking 
‘‘health insurance coverage offered in con-
nection with the plan’’ and inserting ‘‘indi-
vidual health insurance coverage’’; and 
(iii) in paragraph (3), by striking 
‘‘health insurance coverage offered by an 
issuer in connection with such plan’’ and 
inserting ‘‘individual health insurance cov-
erage’’; 
(C) in subsection (c), by striking ‘‘health in-
surance issuer providing health insurance cov-
erage in connection with a group health plan’’ 
and inserting ‘‘health insurance issuer that offers 
group or individual health insurance coverage’’; 
and 
(D) in subsection (e)(1), by striking ‘‘health 
insurance coverage offered in connection with 
such a plan’’ and inserting ‘‘individual health 
insurance coverage’’; 
(7) by striking the heading for subpart 3;
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(CLASS) program are necessary to ensure the long- 
term solvency of that program. 
(b) SENSE OF THE SENATE.—It is the sense of the Sen-
ate that— 
(1) the additional surplus in the Social Security 
Trust Fund generated by this Act should be reserved 
for Social Security and not spent in this Act for other 
purposes; and 
(2) the net savings generated by the CLASS pro-
gram should be reserved for the CLASS program and 
not spent in this Act for other purposes. 
TITLE II—ROLE OF PUBLIC 
PROGRAMS 
Subtitle A—Improved Access to 
Medicaid 
SEC. 2001. MEDICAID COVERAGE FOR THE LOWEST INCOME 
POPULATIONS. 
(a) COVERAGE FOR INDIVIDUALS WITH INCOME AT OR 
BELOW 133 PERCENT OF THE POVERTY LINE.— 
(1) BEGINNING 2014.—Section 1902(a)(10)(A)(i) 
of the Social Security Act (42 U.S.C. 1396a) is 
amended— 
(A) by striking ‘‘or’’ at the end of subclause 
(VI);