II Calendar No. 628 114th CONGRESS 2d Session S. 3326 IN THE SENATE OF THE UNITED STATES September 14, 2016 Mr. Alexander (for himself, Ms. Ayotte , Mr. Barrasso , Mr. Cochran , Mr. Johnson , Mr. Kirk , Mr. Perdue , and Mr. Portman ) introduced the following bill; which was read the first time September 15, 2016 Read the second time and placed on the calendar A BILL To give States the authority to provide temporary access to affordable private health insurance options outside of Obamacare exchanges.

1. Short title This Act may be cited as the State Flexibility to Provide Affordable Health Options Act . 2. Temporary access to affordable private health insurance options outside of Obamacare Exchanges (a) In general For purposes of applying the provisions of title I of the Patient Protection and Affordable Care Act (including the amendments made by that title) to a State that has made a determination under subsection (b), the term qualified health plan shall be deemed to include any health insurance plan that is authorized by the State to be offered in the individual or small group market in the State other than through the State Exchange established under title I of the Patient Protection and Affordable Care Act (or Federal Exchange in the case of a State that is not operating such an Exchange). (b) State determination and notification (1) In general The Governor of a State, in consultation with the applicable State authority (as defined in section 2791(d)(1) of the Public Health Service Act ( 42 U.S.C. 300gg–91(d)(1) )) of a State may make a determination that temporary access to affordable private health insurance options outside of an Exchange established under title I of the Patient Protection and Affordable Care Act is necessary to ensure that residents of the State have access to an adequate number of affordable private health insurance options in the individual or small group markets in such State. (2) Certification In making a determination under paragraph (1), the Governor shall certify to the Secretary of Health and Human Services— (A) that there is at least one county (or, in the case of a State that does not have counties, an equivalent municipality) in the State in which none or only one health insurance issuer offers, or is expected to offer, coverage through the State Exchange (or Federal Exchange in the case of a State that is not operating such an Exchange) for the 2017 plan year; or (B) the existence of other factors in the State, such as increased rates or premiums for private health insurance coverage offered, or expected to be offered, through the State Exchange (or Federal Exchange in the case of a State that is not operating such an Exchange) for the 2017 plan year. (3) Notification A State shall notify the Secretary of Health and Human Services of a determination under this subsection not later than November 1, 2016. (c) Nonapplication of individual mandate Section 5000A of the Internal Revenue Code of 1986 shall not apply with respect to residents of a State that has made a determination under subsection (b) for the 2017 plan year. (d) Application of provision The provisions of this section shall only apply during the 2017 plan year.

September 15, 2016 Read the second time and placed on the calendar